Monday, September 28, 2009

Beware of premature cornea ageing

A pair of contact lenses, positioned with the ...Image via Wikipedia


Neo Chai Chin

HERE's one more thing for contact lens wearers to be wary of - your corneas may be prematurely ageing.

Wearing contact lenses with low oxygen permeability for prolonged periods can damage the cornea, a transparent layer covering the eye. And the majority of Asians are using such lenses, said Australian eyecare expert Professor Brien Holden (picture).

This, in turn, may cause conditions like dry eyes, and cause the corneas to look "older" than normal. A sign of the latter is when the cells on the innermost layer of the cornea become varied in size - a condition called polymegethism, which is closely associated with corneal exhaustion syndrome, said Prof Holden of the University of New South Wales.

Cell density decreases with age, but studies have shown that a lack of oxygen accelerates the process. When that happens, a person may then have to cease wearing contact lenses altogether, he said.

Prof Holden, who is also chief executive of the Institute for Eye Research, an Australian company, was in Singapore yesterday.

"The first thing to do is to consult your local optometrist or ophthalmologist and talk to them about whether you are showing signs of excessive redness of the eye associated with low oxygen of your lenses, " he told Channel NewsAsia.

However, the "simplest thing" is to wear high oxygen permeable contact lenses or silicon hydrogel lenses, he said.

Singaporeans, it seems, are already making the switch.

Optometrists told Today of a rapid uptake since silicon hydrogel lenses became readily available four years ago.

President of the Singapore Optometric Association David Chong said over half his customers are using them. For optometrist Dr Koh Liang Hwee, the number is three in 10 monthly disposable lens users, and nine in 10 bi-weekly disposable lens users.

Silicone hydrogel lenses cost about 20 per cent more than regular soft lenses, they said.

To spread awareness, contact lens manufacturer Ciba Vision is launching a premature corneal ageing campaign this month.

A better alternative however, is to avoid wearing contact lenses altogether, said Dr Ray Manotosh of the Department of Opthalmology at the National University Hospital (corrected at 3:15PM, Sep 1).

"Contact lenses have many side effects (including) infection related to hygiene, and bacterial infection where you can lose your eyesight," he said.

Dr Manotosh added that compared with hard lenses (usually worn on doctor's prescription), the incidence of polymegethism among soft lens wearers is low.

But for those who insist on wearing contact lenses, "silicon hydrogels are the better lens, and the preferred lens should be those for daily wear instead of weekly or bi-weekly wear", he said.

From TODAY, Health – Tuesday, 01-Sep-2009

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Knowing the signs will save your neck

Sagittal section of human vocal tractImage via Wikipedia

When seemingly trivial ailments such as a sore throat may mean cancer

Eveline Gan

THE sign seemed innocuous at first - a sore throat, which Mr L H Sim thought nothing of. But, unlike most sore throats, the discomfort didn't go away.

Mr Sim gradually lost his voice and appetite, too, which prompted him to seek medical attention.

A biopsy taken from a lump in his throat confirmed the 60-year-old car-cushion manufacturer's worst fears - he had third-stage throat cancer, a type of head and neck cancer.

The others in this category include cancer of the oral cavity, nasal cavity, throat, sinuses, larynx or voice box, thyroid and salivary glands.

Head and neck cancer afflicts about 500 Singaporeans each year, but the symptoms are hard to detect. That's because, like the case of Mr Sim, they seem to be trivial ailments.

A sore throat, stuffy nose or mouth ulcer might hardly be cause for alarm, but these could be signs of more insidious medical conditions.

To raise awareness of the disease, which is the sixth most common cancer to afflict men in Singapore, two public forums this Saturday will address issues and treatment options of the various forms of head and neck cancer (see health listings).

"Some of the early symptoms of head and neck cancer are similar to those of common ailments like upper respiratory tract infection and may be ignored," said medical oncologist Dr Leong Swan Swan, who had treated Mr Sim.

"This may cause delays in seeking medical attention and hence more advanced cancers at diagnosis," added the doctor, who is based at Gleneagles Medical Centre's Oncocare Cancer Centre.

About half of head and neck cancers occur in the mouth - mostly on the tongue, floor of the mouth and cheeks, said Assistant Professor Victor Fan, consultant at the National University Hospital's department of oral and maxillofacial surgery.


While a person with early-stage oral cancer may sometimes have no symptoms, a sign to look out for is a non-healing mouth ulcer, said Asst Prof Fan.

"The ulcers that most people get typically heal within 10 to 14 days. Any ulcer that doesn't heal in two weeks is suspicious," he added.

Other warning signs include a persistent sore throat or congested nose, as well as unusual lumps, and red or white patches in the mouth.

In more advanced cases, said Asst Prof Fan, the patient may have difficulty swallowing or slurred speech, especially those who have tongue cancer. Others may have abnormal lumps in the neck.

With many of head and neck cancer symptoms resembling common ailments, when should one sound the alarm?

"Symptoms due to common ailments should resolve spontaneously, or after medication. If they persist, it is always good to seek medical attention," said Dr Leong.

Head and neck cancers are usually diagnosed by specialists, such as an otolaryngologist or a head and neck surgeon, who may perform a biopsy on a suspicious lump or lesion. For oral cancer, a trained dentist can detect warning signs in the mouth, especially those in hidden corners.

With early diagnosis, head and neck cancers are curable, both doctors stressed.

Another plus point is that treatment of the early-stage cancer tends to be less traumatic for patients, said Assistant Prof Fan. The cure rate also drops dramatically if the cancer spreads to other parts of the body.

Traditional treatments involve surgery, radiotherapy or chemo-radiotherapy. According to Dr Leong, new options - such as drugs that target and destroy some types of cancer cells while causing little harm to normal cells - have become available for treatment.

After undergoing chemotherapy and radiotherapy, Mr Sim is now recovering. However, the side effect of his radiotherapy - which left him in excruciating pain and unable to eat or drink properly because his throat and neck were badly burned and scarred inside out - is something he will have to grapple with for a long time.

Quit smoking, drinking ... and chewing betel nuts

Research has found that smoking and alcohol consumption are two of the top causes of oral cancer, which forms about half of all head and neck cancer diagnoses.

According to Assistant Professor Victor Fan, your risk of oral cancer is six times higher than an average person if you smoke heavily, and up to 24 times higher if you smoke and consume more than 30 glasses of alcohol per week.

Other risk factors may be linked to heavy consumption of preserved foods such as salted fish, and viral causes such as human papillomavirus (HPV) infection and Epstein-Barr virus.

The chewing of betel nuts - which contains nicotine - may also increase the risk of cancer.

From TODAY, Health – Tuesday, 01-Sep-2009
In collaboration with Health Promotion Board

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Tainted car seats a hazard

LEAD poisoning in children is usually traced to peeling paint in old homes or old lead pipes. But the family car, and the children's car seats, can also become contaminated, especially if parents work in jobs that expose them to lead.

When six babies and toddlers in Maine, in the United States, were found to have dangerously high levels of lead in their blood last year, public health workers tested the children's homes, but found no traces of lead except in some deck and outdoor areas where family members left their shoes and dirty clothes.
Then they tested the family cars.

"We consider levels of 40 microgrammes per square foot an elevated level for floors, which are a contact area for kids," said Ms Tina Bernier, an environmental specialist for Maine's Childhood Lead Poisoning Prevention Program.

"Some of the numbers in the car seats were in the 400 range, and it went up to 1,000 in other areas of the cars."

The parents of several children worked in removing paint from old buildings under renovation; three of them were employed by the same painting contractor, who did not provide workers with showers or places to change clothes before going home, as required, investigators said.

Another parent was a self-employed metal recycler.

The report, published last week in the Morbidity and Mortality Weekly Report for the Centers for Disease Control and Prevention, is the first known case of lead exposure through car seats, though lead has previously been found in cars. The New York Times

From TODAY, Health – Tuesday, 01-Sep-2009

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Wednesday, September 23, 2009

Imaging tests increase risk of radiation damage

Radioactive hazard trefoilImage via Wikipedia

Doctors should weigh the benefits of medical imaging against the risk of cancer from cumulative exposures to radiation, as the use of the tests grows, researchers said.

Almost 70 per cent of around 950,000 patients surveyed underwent at least one imaging procedure, like a computer tomography scan, that exposed them to ionizing radiation over a three-year period, according to research published on Wednesday in the New England Journal of Medicine.

Low-dose radiation from medical imaging procedures has been linked to cancer, lead author Reza Fazel said. 

Doctors should prescribe tests only when the benefits outweigh the risks, he said. Researchers analysed data from 952,420 people who are part of United Healthcare Group's United Healthcare unit, estimating patients' radiation exposure based on the imaging procedures they were given.

"It is important to note that we are talking about radiation doses that are incurred in one year," said Brahmajee Nallamothu, a study author and cardiologist from the University of Michigan. "Cumulative doses over a lifetime may be much higher." BLOOMBERG

From TODAY, World – Friday, 28-Aug-2009

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Did diet drug damage liver?

RofecoxibImage via Wikipedia

A late post, but something to be aware of concerning some drugs…


WASHINGTON - Health officials in the United States are investigating reports of liver injury in patients who took weight-loss drug Xenical and its over-the-counter version Alli.

The Food and Drug Administration (FDA) said on Monday they have received more than 30 reports of liver damage in patients taking the drug, which is known as Orlistat. The reports, submitted between 1999 and October 2008, included 27 hospitalised patients, and six who suffered liver failure.

Alli and Xenical are both marketed by British drug-maker GlaxoSmithKline, though Xenical is manufactured by Swiss firm Roche.

The FDA says it has not established a direct relationship between the weight loss treatments and liver injury, and advised patients to continue using the drugs as directed.

"Consumers should consult their health care professional if they experience symptoms," the agency said on its website. Signs of liver damage include fatigue, fever, nausea and vomiting.

The FDA said it is reviewing additional details about the suspected cases of liver injury submitted by manufacturers.

Roche referred questions to GlaxoSmithKline.

A spokeswoman for GlaxoSmithKline said there is no evidence the company's drug causes liver injury, noting that it primarily acts on the intestinal tract. She said Alli's safety has been studied in more 30,000 patients enrolled in 100 clinical studies.

"Liver changes can have many causes," said Ms Debbie Bolding, in a statement. "People who are overweight and obese are predisposed to liver-related disorders."

The FDA first approved Xenical in 1999 and Alli in 2007. The prescription pill is twice as potent as Alli.

In general, the FDA has started notifying the public earlier about possible safety issues with drugs, after coming under fire for acting too slowly on problems with blockbuster treatments like Merck's painkiller Vioxx. AGENCIES



Singapore HSA is monitoring Xenical probe

Singapore has two products containing Orlistat: Xenical which is prescription-only and the Xenical which can be dispensed under the supervision of a registered pharmacist.

Since 2000, the Health Sciences Authority has received four adverse reaction reports here that are suspected to be linked to Orlistat.

While two involved liver injuries, the link between the injuries and the weight loss drug could not be "conclusively established due to incomplete information and presence of confounding factors", said a spokeswoman.

Singapore has two products containing Orlistat: Xenical which is prescription-only and the Xenical which can be dispensed under the supervision of a registered pharmacist.

HSA said it will monitor the US FDA's investigation closely.

Meanwhile, patients may continue with the medication as directed by their doctors. But they should seek medical attention if they experience fever, fatigue, jaundice or nausea.

A spokeswoman for Roche said the company will continue distributing Xenical in Singapore: "Roche takes the issues of safety seriously and will continue to work with the health authorities closely."


Taken from TODAY, Health – Wednesday, 26-Aug-2009

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Stealth health

HANSHAN COUNTY, CHINA - JUNE 22:  Rural studen...Image by Getty Images via Daylife

Sneaking in exercise into your everyday life is as easy as ABC

Eveline Gan

Skip the escalator and take the stairs. It helps you burn off 7 calories per kg in an hour. Skip the escalator and take the stairs. It helps you burn off 7 calories per kg in an hour.

MENTION exercise and dreadful images of sweaty bodies and painfully vigorous activities come to mind. But believe it or not, living a healthy lifestyle doesn't have to be that painful or complicated.

Mrs Chan Yoke Yin, deputy director of the physical activity unit at the Health Promotion Board Adult Health Division, said: "People give reasons such as they have no time, they're too busy or that exercising makes them feel more tired.

"But it's a common misconception that to obtain the maximum benefits of exercise, you need to join the gym or even do exercises that make you sweat and feel sore all over."

In fact, physical activities can be easily incorporated into your daily routine, she added.

As most people would know by now, exercise has many benefits, said Mr Lim Kian Chong, a physiotherapist at Alexandra Hospital.

"Recent studies have shown that obese people who become physically fitter have a longer lifespan, and exercise significantly decreases the risk of developing chronic diseases such as diabetes," said Mr Lim.

He added that exercise also provides more energy for your daily activities and improves productivity at work.

Instead of doing half an hour of continuous exercise, it can be conducted in bouts of 10 minutes throughout the day. Mrs Chan suggested starting with simple activities such as alighting from the bus two to three stops earlier and brisk walking home, or using the stairs instead of the lift and escalators.

According to her, brisk walking and climbing the stairs burn about 4 to 7 calories per kg every hour. So, if you're 60kg, you'll expend about 240 calories if you brisk walk for an hour.

Interestingly, you can also engage in "exercise" at the supermarket. Instead of using the trolley, carry your groceries. This helps to burn about 2 to 3 calories per kg every hour.

What about those with deskbound jobs?

Simply sneak in some exercise while you're taking a short break from work, Mrs Chan suggested.

"For those doing deskbound jobs, they can easily tie a resistance band to their table or chair, and do some simple arm and leg strengthening exercises such as bicep curls or leg extensions. They can also do the same with some light weights," she said.

Taken from TODAY, Health – Tuesday, 25-Aug-2009

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Tuesday, September 22, 2009

When mum has an eating disorder

Typical brands of Potato Chips at a superstore.Image via Wikipedia

Older adults, too, suffer from anorexia and bulimia

Eveline Gan

Cecilia stopped eating and began losing excessive weight in her early 20s. Cecilia stopped eating and began losing excessive weight in her early 20s.

FIFTEEN minutes before this interview, Cecilia (not her real name) had been throwing up in the bathroom. The twice-daily purges, during which Cecilia would force herself to vomit what she has eaten, are an everyday affair.

While most people look forward to having a hearty meal, mealtimes are a torture for Cecilia, who weighs a mere 38kg.

"I love food, but I hate what it does to me," she said.

Although she likes savoury food such as potato chips, she tries to stick to a strict diet of two teaspoonfuls of muesli for breakfast, no lunch and a few raw vegetables for dinner. Sometimes, she goes on maniac food binges. Afterwards, she simply heads for the toilet to throw up.

Cecilia is among those who suffer from eating disorders anorexia and bulimia. In anorexia, patients typically starve themselves, while bulimic sufferers go on an eating binge and then purge themselves.

But unlike most cases, in which sufferers are in their teens and early adulthood, Cecilia is 43 and a mother of a four-year-old.

Not exclusive to the young

There are no local figures on the number of older adults suffering from eating disorders.

Singapore General Hospital (SGH), which runs an Eating Disorders Programme, saw about 120 cases last year. Most are teenagers and those in their 20s. About 10 per cent are above 30 years old, said Dr Lee Huei Yen, director of the SGH Eating Disorders Programme. The oldest patient Dr Lee has seen is in her 60s.

Private psychiatrist Dr Ken Ung, who specialises in treating eating disorders, estimated that up to 10 per cent of the patients he sees for eating disorders are in their 40s. Dr Ung is a senior consultant psychiatrist and psychotherapist at Adam Road Medical Centre.

While eating disorders among the middle-aged are "less common", they are not new, said Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre. He sees a handful of cases each year.

And like younger patients, he added, older sufferers tend to display the same pattern of behaviour. "Stress and self-esteem are common themes. The victims tend to be extremely anxious perfectionists and they have a need to control things in their lives," said Dr Wang.

While the underlying issues may be similar, triggering factors in older and younger sufferers are very different, said Dr Lee.

For older female patients, the trigger could be marital problems, work stress or weight issues tied to pregnancy and ageing. In many instances, an eating disorder can wreck havoc on family relationships.

"It affects their ability to care for their kids and may even put a big strain on their marriages," said Dr Wang.

A constant battle

While eating disorders can crop up at any age, many of the diagnoses are what Dr Ung calls "chronic cases", like Cecilia, who has been battling food issues for years.

For Cecilia, her battle lasted two decades, even through her pregnancy. She stopped eating and began losing excessive weight in her early 20s, following an unpleasant breakup with a boyfriend. At her worst, she weighed just slightly over 30kg.

"The longer you've had it (an eating disorder), the harder it is to treat because it becomes a part of your life," said Dr Ung, who estimated that about a third of the "chronic" patients never get out of their eating disorder. From experience, the doctors said it is tougher to treat older patients.

And unlike teens, older patients tend to be more set in their ways, said Dr Wang.

Dr Ung added: "Older anorexic patients may not want to give up their lifestyle because they've been looking thin for so long. For treatment to work, they must have the desire to recover."

Treatment typically includes a multi-disciplinary approach. Hospitalisation may be needed for those who are extremely underweight or malnourished.

Medication, psychotherapy and family therapy - where family members are involved - can also help.

For the sake of her daughter, Cecilia, now undergoing therapy, is desperately trying to get out of her eating disorder.

"I don't want my problem to follow through to my daughter," she said.

Where you can get help

The SGH Eating Disorders Programme is available at SGH LIFE Centre. For appointments, call 6321 4377. For general enquiries, call 6222 3322.

Taken from TODAY, Health – Tuesday, 25-Aug-2009

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Sunday, September 13, 2009

Fresh garlic best for heart


FreshGarlicForHeart MUCH has been made of the benefits of eating garlic, but often left out of the discussion is what kind of garlic to eat. Is fresh-crushed better than paste or pre-peeled cloves? What about garlic powder? How about just popping a garlic pill?

A study by researchers at the University of Connecticut School of Medicine suggests that for certain elements of cardiac health, fresh-crushed is better than processed.

Subhendu Mukherjee, Dipak K Das and colleagues prepared garlic slurries (a suspension of insoluble particles in water) containing about 57g of garlic (10 to 20 cloves, depending on size) in about a cup and a half of water.

Two slurries were made, one with fresh-crushed garlic and the other with garlic that had been crushed but left to dry for two days, allowing hydrogen sulfide and other volatile chemicals to dissipate.

Small amounts of the slurries were force-fed to laboratory rats for 30 days, after which the animals were sacrificed and their hearts put through tests. The findings were published in The Journal of Agricultural and Food Chemistry.

The researchers found that while both slurries provided some cardioprotective benefits, the hearts of rats that had eaten the fresh-crushed garlic had less damage and better recovery after blood flow was restricted for 30 minutes.

Among other things, the fresh-crushed garlic was better at suppressing chemicals that act as a "death signal" for heart muscle cells.

The New York Times
From TODAY, Health – Tuesday, 18-Aug-2009

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Start small

Silhouettes representing healthy, overweight, ...Image via Wikipedia

A modest weight loss is enough to reverse certain health problems

Eveline Gan,

35, Tina Rudaie is supposed to be at the prime of her life. But since the time she was young, she has been so debilitated by her weight that even a 5-minute walk leaves her in pain and gasping.

Last year, the mother-of-one weighed 173kg, more than twice the healthy weight for someone who is 1.57m tall. This brought on problems such as back pain, osteoarthritis in the knees, Type 2 diabetes, hypertension and high cholesterol.

Tina decided to turn her life around when her mother, who was also severely obese - she weighed about 200kg - died from diabetes-related complications. She sought help at the Singapore General Hospital (SGH) Life Centre, a one-stop centre for people with lifestyle-related health conditions.

"I told myself I need to survive for my daughter's sake. She's only 13," said Tina.

Tina went on to lose 39kg after a gastric bypass early this year. But it didn't take such a drastic weight loss before her health improved. Just three days after the surgery, she no longer required medication for diabetes. Three months later, she was able to stop medication for hypertension and high cholesterol. By then, she had lost about 15 per cent, or 27kg, of her initial weight.

Turning the tide

According to Dr Kwek Hwei Min, a sports medicine registrar at Changi Sports Medicine Centre at Changi General Hospital, weight reduction can indeed help reverse or improve obesity-related conditions such as Type 2 diabetes and hypertension.

In fact, said Dr Tham Kwang Wei, a consultant endocrinologist and director of SGH's Obesity and Metabolic Unit, a weight loss of about 5 to 10 per cent of one's body weight is enough to achieve this.

"People can be quite unrealistic when setting weight-loss targets. They think they need to lose a lot of weight in one go to see the effect. In fact, a modest weight loss of 5 per cent of one's body weight can yield significant benefits such as decreasing blood pressure and reducing the risk of diabetes by up to 60 per cent," said Dr Tham.

And although medication and surgical interventions can help, both doctors stressed that making lifestyle changes is key to managing obesity.

A belly full of health risks

Dr Tham said the larger-than-usual waistline of the obese puts them at extra risk. Excess abdominal fat produces chemicals called adipokines, which increase the risk of heart disease and diabetes.

"How you lose weight is important, as it is more favourable to lose fat than muscle during weight loss. For example, when you incorporate exercise in your weight-loss regime, it helps you lose metabolically active fats around your waist.

This decreases the amount of harmful adipokines produced. Exercise also helps lower blood sugar levels, important in preventing and treating Type 2 diabetes," explained Dr Tham.

For the overweight, weighing less also has other health benefits. "Besides reduced pain for those suffering from knee osteoarthritis, you'll see an improvement in mobility and breathing," said Dr Kwek.

But the doctors cautioned against creating a drastic diet or extreme exercise regimen on your own if you're obese.

"Obese patients with medical conditions like diabetes should first undergo a medical examination. This is to ensure their blood sugar levels are well controlled and that there is no underlying heart disease," said Dr Kwek. She added that a safe weight-loss guide is a lost of about 0.5kg to 1kg per week, until the target weight is achieved.

Dr Tham added: "Without medical supervision, you could end up losing more muscle than fat, or end up with malnutrition, or vitamin and mineral deficiencies. Extreme exercise regimes also put one at risk for injuries."

Tina, who hopes to eventually meet her target weight of 100kg, now enjoys activities she has never been able to do before, such as taking long, uninterrupted walks in the park with her daughter. She said: "Now, I can walk very far and I don't feel tired at all. I've never felt healthier and happier."

From TODAY, Health – Tuesday, 18-Aug-2009

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Thursday, September 3, 2009

Eat wisely to lower your risk

Roast beefImage via Wikipedia



AS THE saying goes, you are what you eat. But what you eat - and how your food is prepared - can go a long way in helping to keep various forms of cancer at bay.

There is "enough evidence that vegetables are the least cancer-causing food" Dr William G Nelson, a leading cancer researcher at Johns Hopkins University, told Today in an interview recently.

"For fruits and vegetables, the colours are the antioxidants that seem to be protective - blue in blueberries, red in chillies ...

"Cauliflower, broccoli, daikon (radish), bak choy, which are more common in Asian cuisine, have these protective substances in them," he added.

Studies have also shown that condiments, such as wasabi and Chinese mustard, offered some form of protection against carcinogens in laboratory animals which had been fed with them.

While, as Dr Nelson put it, "there's no downside to vegetables", red meat is something that you may want to think twice before indulging in generous amounts.

"If you look at prostate cancer/breast cancer, colorectal cancer ... the risks seem to be higher when people eat in particular, red meats," said Dr Nelson, who is Marion I Knott Professor of Oncology and Director of the Sidney Kimmel Comprehensive Cancer Centre at Johns Hopkins.

Load up on greens as there is enough evidence that vegetables are the least cancer-causing food. AP

Research has suggested a link between the way red meat is prepared and cancer.

"The risk seems to be higher when people eat in particular - red meats cooked to very high temperatures or over a flame", Dr Nelson said.
This is because carcinogens are created in food at high temperatures. Some safer food preparation methods are baking and steaming, rather than pan-frying and charbroiling, he added.

"Eating things that are extremely hot ... can increase the risk of cancer. You want to avoid eating scalding food; this increases the risk of oesophagus cancer," said Dr Nelson, who was in Singapore last week to meet local cancer researchers.

Ultimately, the key to reducing the cancer risk may lie in a simple practice - whatever food you take, have it in moderate amounts.

"If you're eating that type of food three or four times a day, that's not good for you," said Dr Nelson, who is his early 50s.

Dr Nelson, whose focus of research is prostate cancer, noted that the disease is "at an epidemic level in the Western world". And while it is "not as high in Asia", it is increasing. "Overall, 70 to 80 per cent of cancer can be attributed to environmental lifestyle, which includes cigarette smoking and the next most common is diet," he said.

As to the genetic element, Dr Nelson said the risk of "genetics hit around 40 per cent". Studies have shown that Asian migrants to North America typically lose their gastric cancer risk within one generation. However, the very same group increase their risk to "Western world" cancers, such as prostate and colorectal cancer.

"The question is what did they do? It is not genetics in this case, a lot of it is lifestyle, and most people think it's diet."

Thus, a person who is "genetically susceptible" to cancer may have a greater risk of getting the disease due to his diet or lifestyle.

As such, "personalised treatment" for people with "personalised risk" may be the way of the future when it comes to treating cancer patients, Dr Nelson added.

From TODAY, Home – Wednesday, 12-Aug-2009

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When nature calls ... a little too often

Frequent urination could indicate an enlarged prostate

Eveline Gan

FIVE years ago, Felix (not his real name) began to urinate more frequently. He initially brushed it off as work stress or another sign of ageing. He was then 56 years old.

Then, his trips to the toilet - which took place every half an hour - began to affect his daily routine. Locating the nearest toilet became top priority.

"It was so inconvenient. I became afraid of travelling or even doing simple things like watching a movie. When I had to take a flight, I would book seats by the aisles so my regular trips to the toilet wouldn't disturb my fellow passengers," said the 61-year-old architect.

For many older men, such annoying and embarrassing experiences are a sign of an enlarged prostate, a condition known as benign prostate hyperplasia in medical speak.

Aside from frequent runs to the toilet, another symptom is having a slow urine stream. This means that sufferers will take a longer time to urinate.

Without treatment, the problem gets progressively worse, said Dr Michael Wong, president of the Singapore Urological Association.

"It doesn't go away on its own. A man's lifestyle can be completely changed because of his need to go to the toilet so often," he said.

"In the worst case scenario, the bladder builds up and the man is unable to pee. He will have to rush to the hospital so the urine can be drained." Dr Wong added. This occurs in about 3 per cent of patients.

Aside from frequent runs to the loo, another symptom of an elarged prostate is slow urine stream.


Prostate enlargement is one of the most common urological problems in men over 50. One in two will get it and by 60, about two-thirds of men will be affected, said Dr Wong. 

For men, urine flows from the bladder through the urethra. The prostate - a walnut-sized male organ that adds lubrication to semen - sits at the "front door" of the bladder.

With age, the prostate becomes larger, obstructing the urinary tract, Dr Wong explained. 

Besides having to live with the symptoms, sufferers are at greater risk of contracting urinary tract infections.

"Every time the bladder is not emptied completely, stale urine is left behind and this can cause infections," explained Dr Wong.

Sometimes, an enlarged prostate may be an indication of prostate cancer. If so, the symptoms will only surface during the advanced stages of cancer.


Most men delay seeking medical attention until their daily routines are affected, said Tan Tock Seng Hospital's nurse clinician Heng Lee Choo, who has 12 years' experience in counselling patients with enlarged prostate.

She said that many of them have a fatalistic mindset.

"They believe it's a part of the ageing process, and that there's nothing they can do about it. Plus, such problems are not something you'd discuss with anyone," said Ms Heng.

What men fear the most, added Ms Heng, is hearing that they need surgery.

"They are usually worried. Most of them don't even know where their prostate is. They think the doctor will cut into their penis or abdomen, or remove their testicles," she said.

In mild cases, surgery is not necessary. In fact, there's less need to operate with the roll-out of advanced drugs that help to shrink the size of the prostate and alleviate symptoms, said Dr Wong.

He added that current medication for an enlarged prostate also reduces a man's chances of getting prostate cancer by up to 24 per cent. With medication, the success rate is about 85 per cent.

Only when medication fails or there are complications will surgery be required. It usually involves a tiny tube being passed through the urethra to remove the prostate. The good news is, with current technology, prostate surgery is "virtually bloodless", Dr Wong said.

For Felix, timely medical attention and medication have helped him recover swiftly.

From TODAY, Health – Tuesday, 11-Aug-2009

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