Mar
02
2024

Living with the Aging Process

The following article describes living with the aging process. Older adults undergo the process of aging between the ages of 50 and 80. This is a complex process affecting various systems parallel. There are hormone factors that are particularly prominent in women during menopause. Joints are affected by degenerative changes, which can lead to total knee and hip replacements. The aging process was described in an article by Monica Jimenez at Tufts University.

What is aging?

Aging is the loss of function over time. The body is much more complex than a car, so there are more possible points of failure.  Christopher Wiley is a scientist on the Basic Biology of Aging Team who studies the role of nutrition and metabolism in aging at a cellular level at Tufts University. He said:” The fact that life works is amazing”. He went on to say: “The body tries to maintain itself and restore homeostasis(self-healing) even in the face of all this stress and all this damage. We have these really sophisticated programs for dealing with these points of failure.”

Aging goes on relentlessly

He explains the aging process this way: “It can start with something as simple as a broken molecule, one little thing that goes wrong in one cell, and then it’s like the butterfly effect,” Wiley said. “The tissue starts struggling, and then the organ, and then your entire body.”

Dr. Wiley warns about those who say physicians could make people “immortal”. “There’s definitely a misconception out there that we’re trying to make people immortal. But there is never going to be an immortality vaccine,” Wiley said. “There’s never going to be one thing that defeats all of aging. There’s always going to be another point of failure.”

Slowing down biological aging

The emphasis of research about aging is not to add chronological years. It is on biological aging and on how well our cells and tissues are functioning. Dr. Sarah Booth is the director of the Human Nutrition Research Center on Aging (HNRCA) at Tufts. She said: “Lengthening the time in which we can continue to move around, care for ourselves, and participate in social life and activities, is a worthier goal than extending years of suffering.” Many people become disabled in their last years of life, then they die. “Healthspan” is a new term for our years of freedom from disability, Booth noted.

Factors that prolong healthy aging

  1. Telomere length: One of the factors of longevity is our telomere length. Telomeres are the protective caps at the end of each chromosome. When they wear down, it leads to mistakes in the DNA copies of genetic information. There are supplements and herbs that can elongate telomeres. Exercise and the fasting mimicking diet also make telomeres longer. Older adults in good shape have longer telomeres, which stabilizes the DNA in their cells.
  2. Healthy diet: Researchers have determined that several diets are healthier than others. The Mediterranean diet is anti-inflammatory, so is the DASH diet, which was developed for people with high blood pressure. The HNRCA of Tufts is one of six organizations that got research grants recently to investigate life-prolonging diets. The amount was for $8.5 million.

Exercise and lifestyle factors

  1. Regular exercise: Over the years a lot of research accumulated data that shows regular exercise makes people biologically younger. Heart vessels have less atheromatous deposits and the brain stays younger as well. One study reported that 30 minutes of exercise daily prevents dementia.
  2. Other lifestyle factors: other factors are whether or not you are smoking (it goes without saying that you must quit). In addition, genetics (longevity gene), the environment (polluted or not), stress levels and socioeconomic class all play a factor in how fast we age. These latter points are difficult to tease apart, but they influence us globally. Target organs for aging are: the brain, heart, eyes, and bones, along with cancer, obesity, and more.

Hormone replacement 

  1. Bioidentical hormone replacement: One factor about delaying aging significantly was not mentioned in the review article by Monica Jimenez. But I am including it, because bioidentical hormone replacement is important for women who undergo menopause in their 50’s. I also mention it because men enter andropause in their 60’s. BiEst estrogen and progesterone cream make a big difference for the symptoms of menopausal women. Similarly, men experience a lot of relief with testosterone injections twice a week, when blood testosterone levels are low. If they have a lack of erections (erectile dysfunction) they may in addition need to take the “happy pill”. Sildenafil or tadalafil can treat erectile dysfunction by giving a good erection to a menopausal male. Hormone replacement can add as much as 10 healthy years to your life.

Discussion

Dr. Booth said: “We’re looking at the same question through different lenses with different tools, technologies, and perspectives. Progress in aging research is only going to be achieved by bringing together different disciplines addressing the same problem.”

Christopher Wiley added: “The biggest change I’ve seen in the past ten years is that we really are finding new, different ways of actually intervening somewhere that could potentially extend the healthy years of life, and prevent people from getting age-related diseases.” He mentioned that scientists are gradually reducing the suffering associated with aging: “What aging research is really trying to do is compress the morbidity and make it as small as possible – to alleviate suffering,” Wiley said. “I think that’s a much more humanitarian goal, and I think we’re having a lot of success with those efforts.”

Living with the Aging Process

Living with the Aging Process

Conclusion

Aging is a slow process that starts the moment we are born. But between the age of 50 and 80 we age faster. I mentioned 5 specific areas that can slow down the aging process. If somebody smokes, he/she must stop smoking. Cigarette and tobacco smoking  the biggest aging factor. The protective caps at the end of each chromosome go by the name of telomeres. When they shorten prematurely, mistakes occur in the DNA copies of genetic information. This leads to premature aging.

What keeps you younger for longer

The good news is that exercise, the fasting mimicking diet and several supplements can elongate telomeres. A healthy diet like the Mediterranean diet and regular exercise keeps the arteries open preventing heart attacks and strokes. Bioidentical hormone replacement helps to rebalance your hormones, which is important for normal cell function. In anti-aging circles they talk about life prolongation of about 10 years for hormone replacement alone. It comes down to not simply extend your lifespan, but to extend your years of healthy living without disability.

Feb
04
2024

Beef and Dairy May Cause Cancer and MS

New cancer research suggests that chronic virus particles in beef and dairy may cause cancer and MS (multiple sclerosis). The Medical journal Medscape.com had a review article that summarized this line of research.

Papillomaviruses and cervical cancer

Harald zur Hausen, M.D., D.Sc., a German virologist, detected that papillomavirus causes cervical cancer. He was given the Nobel prize in Medicine in 2008 for “his discovery of human papillomaviruses causing cervical cancer”. In the meantime, we know that there are two strains, namely HPV-16 and HPV-18 that are carcinogenic. We also learnt that papillomavirus causes oropharyngeal cancer, anal cancer, penile cancer and vulvar cancer. Since then, HPV vaccines are commonly in use for cancer prevention.

Evidence for causation of colorectal cancer

Professor Harald zur Hausen and his wife, Professor Ethel-Michele de Villiers, continued work on looking for viral particles in many other cancers. This led them to state that colorectal cancer was due to a latent viral infection. He determined that, when women were breastfeeding their infants for prolonged periods of time (about 1 year), they transmitted oligosaccharides with the breast milk to their offspring, which gave lifelong prevention against colorectal cancer to their children. He also showed that colon cancer patients had round particles in their intestinal mucous membranes, which consisted of single-stranded DNA rings.

Persistent viruses

The researchers said that they came from viruses and they named them bovine meat and milk factors (BMMF). In the same areas in the intestine, they detected acid radicals from oxidative stress typical for chronic inflammation. They postulated that infants who are weaned from breast milk prematurely, and started on cow milk formulas ingest BMMF. This infects the lining of the gut where a chronic subclinical BMMF infection gets established. Decades later the patient comes down with colorectal cancer. They established that children who are breast fed for 1 year do not get BMMF particles in the lining of their guts or colorectal cancer. They also don’t get MS in adult life.

Criticism of two regulatory agencies in Germany

The above results of professor zur Hausen and his wife were published in February of 2019. This led to a lot of press releases questioning these results. In Germany the consumption of beef and milk products is popular. The DKFZ (Deutsches Krebsforschungszentrum) felt that an “all-clear signal” was necessary. The Bundesinstitut für Risikobewertung (BfR) stands for the German Federal Institute for Risk Assessment, situated in Berlin. It is a substructure of the German government responsible for food safety. The second agency is the Max Rubner Institute (MRI) in Karlsruhe, also known as Federal Research Institute of Nutrition and Food. Both agencies started to investigate the facts of Prof. zur Hausen’s research. At the end of November 2022 the BfR and MRI made a joint statement. They stated the following:

  • BMMF were not new viral agents, but variations of already known DNA sequences.
  • BMMF commonly occurred in a variety of animal- and plant-based foods.
  • BMMF were not capable of infecting human cells.
  • It was true that consumption of red and processed meat correlates with the incidence of intestinal tumors.
  • However, consumption of dairy products are linked to a reduced risk of intestinal tumors.
  • There is no evidence that breast cancer would be associated with the consumption of beef or dairy.
  • They stated that milk products and beef are valuable supplementary diet components for infants due to their micronutrients. They further stated that dairy and beef products are safe for people of all ages.

Evidence for causation of multiple sclerosis

Professor zur Hausen and his wife, Professor Ethel-Michele de Villiers both worked at the German Cancer Research Center in Heidelberg. They pursued research about MS. MS is usually attributed to IgG1 and IgG3 autoantibodies that destroy Schwann cells. The Hausen research team found the following perplexing facts:

  • MS was associated with the consumption of dairy products and beef products.
  • They isolated ring-shaped DNA molecules (BMMF) from dairy and cattle blood.
  • Epstein Barr virus (EBV) also plays a role in initiating MS. MS patients have higher antibody titers against EBV.
  • One research paper noticed that MS patients in Antarctica secreted EBV in their saliva in the winter month. However, vitamin D3 stopped the viral excretion. This is very interesting as vitamin D is an important immune response stimulator.

More evidence:

  • They isolated BMMF particles from lesions of MS patients.
  • They noticed the old fact that MS is more common further away from the equator. Vitamin D production from sun exposure reduced cases of MS.
  • Prolonged breast feeding up to one year prevents life threatening rotaviruses and noroviruses in the newborn. The reason is exposure to oligosaccharides in breast milk. The mother starts producing breast milk in the middle of her pregnancy. It protects mother from tumors (including breast cancer), from MS later in life as well as type 2 diabetes.
  • The researchers formulated the hypothesis that both EBV and BMMF are responsible in patients to form MS lesions in the brain when vitamin D levels are low. A good dose of vitamin D3 every day may be helping to keep EBV and BMMF in a dormant phase.

Discussion

At this point there is no consensus why an increased consumption of beef and processed meat causes more colorectal cancer. The question is whether BMMF particles cause colorectal cancer or whether meat consumption experiences metabolization into carcinogenic substances? Either way it would be desirable to cut down on your red meat consumption.

With respect to MS, we know that autoantibodies are destroying the Schwann cells. But the question is why the immune system produces autoantibodies. Could it be that persistent EBV viruses switch the immune system from a normal to an autoantibody mode? Would BMMF be an additional factor?

Beef and Dairy May Cause Cancer and MS

Beef and Dairy May Cause Cancer and MS

Conclusion

Professor zur Hausen, a virologist from Germany and his wife Professor Ethel-Michele de Villiers researched persistent viruses. Professor zur Hausen detected the connection of papilloma viruses to cervical cancer. He received the Nobel prize in medicine 2008. They proposed the theory that newborns in their first year of life have an immature immune system. If they are fed cow’s milk and/or beef during the first year they accumulate bovine meat and milk factors (BMMF), which can subsequently lead to colon cancer or to MS as an adult. Two top German institutes banded together to criticize Prof. zur Hausen’s research.

Criticism of Professor zur Hausen’s research

The Bundesinstitut für Risikobewertung (BfR) stands for the German Federal Institute for Risk Assessment, situated in Berlin. It is a substructure of the German government responsible for food safety. The second agency is the Max Rubner Institute (MRI) in Karlsruhe, also known as Federal Research Institute of Nutrition and Food. These research institutes concluded that not all of the findings of Professor zur Hausen were valid. I listed 7 of their concerns. On the other hand, they agreed that it was true that consumption of red and processed meat correlated with the incidence of intestinal tumors. Time will tell which parts of the research ultimately will be valid and which are not.

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Jan
07
2024

Backup your New Year’s Resolutions by looking at short-term Consequences

In the New Year it pays to backup your New Year’s resolutions by looking at short-term consequences. An article in “the conversation” explains how you can keep yourself motivated to stick to healthy habits. The alternative would be to fall back into unhealthy habits, which lead to various disease conditions. Traditional thinking centered around keeping long-term outlooks in front of your mind when tempted by the smell of doughnuts. In these cases, you think that the long-term consequences of eating doughnuts or consuming sugary drinks result in diabetes and obesity. But the smell or taste of unhealthy foods can be so overpowering that the long-term consequences of potential diseases is forgotten. This is the point when your New Years resolution may fade away in favor of falling back to unhealthy eating habits.

Think short-term to resist temptation

The new approach is to replace the thinking of long-term outlooks by short-term outlooks. The authors cited an example of 4000 participants in 7 separate studies. When the short-term consequences of anxiety and a sugar and caffeine crash were explained for caffeine containing sugary drinks, 25% of participants were able to abstain from the energy drinks in comparison to those who were informed about long-term consequences.

Another experiment

A similar experiment involved the consumption of sugar in the form of cookies. One group of participants read about the short-term effects of eating sugar. A second group read about the long-term effects of eating sugar. A third group did not get any information about the effect of sugar. There was also a “reward system” for all the participants: they had to decide between receiving a tote bag or eating cookies. Those who had read about the short-term effects of sugar were 30% less likely to choose cookies than the ones who read about the long-term effects. The ones who read the short-term effects were 45% less likely to choose the cookies than the ones who read nothing about the effects of sugar.

Verbalizing short-term consequences

Here are some thoughts that help to verbalize short-term consequences:

  • For alcohol: excessive drinking can lead to poor sleep and hangovers.
  • Fast food can make you feel bloated or give you indigestion.
  • Sugar and starchy meals: make you bloated and give you an acidy stomach, also will lead to rapid weight gain.
  • Focus on the good taste of apples and carrots. People will eat more of it and get the health benefits without mentioning it.

You can keep your goals easier when you combine them with small rewards here and there. When you have achieved one thing, you could watch your favorite TV show. Another reward could be a brief visit to the gym that makes you feel more fit. Or go and buy yourself a new pair of shorts for the gym. The authors of this article provide evidence from studies that showed that several mini rewards distributed throughout the day are more effective than big rewards at the end of the day.

Measurements of weight fluctuations

I found that body composition scales are very useful to monitor your diet intake. Here is an example how I use this device. My weights, fat% and body mass index for a number of days is listed below. The first line shows the baseline measured in the morning. On Saturday lunchtime I was invited to a Christmas family dinner. I ate more than I should have had. You can see the results on the Sunday readings: weight up, fat up and BMI up. I watched my calorie intake throughout Sunday.

Weekday              Weight (KG)                 Fat %        Body mass index

Saturday:                   63.6                           13.2                  21.7

Sunday:                     64.0                           14.2                  21.9

Monday:                    63.4                           14.3                  21.7

It took another two days (Wednesday) before the fat percentage was down to 12.9.

There is another powerful tool, Dr. Valter Longo’s fasting mimicking diet. I reported about this under this link. Briefly, once a month I eat only 500 to 600 calories daily for 5 days. This helps me to lose my body mass index from 21.8 down to 21.1 or 21.2. After that I can eat a normal diet until the next month when I do the fasting mimicking diet again. It is an easy way to keep my body mass index in the 21.0 to 22.0 range. My wife and I prepare our own 500 to 600 calorie diet with natural food.(No, you do not get much, but it can taste good!) We do not buy Dr. Longo’s expensive diet boxes.

Backup your New Year’s Resolutions by looking at short-term Consequences

Backup your New Year’s Resolutions by looking at short-term Consequences

Conclusion

Focusing on short-term goals and consequences increases the percentage of success for those who have New Year’s resolutions. You can use this for many different approaches: eating less sugar, losing weight, getting regular exercise, reducing your alcohol intake, cutting out fast food and increasing your healthy vegetable and fruit intake. I also added a description of what I do with the help of body composition scales to control my weight and body mass index. I also use Dr. Longo’s fasting mimicking diet once per month for 5-days. Since December 2017 (for 6 years) I practiced this. I find it extremely useful to maintain my body mass index in the 21.0 to 22.0 range. Medicine knows that it is important to keep your body mass index below 25.0. This will prevent heart disease, type 2 diabetes and cancer. It also helps to look forward to a healthy New Year.

Dec
23
2023

Any Form of Exercise is good

Here are a few items that can prolong life; among them any form of exercise is good. This article concentrates on the exercise part in relation to longevity. A recent publication described how regular exercise prolongs your long-term survival. According to a study released on occasion of the American Heart Association’s Scientific Session 2023 there are 8 major factors that prolong life: healthy diet, physical activity, nicotine exposure, sleep health, BMI, cholesterol, blood sugar, and blood pressure.  Among this group of factors regular physical activity plays a major role to prolong your life. Researcher who studied various people found that those who neglected their physical health had a chronological age of 53, but their average biological age was 57. On the other hand, a group of fit people who engaged in regular physical exercise had a chronological age of 41 years, but a biological age of 36.

Clinical trials showing that any form of exercise is good

JAMA Internal Medicine study by Dr. del Pozo Cruz 

This study examined what the optimal amount of physical activity per week is to reduce mortality compared to an inactive population. 500,705 eligible US adults were observed for about 10 years. The abbreviations that the authors used in the study were as follows:

MPA: moderate aerobic physical activity

VPA: vigorous aerobic physical activity

MSA: muscle-strengthening activity

Results of mortality reduction with various amounts of physical activity

  • The best group engaged in more than 0 to 75 minutes of MPA combined with more than 150 minutes of VPA and 2 or more MSA sessions per week. Their mortality rate was 50% lower than an inactive comparison group.
  • The optimal combination for reduction of cardiovascular disease (CVD) and cancer mortality risk was as follows: more than 150 to 225 minutes of MPA, more than 0 to 75 minutes of VPA, and 2 or more MSA sessions per week. This reduced combined mortality of CVD and cancer by 70%.
  • The researchers stated that the adjusted mortality rates represented 50% lower mortality rate for all-cause and cancer mortality. The mortality rate for CVD mortality was 3-fold lower than for inactive controls.

Smallest amount of exercise that reduces mortality

In a study published in the European Heart Journal the authors asked how little exercise per week was enough to reduce mortality from heart disease. They found that it takes at least 15–20 min/week of vigorous physical activity (VPA) to reduce mortality from heart attacks by 16–40%. If you increased the exercise level by 50–57 min/week the mortality rates reduced even further.

Are physically active jobs healthy?

Recent research showed that people who work in physically demanding jobs are more likely to develop early cognitive impairment. This is the pre-stage of Alzheimer’s disease. 15.5 % of people who worked in high levels of occupational physical activity developed dementia. This compared to 9% risk for people whose work involved a low level of physical activity, not too much and not too little. The finding confirms the notion that there is a need for balance of physical exercise. Several publications stressed what is optimal in terms of exercise: vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week). People who expose themselves to these amounts of exercise live the longest and stay healthy.

Discussion

The studies discussed here showed that the right amount of exercise can reduce mortality from heart disease and cancer. However, exercise is not the only factor that can do this. It is important to combine regular exercise with a healthy diet. Your diet should consist of fruits and vegetables, whole grains, low-fat dairy products, lean proteins and limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight, manage your stress, and don’t smoke.

Any Form of Exercise is good

Any Form of Exercise is good

Conclusion

In this review I touched on the importance of regular exercise to reduce mortality from heart disease and cancer. Vigorous (75 to 300 minutes per week) and moderate physical activity (150 to 600 minutes per week) reduce mortality from heart attacks by 16% to 40%. But physical exercise is only one factor of mortality reduction. If you want the full benefit from other factors, you must quit smoking, eat a Mediterranean type diet with fruits and vegetables, whole grains, low-fat dairy products and lean proteins. Also you should limit saturated and trans-fat, added sugars, and sodium. In addition, you need enough sleep, maintain a healthy weight and manage your stress. Once you adopted this lifestyle, you live longer and you will get less diseases.

Dec
09
2023

Too much Ultraprocessed Food Makes you sick

A Lancet study published on Nov. 13, 2023 found that too much ultraprocessed food makes you sick. Researchers noted that ultraprocessed animal products and sweetened beverages were linked to an increased cancer risk as well as other diseases such as strokes or diabetes.

In Europe more than half of the food intake consists of ultraprocessed food. In the US a 2019 study found that 71% of the food supply is ultraprocessed.

Details of the study

The details of the study were summarized in a CNN report. Researchers of the study collected nutritional data from 266,666 men and women (60% were women) from 7 European countries between 1992 and 2000. The researchers followed the participants for 11 years. During that time they observed the participants for the development of chronic diseases and cancer. During the observation time 21,917 primary cancers, 10,939 cardiovascular events, and 11,322 type 2 diabetes cases developed. On entry into the study participants were questioned about their food intake in the past 12 months. This was matched with the NOVA classification system. It became clear that not all ultraprocessed foods were detrimental to the health of the participants. Animal products and sugar-sweetened drinks and foods caused chronic diseases in the participants of the study. However, ultra-processed breads, cereals or alternative plant-based products were neutral in terms of health risks.

Main findings of the study: too much ultraprocessed food makes you sick

The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. However, when you reduce your intake of ultraprocessed food your risk of developing these diseases reduces. The key is to eat more fruit and vegetables and concentrate on eating minimally processed food.

Other studies with similar findings

In 2022 the British Medical Journal published two studies that documented a higher colorectal cancer rate and cardiovascular disease rate when subjects were eating larger amounts of ultraprocessed foods (UPF). Specifically, when men had exposure to a high percentage of UPF in their diet they developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet.

French study 2019

A French study in 2019 followed 44, 551 French adults 45 years or older for 7.1 years. A 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. The authors stated that 80% of all premature deaths from noncommunicable disease are due to cardiovascular disease (CVD), respiratory disease, cancer, and diabetes. The authors discussed in detail the problems with overconsumption of ultraprocessed food.

Some of the contents of ultraprocessed food

Ultraprocessed food contains:

  • High salt content, and high sodium intake has been associated with cardiovascular deaths and increased stomach cancer risk.
  • Excessive amounts of added sugar. There is an association between added sugar consumption and an increased risk of mortality from cardiovascular disease.
  • Ultraprocessed foods contain very little fiber. More dietary fiber in one’s diet has an association with lower death rates.
  • Studies have estimated that reducing saturated and trans fats, salt, and added sugar in the diet prevent cardiovascular deaths.
  • High temperature food processing produces acrylamide. Acrylamide is a known carcinogen.
  • Consumption of processed meat products causes a higher risk of colorectal cancer and stomach cancer.
More ingredients of ultraprocessed food
  • Artificial sweeteners can alter microbiota and can cause the onset of type 2 diabetes and metabolic diseases.
  • With bisphenol A coating in food packaging endocrine disruptors enter the food. Bisphenol A causes endocrine cancers and metabolic diseases, such as diabetes and obesity.
  • The food industry uses additives frequently in their formulations. Some studies raised concerns about the health consequences of food additives. For instance, the food industry uses titanium dioxide widely. There is an association of titanium dioxide and increased risk of chronic intestinal inflammation and carcinogenesis.

It is easy to see that when we expose our bodies to a mix of these ingredients this can cause cardiovascular diseases, cancers and diabetes. The final outcome is that this leads to premature deaths.

Too much Ultraprocessed Food Makes you sick

Too much Ultraprocessed Food Makes you sick

Conclusion

Too much ultraprocessed food (UPF) makes you sick. This is the conclusion of a large study, which the Lancet published on Nov. 13, 2023. Researchers followed 266,666 men and women (60% women) for 11 years. The main findings of the study were that ingesting mostly ultraprocessed food leads to a 9% increase of heart attacks, strokes, diabetes and cancer. This is in comparison to controls who ate very little ultraprocessed food. Other studies going back to 2019 and 2022 showed very similar findings.

Other studies

A French study from 2019 noted that a 10% increase of consumption of ultraprocessed food caused a 14% higher risk of all-cause mortality. Several studies in 2022 showed that men who had an exposure to a high percentage of UPF in their diet developed 29% more colorectal cancer after 28 years of observation in comparison to men who ate a low percentage of UPF. A related study that went on for 14 years showed a 32% higher risk for death from cardiovascular disease for men who ate a high UPF diet in comparison to men on a low UPF diet. It follows from this data that a simple diet consisting of vegetables, fruit, nuts and lean meat (chicken turkey, fish) with minimal amounts of UPF protects you from premature death.

Nov
11
2023

New Treatment against Advanced Bladder Cancer

At a Cancer congress in Madrid, Spain a new treatment against advanced bladder cancer was discussed at this year’s European Society for Medical Oncology Congress. The standard treatment for advanced bladder cancer is gemcitabine in combination with cisplatin or carboplatin. According to CNN the median survival with the standard chemotherapy is 16.1 months. In contrast, treatment with the new intravenous antibody drug enfortumab vedotin in combination with intravenous pembrolizumab resulted in longer survival. The combination yielded a survival of 31.5 months for advanced bladder cancer patients. This new immunotherapy method resulted in a 96% longer survival. The safety profile of the two approaches were similar. 55.9% of patients taking the combination immune therapy developed skin rashes or hyperglycemia, while 69.5% of those taking platinum chemotherapy developed this.

Other new findings about advanced bladder cancer treatment

Dr. Thomas Powles is a professor of urology cancer at the University of London and director of the Barts Cancer Centre in the United Kingdom. He said:” The problem with chemotherapy is although it works quite well initially, resistance occurs quickly, and the median survival for metastatic bladder cancer has been about a year. What this study showed is, we did a big, randomized Phase 3 study where we compared a new treatment — two new drugs — with standard chemotherapy,” Powles said. “And in this randomized trial, when you gave those two drugs together, you reduced the risk of death for this cancer by over 50%. So, you’ve doubled survival, with patients living twice as long, and we’ve got long-term durable remission.”

Erdafitinib study

A second study from the New England Journal of Medicine used erdafitinib in comparison to standard chemotherapy. Erdafitinib is a small molecule inhibitor of fibroblast growth factor receptor and is effective in the treatment of cancer. This study compared 136 patients on erdafitinib with 130 patients on chemotherapy. Patients treated with standard chemotherapy had a median overall survival of 7.8 months. This compares to 12.1 median survival for the erdafitinib group. Erdafitinib, a kinase inhibitor drug, is slowing the spread of cancer cells.

Side effects that led to death were less common with erdafitinib than with chemotherapy. Only 0.7% of erdafitinib patients had serious side effects versus 5.4% of chemotherapy patients.

Nivolumab study

Another clinical trial was recently published in the New England Journal of Medicine.

Nivolumab is an immune checkpoint inhibitor that was originally developed for treatment of intractable melanoma. However, subsequently it was found to be active also against lung cancer, kidney cancer and bladder cancer. In the clinical study mentioned above 304 patients with intractable bladder cancer were treated with standard chemotherapy alone. They were compared to 304 patients on standard chemotherapy plus nivolumab.

The median complete response with the nivolumab-combination therapy was 37.1 months. In contrast, with gemcitabine–cisplatin alone it was only 13.2 months. Side effects of the two treatments were about similar. The authors concluded that treatment with the immune checkpoint inhibitor, nivolumab plus standard chemotherapy with gemcitabine–cisplatin resulted in better survivals than treatment with gemcitabine–cisplatin alone.

Discussion

Immunomodulation is one of the newest approaches to cancer treatment. But at the Hope 4 Cancer Clinic immunomodulation is only one aspect of a comprehensive approach to cancer treatment.They mention that they restore the microbiome in the gut. Great detail is spent to a full spectrum nutrition. Detoxification and non-toxic cancer therapies are employed. Oxygenation helps to restore the acid/base balance. Immunomodulation with the newer agents mentioned above helps as well to combat cancer. Low-dose laser photodynamic therapy with various light frequencies helps to destroy cancer cells as well. These lasers activate a variety of sensitizers, which are taken up by cancer cells and lead to their destruction. Finally, the cancer patients are taught how to achieve spiritual and emotional well-being. The Hope 4 Cancer Clinic demonstrates that treatment with immunomodulation is best combined with other treatment modalities to improve patient survival.

New Treatment against Advanced Bladder Cancer

New Treatment against Advanced Bladder Cancer

Conclusion

Physicians used three different immune therapies to treat advanced bladder cancer. Erdafitinib vedotin, a kinase inhibitor drug, in combination with intravenous pembrolizumab resulted in a survival of 31.5 months for advanced bladder cancer patients versus 16.1 months with standard chemotherapy. Another clinical trial showed that patients on standard chemotherapy had a median overall survival of only 7.8 months for advanced bladder cancer. This compares to 12.1 months median survival for the erdafitinib group. Finally, nivolumab, an immune checkpoint inhibitor was combined with standard chemotherapy. When end stage bladder cancer patients were treated with this combination, they survived 37.1 months. In comparison, the control group with chemotherapy alone (gemcitabine–cisplatin) survived only 13.2 months. There is definitely better survival of patients when immunomodulation is used. The hope is that future immunomodulators will have a stronger effect against cancer with less side effects.

Oct
23
2023

News from the Blue Zones Regarding Longevity

This article is about news from the Blue Zones regarding longevity. Blue Zones are areas where many centenarians live. Medical News Today ran a review article about Blue Zones on Sept. 23, 2023. These Blue Zones are located in Sardinia, Italy; Ikaria, Greece; Nicoya, Costa Rica; Loma Linda, California and Okinawa, Japan. Many studies looked at centenarians in these areas and analyzed what lifestyles led to their longevity. Dan Buettner summarized at a conference that only 20% of deaths in the world are due to genetic conditions. 80% of people can postpone their death date by adopting healthy lifestyles.

Factors associated with longevity

Dan Buettner called the factors that lead to prolonged life “Power 9”. The following factors must be adopted simultaneously, if you want to reach 100 years of age and more:

  • Moving naturally and regularly
  • People in Blue Zones have a purpose in life
  • Reduce stress in your life
  • Practice the 80% diet rule, which is to stop eating when 80% full
  • Adopt a plant-based diet.
  • Consume alcohol in moderation
  • Be part of a community
  • Put family first
  • keep a social circle that supports healthy behaviors

A diet for longevity

Dan Buettner analyzed the dietary habits of centenarians. He found that 90% of the diet they consumed consisted of whole food, plant-based sources and about 65% of their diet were complex carbs. Buettner noted: “The pillars of every longevity diet in the world are whole grains, nuts, greens, and other garden vegetables, tubers and beans.” For years the benefits of a Mediterranean diet were investigated and found to be life prolonging. It also emphasizes vegetables, whole foods, greens, grains, nuts and beans. The review article in Medical News Today that I mentioned above contains recommendations of how to change your diet to a healthier one.

Regular exercise

We are built in a way that requires regular exercise. When you exercise regularly, your body produces healthy HDL cholesterol that balances the unhealthy LDL cholesterol. Overall, this counteracts clogging of arteries and prevents heart attacks and strokes.

When you prevent strokes and heart attacks, you live longer.

Have a purpose in life

When you have a purpose in life, your mind is focused on what excites you. Achieving what is your dream satisfies you. Your brain releases feel-good brain hormones (dopamine, serotonin, endorphins, and oxytocin). When these hormones are released, you relax and cope with stress better. Your blood pressure normalizes, hardening of the arteries is postponed. At the same time, you prevent heart attacks and strokes. This contributes to longevity.

Reduce stress in your life

When under stress, your adrenal glands release adrenaline and cortisol. In the short term these stress hormones help you to cope better with stress. But when stress gets chronic, it weakens your immune system and increases your risk for a heart attack or stroke. It ages you faster. You can counter stress in your life by adopting stress management techniques. Regular exercise stabilizes your emotional life. You can listen to relaxation recordings or to relaxing music to calm your nerves. Developing friendships is another method of coping with stress. Here is more information on how to reduce stress in your life.

Limit alcohol consumption

In the past it was thought that small amounts of alcohol would prevent cardiovascular disease. But these studies overlooked the fact that even small amounts of alcohol can cause various cancers. So, by limiting the amount of alcohol consumption you also limit your probability of getting cancer.

Be part of a community

Many psychological studies showed that social isolation leads to health problems. It follows from this that being part of a community stabilizes your health and prevents disease. When you socialize with other people you counter stress and prevent loneliness.

Putting family first

When you care about your family, family members will care about you. Studies showed that this is an important factor in preventing disease. It even reduces mortality. Lower mortality leads to longevity.

Keep a social circle that supports healthy behaviors

Strangely enough here is another psychological factor that leads to longevity: getting support from a social circle. Being part of a social circle can create positive energy that prevents health problems.

Discussion of factors that lead to longevity

It is interesting to see that a lot of the longevity factors are psychological in nature. But physical factors are also important, like a Mediterranean diet and regular exercise. One factor that was not mentioned by Dan Buettner is the importance of preservation of hormone stability. I attended many yearly conferences of the American Academy of Anti-Aging Medicine (also known as A4M). They take place in the middle of December in Las Vegas every year. Over the years many lectures centered around hormone deficiencies. They collectively lead to premature aging and deaths. However, speakers also stressed that when you replace the missing hormones, you can reach a balance point where life gets prolonged.

Hormone replacement

One of the speakers, Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular HGH injections can add 26.5 years to your life expectancy. But other hormones like thyroid hormones, testosterone in males, and progesterone and estrogen in females can prolong life when replaced after menopause or andropause (the male version of menopause).

News from the Blue Zones Regarding Longevity

News from the Blue Zones Regarding Longevity

Conclusion

Many factors contribute to longevity in centenarians. A lot of the factors are psychological in nature, like having a purpose in life or reducing stress in your life. Others are: be part of a community, put family first and keep a social circle that supports healthy behaviors. Physical factors causing longevity are moving naturally and regularly; adopt a plant-based diet; and consume alcohol in moderation. There is one important factor of longevity that Dan Buettner overlooked: your hormone balance. When we approach age 60 and beyond many people stop producing adequate amounts of hormones.

Replacing missing hormones

Anti-aging doctors have done studies showing that replacing missing hormones in proper doses will prolong life. Dr. Hertoghe, an endocrinologist from Brussels mentioned in various talks that a lack of human growth hormone (HGH) in older age can lead to premature death. When IGF-1 levels in the blood are low, replacing the missing HGH with regular injections can add 26.5 years to your life expectancy.

Jul
15
2023

Poor Health is Linked to Loneliness and Social Isolation

In June 2023 a new study showed that poor health has a link to loneliness and social isolation. It was also reviewed by CNN. There have been many studies in the past examining whether poor health shows an association to loneliness and social isolation. But this new study is different: it is a meta-analysis of 90 prospective studies with follow-up from 6 months to 25 years. The study included only persons age 18 years and older. There was a total of 2.2 million participants. The study specifically examined the links between loneliness, social isolation and early death.

The Meta-analysis

This new meta-analysis is significant, because with such a high number of participants the statistical strength is much better than with smaller studies. All of the 90 studies examined were prospective studies. The meta-analysis showed the difference between controls and various experimental groups suffering loneliness, social isolation and early death. The researchers identified independent risk factors of subsets among the 2.2 million subjects as discussed further below.

Loneliness

The definition of loneliness in the study was the subjective distress people feel when there is a discrepancy between the social relationships they have and what they want. If their is no fulfillment of the need for connection or intimacy in their relationships, this too can be a source of loneliness. There is increased isolation of Americans due to the increase in TV watching, spending more computer time and increase in cell phone use. This is loneliness by choice. But very few know that this can cause disease.

Social isolation

When people are under social isolation, they are under chronic stress, which translates into disease. In the statistics below it is apparent that cancer and cardiovascular mortality show a significant elevation from social isolation. In women with breast cancer there was a 51% increased mortality due to social isolation.

Findings of the study

Here are the findings form the metaanalysis. All the findings of patients suffering from loneliness and social isolation were in comparison to control groups without social deprivation.

  • There is a 32% all-cause mortality from loneliness and social isolation
  • Loneliness is responsible for a 14% increase in mortality compared to those who are not lonely
  • There is a 24% increased cancer mortality due to social isolation
  • Social isolation is responsible for a 34% increase of cardiovascular mortality
  • Socially isolated individuals with cardiovascular disease had a 28% increased all-cause mortality
  • Socially isolated women with breast cancer had a 51% increased all-cause mortality

Life style factors part of loneliness and social isolation

Turhan Canli, a professor of integrative neuroscience in the department of psychology at New York’s Stony Brook University had no involvement in the study. He said: ”People who feel socially isolated or lonely tend to have unhealthy habits, such as smoking, alcohol use, poor diet or little exercise. Having a small social network or little to no contact with the outside world can also make someone less likely to receive medical care if they don’t have anyone checking on them.”

Broadening social connections

We learnt how devastating loneliness and social isolation are for your health. It follows from this that the solution is to concentrate on broadening social connections as a preventative measure. Canli said: “Think of maintaining a social network like any other health-promoting activity: exercising regularly, eating well, looking after yourself.” Cultivate your social connections with a higher priority than in the past. Engage in new circles of like-minded people. Seek opportunities out like joining an exercise class or a discussion group.

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Conclusion

Loneliness and social isolation are a real entity that threatens all of our health. A meta-analysis of 90 prospective studies (6 months to 25 years of follow-up) including more than 2 million people showed the following. There is a 32% all-cause mortality from loneliness and social isolation. Cancer mortality is up 24% due to social isolation. Socially isolated individuals with cardiovascular disease had a 28% increased all-cause mortality. Socially isolated women with breast cancer had a 51% increased all-cause mortality. There were more findings than these. Overall, this stresses the importance to cultivate your social connections, which prevents social isolation and loneliness. You will stay healthier for longer and not die prematurely.

May
20
2023

Lung Cancer Screening Program

In 2013 the US Preventive Services Task Force recommended a yearly lung cancer screening program. The target population was age 55 to 80. Specifically, this program was to screen people who currently smoke, or had quit within the last 15 years and had a smoking history of 30 or more pack-years. Screening occurs with a special CT scan using low-dose radiation for lung screening. In the US Medicare and Medicaid reimburse residents for the cost of this procedure. The BCMA Journal describes the introduction of a similar lung cancer screening program in BC since May 2022. In the US the lung cancer mortality experienced a 20% drop since the introduction of the lung cancer screening program. This is because physicians now find lung cancer at stage 1 where treatment with surgery, radiotherapy or chemotherapy is much more effective.

Feasibility of a lung cancer screening program

Typically, with the conventional plain X-ray screening of symptomatic patients 40% of them, which radiologists diagnosed had lung cancer at a late stage, namely stage 4. At that stage the 5-year survival is less than 10%. However, now they diagnose patients with early lung cancer at stage 1 using a low-dose CT scanner with the lung cancer screening program. At this stage the 5-year survival rate is 73% to 90%. We know that the main lung cancer cause is cigarette smoking, the second cause is the aging process.

Lung cancer screening program free for patients

Similarly to the US the government sponsors the BC Lung Cancer Screening Program with no cost to the patient. With yearly checks the low-dose CT scanner detects early lung lesions that are highly suspicious of lung cancer. The screening program includes the higher age group and the ones who were heavier smokers. This is the highest lung cancer risk group, which benefits most from the lung cancer screening program.

What happens when the lung cancer screening program identifies early lung cancer?

With all the nodules that the CT scan screening finds, some have the features of suspicious nodules that require biopsy to check histologically whether or not there is lung cancer present.

Various methods to do lung biopsies

The simplest way for the physician to do this is by way of a bronchoscopy, where he inserts a needle into the nodule and retrieves a tissue sample. The pathologist analyzes this biopsy under the microscope. Not all suspicious nodules are within easy reach by bronchoscopy. If a lesion is located close to the lung surface the physician can do a needle biopsy through the skin (transcutaneous biopsy or transthoracic biopsy). Some patients require a biopsy using video-assisted thoracic surgery, which is performed under general anesthesia. Other patients require an open biopsy, which the chest surgeon performs under general anesthesia. In this case the chest surgeon opens the chest cavity and removes a piece of lung tissue, which the pathologist later analyzes for cancer.

Test to determine the extent of the lung cancer

The lung cancer stages are: stage I, II, IIIA, IIIB and IV. Following the initial X-ray, the physician will order an MRI or CT scan in order to determine whether the lung lesion was the only finding or whether there were metastases nearby. The MRI/CT scan can show whether or not there is involvement of the lymph glands in the chest or not. If there are lymph glands in the chest, a thoracic surgeon may be called in to do a mediastinoscopy, where the surgeon can look into the space between the lungs and the rib cage and assess the extent of the metastases in this otherwise difficult to assess space.

Distant metastases

The oncologist will want to continue to do the staging tests by doing CT scans of the liver, the adrenal glands and the brain to determine whether distant metastases are present. Blood tests and bone scans will rule out bone metastases. Finally, when all this information is gathered, the oncologist can do what is called an” extent of disease evaluation”. The following could be found for the various stages.

Extent of disease evaluation: Staging of lung cancer

Stage: 

I :  solitary lung tumor of less than 3 cm (=1 1/4″) in diameter

II :  tumor more than 3cm(= 1 1/4″) in diameter, local lymph gland metastases on the same side as the tumor

IIIA :  peripheral lung tumor: invaded the chest wall; central lung tumor: invaded distal mediastinal nodes on the same side

IIIB :  same as stage IIIA, but more extensive lymph gland invasion involving mediastinal organs and pleural cavity

IV :  Any of the above stages, but in addition distal metastases

Is it wasted time to do the staging procedure?

Why are oncologists “wasting time” to do the staging procedures? Studies over several decades have taught us that treatment of cancer without staging often gives everyone a false sense of security, where they learn later that the real extent of the cancer was much worse than originally thought. While everyone was thinking no further therapy was necessary, the cancer quietly multiplied and spread until it was too late to do anything about it. With the progress in the treatment of childhood leukemia oncologists learnt that long-term survival and cure rates could show significant improvement with adequate staging in the beginning and by following appropriate treatment protocols. In the last few years this has paid off for lung cancer as well.

Treatment of lung cancer

When the oncologist does an “extent of disease evaluation” he can discuss with the patient and the family what stage the lung cancer is in and what the chances of survival for the lung cancer are based on a vast amount of knowledge. There is a discussion of treatment options in detail and the oncologist can tailor the therapy to the needs of the patient. In principle, the approach to treat stage I and II is mainly by surgery to remove all cancer within the healthy surrounding tissue.

Surgical risk and treatment of stage III and IV

With an oncological or thoracic surgeon this kind of surgery has only a mortality of 1% to 8%. In younger patients this risk is lower, in patients above 75 years of age the risk is higher. With surgery higher survival rates are achievable (up to 80 % in stage I, up to 50% in stage II). Stage IIIA can be managed surgically, but stage IIIB needs another approach. Usually with this stage as well as with stage IV radiotherapy and combination chemotherapy is needed.

Lung Cancer Screening Program

Lung Cancer Screening Program

Conclusion

In the US a lung cancer screening program is in place since 2014. Since then, lung cancer mortality has dropped 20%. Also, in 80% of cases lung cancer is in stage I, the earliest form of lung cancer. In the past the majority of diagnosed lung cancer was in stage IV with a 5-year survival of only 5-10%. Now with the CT scan lung cancer screening program the 5-year survival is 73% to 90%. Treatment is mostly surgical for earlier-stage lung cancer (stage I, II and IIIA). For stage IIIB and stage IV a combination of surgery, radiation therapy and possibly chemotherapy is in use. The emphasis is on smoking cessation and yearly screening with a low-dose CT scanner.

May
07
2023

Colorectal Cancer in a younger Population

There seems to be a trend that physicians see colorectal cancer in a younger population. In the past colorectal cancer was almost solely confined to people above 50. But now some people get diagnosed as early as 35 years or 40 years.

On March 10 CNN published a report from Sara Stewart, a film and culture writer.

Example of person who was diagnosed with colorectal cancer at age 45

She describes that she was diagnosed at age 45 with a stage 3 colon cancer. She thinks that the medical profession does not pay enough attention to toxins that may be  causing colorectal cancer. Statistics show that colorectal cancer among younger patients than colorectal cancer among younger patients than 55 increased increased from 11% in 1995 to 20% in 2019.

At the same time colorectal cancer has decreased from 66 per 100,000 in 1985 to 35 per 100,000 in 2019. This means the incidence of colorectal cancer almost halved in 34 years.

Since the 1980’s doctors did colonoscopies on a large scale, which contributed to the rates of colorectal cancer decreasing. With a colonoscopy the doctor removes any identified polyps, which otherwise convert into colorectal cancer. It is a preventative procedure, which is very effective in preventing this cancer.

Colonoscopy screening

Earlier on the medical profession recommended screening with colonoscopy at age 50 and beyond; now the recommendation is from 45 onward. But more and more people are coming down with colon cancer at younger and younger ages, like 30 to 35. With a screening colonoscopy at the age of 30, the doctor can prevent these cancers because he/she removes colorectal polyps that are precursors of cancer. If the physician does not find a polyp at the age of 30, the next screening could take place at age 38 or 40. With a positive polyp test further screening could take place every 3 years. This would prevent a lot of colorectal cancers.

Statistics of colorectal cancer in a younger population

Newer cancer statistics show the following:

  • In the US from 2011 to 2019, colorectal cancer rates increased 1.9% each year in people below the age of 55.
  • In younger than 50-year-old patient death rates from colorectal cancer climbed 1% each year. At the same time the overall death rate of colorectal cancer fell 57% between 1970 and 2020 (largely due to the effect of doing colonoscopies).
  • There are huge differences in cancer rates of colorectal cancer in different states: Utah colorectal cancer rates were lower: 27 cases per 100,000 people; in contrast, the number was 46.5 per 100,000 in Mississippi. This points to environmental/industrial factors playing a larger role in causation of colorectal cancer.

Causation of colorectal cancer in a younger population

In 2020 the National Cancer Institute reported about scientists “examining factors in the environment as potential causes of early-onset colorectal cancer. Such factors include air and water pollution, chemicals in soil and food, and pesticide use.” In some cases, there may be adverse lifestyle factors at play like poor diets (too much fat, too much meat and junk foods), excessive weight and lack of exercise. Dr. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana Farber Cancer Institute, told NBC News the following.

Environmental factors causing early colorectal cancer

“It isn’t just diet and lifestyle, there is something else. We see so many young patients with colorectal cancer who follow very healthy lifestyles and diets.” Dr. Folasade P. May, an associate professor of medicine in the University of California, Los Angeles Vatche and Tamar Manoukian Division of Digestive Diseases added: “When something is affecting people who have their birth years in common, then we know it’s something in the environment that has led this whole group of people to have higher rates.  Among industrial poisons benzene, asbestos, vinyl chloride, radon, and arsenic are examples of toxic substances that can increase the risk of cancer to those who are exposed.”

Colorectal Cancer in a younger Population

Colorectal Cancer in a younger Population

Conclusion

On the one hand colorectal cancer has decreased in frequency by almost 50% between 1985 and 2019. But on the other hand, colorectal cancer in the younger population has a much earlier onset, way before the previously common age of 50. Doctors find the cancer at a later stage, which has a higher mortality rate. Experts expect environmental factors to play a role like exposure to benzene, asbestos, vinyl chloride, radon, and arsenic. In addition, air and water pollution, chemicals in soil, food, and pesticide use could play a role. In some cases, there may be adverse lifestyle factors at play like poor diets (too much fat, too much meat and junk foods), excessive weight and lack of exercise.

Start initial colonoscopy screening at age 30

The solution to this problem could be a very early colonoscopy screening around the age of 30. In the case of an examination that is negative for polyps at age 30, the next screening could take place at age 38 or 40. With a positive test for polyps at age 30 further screenings could take place every 3 years. This would prevent a lot of colorectal cancer in the younger age population.