prevention and fitness – Page 32 – watercress words by Dr Aletha

You may have heard that the American Cancer Society (ACS) has published new guidelines on breast cancer screening. The last guidelines are 12 years old so it is time for an update based on current understanding of the value versus the risk of breast cancer screening.

According to the report published in JAMA, screening mammograms can reduce deaths from breast cancer. Breast exams done routinely do not decrease mortality.

These guidelines apply only to women at average risk of breast cancer, which is most women.

They are not used for high risk women- women with

a history of previous breast cancer
a suspected or confirmed genetic mutation known to increase breast cancer risk
a history of radiation to the chest
a close family history of breast history, usually meaning parent, sibling, grandparent, aunt/uncle, or cousin.

Screening guidelines also do not apply to women with breast symptoms suggestive of cancer.These women need appropriate diagnostic testing which might include mammography, ultrasound, MRI, and/or biopsy.

woman having a mammogram — photo from Medline, National Library of Medicine

In summary, here are the new guidelines from the ACS-

Offer annual screening to women age 40 to 44 years.
Perform a mammogram annually in women 45 to 54 years.
Perform a mammogram annually or every other year starting at age 55 years.
Continue screen mammography as long as a woman’s overall health is good, with a life expectancy of 10 years or longer.
Routine breast exams by either the patient or a physician are not recommended.

These are guidelines for physicians to apply to each individual patient, not hard and fast rules. Some physicians may choose to follow the guidelines of the U.S. Preventive Services Task Force (USPSTF)

For ages 40-49 years, individualize the decision to screen every 2 years
For ages 50-74 years, screen every 2 years
For ages 75 years and older there is no recommendation.

Both organizations recommend that physicians discuss the decision to screen or not to screen with patients and base the decision after considering possible harms versus potential benefit.

And while breast cancer is the second leading cause of cancer death among women in the United States, it is treatable and the chance of long term survival is high.

Here are sources for more information

Breast Cancer

Mammography

Screening Guidelines

Breast cancer screening benefits and harms

Follow this link to an updated version of this post

What you should know to avoid kidney stones

Stones, or urinary tract calculi, don’t usually cause symptoms as long as they stay in the kidney. But if they migrate down into the ureter, the tiny tube that connects the kidneys to the bladder, trouble begins. As the stones try to wiggle their way down the narrow passageway, spasms of pain result; and the…

August 5, 2020August 1, 2020

No, these are not kidney stones but if, like me, you have had one, it probably felt this big.

Almost nothing compares to the agony of kidney stones; it is often compared to the pain of labor and childbirth; I can attest to that, having had both.

Called renal colic, the pain of kidney stones is similar to the episodes of crying and distress in infants. (I will have a post on infant colic soon.)

Stones, or calculi, don’t usually cause symptoms as long as they stay in the kidney. But if they migrate down into the ureter, the tiny tube that connects the kidneys to the bladder, trouble begins. As the stones try to wiggle their way down the narrow passageway, spasms of pain result; and the bigger the stone the worse.

The urinary tract- kidney, ureters and bladder

Fortunately, most stones eventually pass into the bladder and out the body through the urethra. Some get stuck and must be removed. Occasionally, large stones can block the kidney, leading to infection. But , once you have had a stone, you want to prevent another.

What causes kidney stones?

We know what substances cause most stones- chemicals that normally pass through the urine but sometimes build up, harden and form into tiny rock -like structures called calculi. These chemicals mostly come from food, so changes in diet are one way to prevent new stones from forming.

5 tips to keep away kidney stones-watercresswords.com

Steps to stopping kidney stones

These steps can help lessen the risk of new stones in people who have already had one. We don’t know if it applies to people who have never had any stones. Check with your doctor to see if any of these are right for you.

Drink enough water to produce 2-2.5 quarts/liters of urine every day.

Recommendations to drink a set amount of water daily do not take into account how much water a person needs, which can vary depending on activity level and other factors. It is more reliable to consider how much urine comes out, or how many times one urinates daily.

Limit the amount of sodium, salt, in the diet.

Since the majority of stones contain calcium, it might make sense to limit calcium. But the kidneys spend more time filtering sodium; so with less sodium, more calcium can be filtered out and not be available to make stones. Here are 5 tips to reduce salt intake from WebMD

Limit intake of oxalate rich foods.

Oxalate is another chemical found in kidney stones. It comes from eating rhubarb, spinach, tea, nuts and cocoa.

Although watercress and other greens contain oxalate, it’s probably not necessary to avoid them entirely; they also are a good source of calcium which attaches to the oxalate, removing both from the body. Moderate amounts with adequate fluid intake should be safe, unless your doctor tells your otherwise.

Limit intake of non-dairy animal protein.

eat more fruits and vegetables

Drink beverages with lime and lemon juice.

fresh vegetables-lettuce, tomatoes, radishes

Get expert advice about kidney stones at these links.

Eating tips from the National Kidney Foundation

Watch a brief video about kidney stones from MedlinePlus here.

Print a PDF handout at this link- Preventing Kidney Stones -from the American Academy of Family Physicians

exploring the HEART of health

Thank you for joining me to explore the HEART of health. I hope you’ve learned something. Please contact me about topics you want to read about.

Category: prevention and fitness

When should a woman have a mammogram?