Mark Corson

By M. Gelford. Digital Media Arts College.

A man’s risk for developing prostate cancer is two times higher if his father has had the disease generic phenergan 25mg amex, five times higher if a brother has had it buy 25 mg phenergan free shipping, and two times higher if his mother or sister has had breast cancer quality 25mg phenergan. In the United States, prostate cancer is found mainly in men over age 55, and more than 8 out of 10 cases are in men over 65. Prostate cancer is roughly twice as common in African-American men as in white men. Testosterone is thought to stimulate hormone-dependent prostate cancer in much the same way that estrogen stimulates breast cancer. Current research indicates that diets high in red meat, dairy, and saturated fat are associated with an increased risk of developing prostate cancer. Risks are also increased for those who have diets low in fruits, vegetables, phytoestrogens, selenium, vitamin E, lycopene, and other dietary antioxidants. Diagnostic Considerations The most important aspect of detecting prostate cancer for men over the age of 50 years is seeing a physician for an annual physical exam that includes: • Digital rectal exam. The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas. Researchers are looking for ways to distinguish between cancerous and benign conditions, and between slow-growing cancers and fast-growing, potentially lethal cancers. A biopsy of the prostate involves taking tissue samples from the prostate via the rectum with the use of a biopsy gun that inserts and removes special hollow-core needles (usually three to six on each side of the prostate) in less than a second. The tissue samples are then examined under a microscope to determine whether cancer cells are present and to evaluate the microscopic features (or Gleason score) of any cancer found. The rationale for early detection of cancer is that it leads to more effective treatment. It is believed that in most cases the prostate cancer would not have seriously affected the patient’s life expectancy if it had simply been left alone. Most prostate cancers are extremely slow-growing, meaning that men can live with prostate cancer, rather than die from it. In fact, autopsy studies report that more than 30% of all men over the age 50 have evidence of prostate cancer, but only 3% will die from it. Our feeling is that the problem with early screening is not the screening but what happens after the screening. And if the biopsy is positive, even then a conservative approach should be taken with the majority of men. In fact, we recommend just the opposite: an aggressive focus on the measures detailed in this chapter, which can help prevent or even reverse the disease. Therapeutic Considerations The therapeutic goal is to reduce as many risk factors as possible while simultaneously implementing dietary and lifestyle factors associated with prostate cancer prevention. Most of the lifestyle factors linked to preventing cancer in general, such as avoiding cigarette smoke or excessive intake of alcohol, also apply to prostate cancer. Diet There is so much convincing evidence on the role of diet in prostate cancer that Dr. William Fair and colleagues from Memorial Sloan-Kettering Cancer Center went so far as to suggest that prostate cancer may be a nutritional disease. As is also the case in breast cancer, these dietary factors are known to affect sex hormone levels, detoxification mechanisms, and antioxidant status. The results indicated that men with any degree of male-pattern baldness (characterized by gradual hair loss at the front and/or crown of the head) in their mid-twenties were 50% more likely to develop prostate cancer. There are receptors for testosterone on the cells of both hair follicles and the prostate. These findings mean not that balding men will definitely get prostate cancer, but only that they are at increased risk, meaning that they would be wise to be more aggressive with dietary and supplementation programs to reduce their risk of developing prostate cancer. In fact, it would be worthwhile to read the chapter “Breast Cancer (Prevention)” to gain an even greater appreciation of how diet can affect hormone-sensitive tissues like the breast and prostate. One of the interesting dietary associations in breast cancer is the high risk that comes with eating well-done or charbroiled meat; frequent consumption of well-done meat, for example, was associated with a nearly 500% increase in breast cancer. Higher consumption of hamburgers, processed meats, grilled meats, and well-done meat was associated with an approximately 50 to 80% increase in aggressive forms of prostate cancer. In a study conducted in Canada, researchers found a twofold increased risk of prostate cancer associated with an increased intake of milk. Interestingly, it was the only dairy product associated with an increased risk for prostate cancer. It is also important to point out that the Mediterranean diet has been shown to help prevent prostate cancer. That would be expected given that it is high in vegetables, legumes, dried and fresh fruits, and fish; olive oil is its main fat source; it is low in animal fats, processed red meat, milk and dairy products; and it includes regular but low alcohol intake (wine with meals). The high intake of soy may be one of the key protective factors accounting for the low rate of prostate cancer in Japan and China compared with other parts of the world: blood and urine concentrations of soy isoflavones (an indicator of intake) were found to be 7 to 10 times higher in Japanese men consuming a traditional Japanese diet compared with Finnish men consuming a typical Western diet. Information on the isoflavone content of common soy foods can be found on page 788. Just as in breast cancer again, the benefits of these long-chain omega-3 fatty acids are magnified when the level of animal fat (saturated fat, and arachidonic acid in particular) is also reduced. A high ratio of dietary omega-6 to omega-3 fatty acids is major risk factor for prostate cancer. Unfortunately, no one has actually looked at the effect of flaxseed oil in prostate cancer. At this time it appears that men in general may be better off avoiding flaxseed oil supplements and focusing on ground flaxseed (for the lignans) and fish (for the omega-3 fatty acids). Flaxseed Ground flaxseed appears to be quite helpful not only in preventing prostate cancer but also in men with existing prostate cancer.

Conditions That Respond Significantly to Placebo Angina Anxiety Arthritis Asthma Behavioral problems Claudication cheap 25mg phenergan amex, intermittent Common cold Cough cheap phenergan 25 mg, chronic Depression Diabetes (type 2) Drug dependence Dyspepsia Gastric ulcers Hay fever Headaches Hypertension Insomnia Labor and postpartum pain Ménière’s disease Menstrual cramps Nausea of pregnancy Pain Premenstrual syndrome Psychoneuroses Tremor The Holy Trinity of the Placebo Response Noted Harvard psychologist Herbert Benson purchase phenergan 25mg amex, M. Benson believes that the placebo effect yields beneficial clinical results in 60 to 90% of diseases. He states that the placebo “has been one of medicine’s most potent assets and it should not be belittled or ridiculed. Unlike most other treatments, it is safe and inexpensive and has withstood the test of time. If the therapeutic interaction between the physician and the patient does not stimulate the patient’s hope, faith, and belief, the chances of success are measurably diminished no matter how strong or effective a medication may be. It has been repeatedly demonstrated in clinical trials designed to better understand the placebo effect that the beliefs of both the patient and the doctor, as well as their trust in each other and the process, generate a significant portion of the therapeutic results. Conventional medicine often criticizes and belittles therapies that have not been stringently tested using the double-blind, placebo-controlled trial, but in doing so it is arguing against something that is time-tested—the art of healing. The bottom line here is that patients of a compassionate, warm, and caring physician will experience better outcomes and fewer medication-related side effects than patients of an uninterested, cold, and uncaring physician. The Opposite of a Placebo The word placebo comes from the Latin term for “I will please. It describes the experience of having a side effect from an apparently inert treatment or substance. Healthy individuals have adverse effects from placebos about 25% of the time, but if patients are specifically asked about adverse effects, this figure can rise to 70%. While a nocebo response is usually used to describe an adverse reaction to a placebo, it could also be applied to describe an unusual or exaggerated response to a medication. The classic example given is the fact that in the Framingham Heart Study, women were four times more likely to die from a heart attack if they believed they were prone to heart disease, compared with women with similar risk profiles who did not have that belief. Definitions of Some Expectation Effects Behind the Placebo Response Hawthorne effect Subjects respond to knowledge of being evaluated and observed Jastrow effect Subjects respond to explicit expectations about outcome Pygmalion effect Evaluators expect therapeutic benefit, so they see it John Henry effect Control subjects attempt to emulate expected outcomes Halo effect Subjects respond to treatment novelty (i. Prayer costs nothing, has no negative side effects, and fits perfectly into any treatment plan. No matter what faith you embrace, you can use the power of prayer to lead you to better health—of body, mind, and soul. Most physicians are taught that any consideration of religious commitment is beyond the legitimate interest and scope of medical care. It should not be this way, but the reality is that many believe faith and medical science are mutually exclusive despite the fact that numerous scientific studies have now fully validated the efficacy of faith, prayer, and religion in healing. Indeed, many medical experts feel that not to include a spiritual dimension in a patient’s plan for treatment and recovery is to be medically irresponsible. Not surprisingly, he found that prayer has received relatively little attention from the research community. National Library of Medicine) from 1980 to 1996 revealed only 364 studies that included faith, religion, or prayer as part of the treatment. The numbers are small, but the conclusion is huge: the data show that prayer and religious commitment promote good health and healing. Scientific investigation into the healing power of prayer has shown that prayer can affect physical processes in a variety of organisms. Specifically, studies have explored the effects of prayer on humans and on nonhuman subjects, including water, enzymes, bacteria, fungi, yeast, red blood cells, cancer cells, pacemaker cells, seeds, plants, algae, moth larvae, mice, and chicks. In these studies, prayer affected the manner in which these organisms grew or functioned. What scientists discovered —no doubt to their amazement—is that prayer affected a number of biological process, including • Enzyme activity • The growth rates of leukemic white blood cells • Mutation rates of bacteria • Germination and growth rates of various seeds • The firing rate of the heart’s natural pacemaker cells • Healing rates of wounds • Size of goiters and tumors • Time required to awaken from anesthesia • Autonomic effects such as electrical activity of the skin • Hemoglobin levels Given the scientific support for prayer’s beneficial effects, not praying for the best possible outcome may be the equivalent of deliberately withholding an effective drug or surgical procedure. Benson of Harvard found that patients who prayed or meditated evoked their body’s relaxation response. This response—the exact opposite of the stress response, the “fight-or-flight” reaction that we feel during tense situations —includes decreases in heart rate, breathing rate, muscle tension, and sometimes even blood pressure. The medical implications of the relaxation response are enormous and may serve as the underlying basis for most mind-body techniques, such as guided imagery (discussed below) and meditation. The relaxation response has been shown to produce useful effects in a variety of different disease states. For example, cancer patients who undergo chemotherapy and learn to evoke the relaxation response are significantly less likely to experience nausea and fatigue. Notice with each breath you take that you are breathing effortlessly by using your diaphragm. You should feel as if the air is first expanding into your abdomen and up into your lungs, then expanding warmth to all parts of your body. If you find yourself having trouble learning how to relax or perform visualization exercises, find a practitioner who specializes in guided imagery by contacting the Academy for Guided Imagery at (800) 726-2070 or www. Taking a yoga class is also a great way to learn how to breathe with your diaphragm and learn how to relax. As a first-year graduate student in the School of Public Health at the University of North Carolina in Chapel Hill, Levin became intrigued by two articles that found a surprising and significant connection between spirituality and heart disease, a connection that remains one of the best-researched areas of the positive effects of religious behavior on health. His curiosity led to an in-depth evaluation and pioneering research on the impact of religious practices on disease. Levin notes that there are more than 50 studies in which religious practices were found to be protective against heart disease, decreasing the risk of death from heart attacks and strokes as well as reducing the incidence of numerous risk factors including high blood pressure and elevated cholesterol and triglyceride levels. Levin highlights the strong inverse correlation between religious commitment and blood pressure that was evident no matter what religion an individual chose to practice or his or her geographical location or ancestry. Final Comments Often practitioners of natural medicine are asked for a blueprint for good health and effective healing. Most people are looking for a simple answer, but our feeling is that living healthfully requires a truly comprehensive commitment in all aspects of being.

Other defects associated with Patau’s syndrome include poly- dactyly purchase phenergan 25mg otc, rocker-bottom feet order phenergan 25 mg without a prescription, and congenital heart diseases generic 25mg phenergan overnight delivery. Trisomy 18 (Edwards’ syndrome) is characterized by mental retardation, micrognathia (tiny jaw), low-set ears, rocker-bottom feet, and congenital heart diseases. Perhaps most characteristic is a clenched fist with overlapping fingers: the index finger overlying the third and fourth fingers, while the fifth finger overlaps the fourth. Edwards’ syndrome is also associated with polyhy- dramnios and a single umbilical artery. Trisomy 21 (Down’s syndrome) is the most common chromosomal abnormality and is an important cause of mental retardation. Children with Down’s syndrome invariably have severe mental retardation, which pro- gressively declines with advancing age. Patients have characteristic facial features that include a flat facial profile, oblique palpebral fissures, and epi- canthal folds; a horizontal palmar crease; and a decreased muscle tone at birth that leads to a “floppy baby. There is also a marked increase in the incidence of acute leukemia, usually acute lymphoblastic leukemia, in children with Down’s syndrome who are younger than 3 years of age. There is almost a 100% incidence of Alzheimer’s disease in patients with Down’s syndrome 120 Pathology by the age of 35. Changes in the brains of patients with Down’s syndrome similar to those seen in the brains of patients with Alzheimer’s disease include senile plaques and neurofibrillary tangles. DiGeorge’s syndrome is associated with absence of the thymus, which leads to cell-mediated immune deficiencies, and absence of the parathyroids, which leads to hypocalcemia. The 5p− syndrome is also called the cri-du-chat syndrome, as affected infants characteristically have a high-pitched cry similar to that of a kitten. Additional findings in this disorder include severe mental retarda- tion, microcephaly, and congenital heart disease. Affected infants have many defects including micrognathia and a prominent forehead. The 11p− syndrome is characterized by the congenital absence of the iris (aniridia) and is often accompanied by Wilms tumor of the kidney. The 13q− syndrome is associ- ated with the loss of the Rb suppressor gene and the development of retinoblastoma. Deletions involving chromosome 15 (15q−) may result in either Prader-Willi syndrome or Angelman’s syndrome depending on whether the defect involves the paternal or the maternal chromosome (genetic imprinting). This finding is in sharp contrast to the classic concept of Mendelian inheritance, which states that the phenotype of a certain allele is independent of whether the chro- mosome is the maternal or the paternal chromosome. The best example of genetic imprinting involves deletions involving chromosome 15 (15q−). If the deletion involves the maternal chromosome, then Angelman’s syn- drome results, while deletions involving the paternal chromosome result in Prader-Willi syndrome. Angelman’s syndrome is characterized by severe mental retardation, seizures, a stiff ataxic gait with jerky movements, inap- propriate laughter, and occasional oculocutaneous albinism. Because of the combination of ataxic gait and inappropriate laughter, these patients are sometimes referred to as “happy puppets. The cause of genetic imprinting is not known, but it may relate to the degree of methylation of genes. Note that a loss of chro- mosome 15 can also occur if two parental chromosomes of the same type are derived from the same parent. This condition is called uniparental dis- omy, whereas the normal condition is called biparental disomy. Inheritance of the same (duplicated) chromosome is called isodisomy, while inheri- tance of homologues from the same parent is called heterodisomy. To illus- trate this concept, consider paternal uniparental disomy of chromosome 15. This refers to inheriting two copies of paternal chromosome 15 and no maternal chromosome 15. Therefore, this is essentially the same as a dele- tion of maternal chromosome 15, which produces Angelman’s syndrome. Inheriting two copies of paternal chromosome 11 results in Beckwith- Wiedemann syndrome. This is not a trisomy, as the maternal chromosome is lost, and therefore this would be a paternal uniparental disomy for chro- mosome 11. Patients also develop hypoglycemia because the genes for insulin and insulinlike growth factors are located in this region. Smith-Margens syndrome (17p−) is associated with self-destructive behav- ior, while Wolf-Hirschhorn syndrome (4p−) is characterized by growth retardation, severe hypotonia, and micrognathia. Characteristics of this syndrome include small stature due to a lack of a growth spurt during adolescence, a webbed neck, and multiple skeletal abnormalities that include a wide carrying angle of the arms where the elbow is out (cubitus valgus), a “shield-shaped” chest, and a high-arched palate. Individuals with Turner’s syndrome are phenotypic females, but they fail to develop secondary characteristics at puberty. Patients have streak gonads, histologic sections of which reveal atrophic, fibrous strands and are devoid of ova and follicles. These hypermaturing ovaries produce decreased estrogen levels, resulting in primary amenorrhea with no menar- che. About one-half of patients develop hypothyroidism due to autoanti- bodies against thyroid hormone. The relationship of the extra Y to behavior is controversial, but these individuals do have problems with motor and language develop- ment. Multi-X females are normal, except there is an increased tendency toward mental retardation that is proportional to the number of X chromo- somes that are present.