20070423

Diabetes - Preventing Type 2 Diabetes



"Preventing Type 2 Diabetes"

Sam Kitching: I certainly don't want diabetes. That's one of the greatest fears -- it caused my mother to lose her eyesight prematurely, sores would not heal, the medication was terribly expensive and awfully inconvenient.

Carmencita Domingo: My biggest fear is not to get what my aunts and aunties had, both on my father and my mother's side and that is diabetes.

Frenchy Risco: Without question, diabetes is a silent killer. It is devastating in the Afro-American community and most people of color. Absolutely devastating.

Announcer: These people are talking about diabetes, a serious disease affecting over 18 million people in the United States.

Dr. James Gavin: The groups that are at risk for diabetes and therefore who are the targets for this program include African-Americans, Native Americans, Asian and Pacific Islanders, groups like Latinos and older citizens -- people over the age of 60.

Announcer: Millions of people are at risk for diabetes. Although there is no cure for Type II diabetes, those at risk can take steps to prevent the disease.

Dr. James Gavin: Once a person is diagnosed with Type II diabetes, there is no known cure. There are very effective treatments and we've done very well in treating and controlling this disease, but the complications are serious, they are devastating, they are expensive and that's why it is so important that we prevent this disease in the first place.

Announcer: Risk factors for Type II diabetes include being over 45 years of age, being overweight, having high blood pressure or abnormal cholesterol, having a family history of the disease. Recent research has shown that you can sharply lower your chance of getting Type II diabetes. According to a new campaign for the U.S. Department of Health and Human Services called Small Steps, Big Rewards, taking small steps can help.

Dr. James Gavin: We now have the evidence from important clinical trials, major studies, to show that even if you are overweight, at very high risk and the age 45 and over age group, you can, by taking small steps -- physical activity, changing your eating patterns and your eating behavior, you can actually prevent the development of Type II diabetes.

Announcer: Sam Kitching is taking that advice. Not only has he started exercising -- bike riding with his wife and working out at the local gym to lose weight -- but he has also changed his diet.

Sam Kitching: We're not eating some of the things that we actually grew up eating and had to change the patterns of the way we did it. We no longer keep the big red bucket of ice cream in the freezer, no longer keep the chips and the cookies for the grandkids in the closet.

Announcer: Frenchy Risco also recognizes the importance of changing his diet.

Frenchy Risco: You will have high blood pressure and diabetes before you know it and that's because for years we've had improper diets, improper ways that we cook our food and when it's generation after generation and you don't know any better, the end result is that you don't change and it's imperative that everybody change their diet.

Announcer: Frenchy was so determined to change his eating habits that he enrolled in classes to learn how to cook healthier food.

Frenchy Risco: At this class, they taught us how to cook it -- not only did they cook it for you, so that you could see what it should look like and what it should taste like, then they teach you how to do it yourself. You'd be surprised at what some of this food tastes like -- so good!

Announcer: Dr. Gavin, who heads up the National Diabetes Education Program, emphasizes that it's the small steps that can make the difference.

Dr. James Gavin: In this campaign we are really trying to get people to understand that it is not necessary to run a marathon, it is not necessary to go to the gym every day. Small steps are required. 150 minutes of walking a week, 30 minutes a day for five days a week. It is not necessary to go on a starvation diet. It is not necessary to lose 100 pounds. Five to seven percent of your starting body weight. For a 200 pound person -- 15 pounds over a two-year period. Small steps.

Announcer: Carmencita Domingo is doing just that -- she's taking small steps with older adults in her community by getting them to exercise.

Carmencita Domingo: I will tell my friends and family how good it is to have a good health because you are not sick, you are not miserable, and there are ways to follow it, to prevent it and that is by the combination of good, healthy eating, portion control and exercise.

Dr. James Gavin: When you realize that the small investment of increasing your activity by doing something as simple as walking could cut your risk for heart attacks, blindness, strokes, kidney failure, amputations, that's an investment worth making. Small step, a huge reward.

Diabetes Defined

If you have diabetes, your body cannot make or properly use insulin. Insulin is a hormone that helps control the sugar, or glucose, in your blood. Glucose is the main source of fuel for your body.

When you have diabetes, the levels of blood glucose are too high. High blood glucose can cause symptoms such as blurred vision, frequent urination, increased thirst, unintended weight loss, slow healing sores, and feelings of hunger and tiredness. However, some people with diabetes do not have symptoms.

Diabetes is a serious disease. Over time, diabetes that is not well controlled causes serious damage to the eyes, kidneys, nerves, and heart.

About 18.2 million Americans, or 6.2 percent of the population, have diabetes. Thirteen million people have diagnosed diabetes, while an estimated 5.2 million people are undiagnosed. More than 8 million people 60 years or older have diabetes. This figure represents 18.3 percent of that age group.

About 5 to 10 percent of people with diabetes have type 1 diabetes. Type 1 diabetes usually occurs in children, teenagers, or adults under age 30. In people with type 1 diabetes, the body can no longer produce insulin.

About 90 percent of people in the United States with diabetes have type 2 diabetes. It is most common in adults over age 40, and the risk of getting type 2 diabetes increases with age. With this form of diabetes, the body does not always produce enough insulin or does not use insulin efficiently. Being overweight and inactive increases the chances of developing type 2 diabetes.

Type 2 diabetes is also more common in people with a family history of diabetes and in African Americans, Hispanic Americans, American Indians and Alaska Natives, and Asian and Pacific Islanders.

Some women develop gestational diabetes during the late stages of pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too high or too low. About two-thirds of people with diabetes die of heart disease, so it is also important to control blood pressure and cholesterol. This may require taking medications prescribed by a doctor.

When blood glucose levels drop too low, a condition known as hypoglycemia, a person can become nervous, shaky, and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia. Diabetics may go into a coma if their blood sugar levels rise too high.

Strict control of blood glucose as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes. People who take steps to control their diabetes can make a big difference in their health. If you have diabetes, stick to a diet plan, monitor your blood sugar, exercise regularly, take prescribed medication, and make healthy lifestyle choices.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070416

Glaucoma - What is Glaucoma?



Glaucoma Defined

Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. While glaucoma can strike anyone, the risk is much greater for people over 60.

There are several different types of glaucoma. Most of these involve the drainage system within the eye. At the front of the eye there is a small space called the anterior chamber. A clear fluid flows through this chamber and bathes and nourishes the nearby tissues.

In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and result in loss of vision.

The most common type of glaucoma is called open-angle glaucoma. In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet. When fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build. If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result.

There is no cure for glaucoma. Vision lost from the disease cannot be restored. However, there are treatments that may save remaining vision. That is why early diagnosis is important.



Glaucoma - Causes and Risk Factors

Nearly 2.2 million people have glaucoma, a leading cause of blindness in the United States. Although anyone can get glaucoma, some people are at higher risk. They include
African-Americans over age 40
everyone over age 60, especially Mexican-Americans
people with a family history of glaucoma.

Studies show that glaucoma is
five times more likely to occur in African-Americans than in whites
about four times more likely to cause blindness in African-Americans than in whites
fifteen times more likely to cause blindness in African Americans between the ages of 45-64 than in whites of the same age group.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Glaucoma - Early Diagnosis, Timely Treatment



Glaucoma - Symptoms and Diagnosis

Glaucoma can develop in one or both eyes. The most common type of glaucoma, open-angle glaucoma, has no symptoms at first. It causes no pain, and vision seems normal.

Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.

Glaucoma is detected through a comprehensive eye exam that includes a visual acuity test, visual field test, dilated eye exam, tonometry, and pachymetry.

A visual acuity test uses an eye chart test to measure how well you see at various distances.

A visual field test measures your side or peripheral vision. It helps your eye care professional tell if you have lost side vision, a sign of glaucoma.

In a dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

In tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

With pachymetry, a numbing drop is applied to your eye. Your eye care professional uses an ultrasonic wave instrument to measure the thickness of your cornea.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Glaucoma - Coping with Glaucoma



Glaucoma - Treatment

Although open-angle glaucoma cannot be cured, it can usually be controlled. While treatments may save remaining vision, they do not improve sight already lost from glaucoma.
The most common treatments for glaucoma are medication and surgery.

Medications for glaucoma may be either in the form of eye drops or pills. Some drugs reduce pressure by slowing the flow of fluid into the eye. Others help to improve fluid drainage.

For most people with glaucoma, regular use of medications will control the increased fluid pressure. But, these drugs may stop working over time. Or, they may cause side effects. If a problem occurs, the eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem.

Laser surgery is another treatment for glaucoma. During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This results in a series of small changes that makes it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs.

Researchers are studying the causes of glaucoma and are looking for ways to improve its diagnosis and treatment. For instance, the National Eye Institute, or NEI, is funding a number of studies to find out what causes fluid pressure to increase in the eye.

By learning more about this process, doctors may be able to find the exact cause of the disease and better learn how to prevent and treat it. The NEI also supports clinical trials of new drugs and surgical techniques that show promise against glaucoma.

Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. So, if you fall into one of the high-risk groups for the disease, make sure to have your eyes examined through dilated pupils at least every two years by an eye care professional.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070413

Prostate Cancer "Detecting Prostate Cancer"



Prostate Cancer - Causes and Risk Factors
Scientists don't know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease.

Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 65 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 70.

Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men.

A man's risk for developing prostate cancer is higher if his father or brother has had the disease.

Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

Scientists have wondered whether an enlarged prostate, a condition also known as benign prostatic hyperplasia or BPH, might increase the risk for prostate cancer. They have also studied obesity, lack of exercise, smoking, radiation exposure, and a sexually transmitted virus to see if they might increase risk. But at this time, there is little evidence that any of these factors contribute to an increased risk.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Prostate Cancer "External Radiation Therapy"



Symptoms and Diagnosis

Most cancers in their early, most treatable stages don't cause any symptoms. Early prostate cancer usually does not cause symptoms.

However, if prostate cancer develops and is not treated, it can cause these symptoms:
a need to urinate frequently, especially at night
difficulty starting urination or holding back urine

Possible symptoms of prostate cancer:
inability to urinate
weak or interrupted flow of urine
painful or burning urination

Possible symptoms of prostate cancer:
difficulty in having an erection
painful ejaculation
blood in urine or semen
pain or stiffness in the lower back, hips, or upper thighs.

Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If you have any of these symptoms, see your doctor or a urologist right away to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system.

The doctor will ask questions about your medical history and perform a digital rectal exam to try to find the cause of the prostate problems. In this exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean cancer is present.

The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present.

Neither of these screening tests for prostate cancer is perfect. Screening tests check for disease in a person who shows no symptoms. Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers.

The doctor may order other exams, including ultrasound and x-rays, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope.

If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope.

One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Prostate Cancer "Surviving Prostate Cancer"



Prostate Cancer -Treatments and Research - Planning Treatment

If tests show that you have cancer, you should talk with your doctor in order to make treatment decisions.

A team of specialists often treats people with cancer. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others.

Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it.

Some prostate cancer patients take part in studies of new treatments. These studies -- called clinical trials -- are designed to find out whether a new treatment is safe and effective.

Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Men with prostate cancer who are interested in taking part in a clinical trial should talk with their doctor.

Prostate Cancer - Treatments and Research - Staging Prostate Cancer

If cancer is found in the prostate, the doctor needs to know the stage of the disease and the grade of the tumor. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The grade tells how closely the tumor resembles normal tissue in appearance under the microscope.

Doctors use various blood and imaging tests to learn the stage of the disease. Imaging tests, such as ultrasound and magnetic resonance imaging, or MRI, produce pictures of images inside the body.

There are four stages used to describe prostate cancer. Doctors may refer to the stages using the Roman numerals I-IV or the capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.

Stage I or Stage A -- The cancer is too small to be felt during a rectal exam and causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate. A sub-stage, T1c, is a tumor identified by needle biopsy because of elevated PSA.

Stage II or Stage B -- The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.

Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues. The person may be experiencing symptoms, such as problems with urination.

Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body. The bones are a common site of spread of prostate cancer. There may be problems with urination, fatigue, and weight loss.

Prostate Cancer - Treatments and Research - Standard Treatments

There are a number of ways to treat prostate cancer, and the doctor will develop a treatment to fit each man's needs. The choice of treatment mostly depends on the stage of the disease and the grade of the tumor. But doctors also consider a man's age, general health, and his feelings about the treatments and their possible side effects.

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is the goal for men whose prostate cancer is diagnosed early.

You and your doctor will want to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life.

Surgery, radiation therapy, and hormonal therapy all have the potential to disrupt sexual desire or performance for a short while or permanently. Discuss your concerns with your health care provider. Several options are available to help you manage sexual problems related to prostate cancer treatment.

The doctor may suggest watchful waiting for some men who have prostate cancer that is found at an early stage and appears to be growing slowly. Also, watchful waiting may be advised for older men or men with other serious medical problems.

For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits. Doctors monitor these patients with regular check-ups. If symptoms appear or get worse, the doctor may recommend active treatment.

Surgery is used to remove the cancer. It is a common treatment for early stage prostate cancer. The surgeon may remove the entire prostate with a type of surgery called radical prostatectomy or, in a few cases, remove only part of it.

Sometimes the surgeon will also remove nearby lymph nodes. Side effects of the operation may include lack of sexual function or impotence, or problems holding urine or incontinence.

Improvements in surgery now make it possible for some men to keep their sexual function. In some cases, doctors can use a new technique known as nerve-sparing surgery. This may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.

Some men with trouble holding urine may regain control within several weeks of surgery. Others continue to have problems that require them to wear a pad.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Doctors may recommend it instead of surgery or after surgery to destroy any cancer cells that may remain in the area.

In advanced stages, the doctor may recommend radiation to relieve pain or other symptoms. It may also be used in combination with hormonal therapy. Radiation can cause problems with impotence and bowel function.

The radiation may come from a machine, which is external radiation, or from tiny radioactive seeds placed inside or near the tumor, which is internal radiation. Men who receive only the radioactive seeds usually have small tumors. Some men receive both kinds of radiation therapy.

For external radiation therapy, patients go to the hospital or clinic -- usually 5 days a week for several weeks. Internal radiation may require patients to stay in the hospital for a short time.

Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. This treatment is often used for prostate cancer that has spread to other parts of the body.

Sometimes doctors use hormonal therapy to try to keep the cancer from coming back after surgery or radiation treatment. Side effects can include impotence, hot flashes, loss of sexual desire, and thinning of bones. Some hormone therapies increase the risk of blood clots.

Regardless of the type of treatment you receive, you will be closely monitored to see how well the treatment is working. Monitoring may include
a PSA blood test -- usually every 3 months to 1 year.
bone scan and/or CT scan to see if the cancer has spread.

Monitoring may include
a complete blood count to monitor for signs and symptoms of anemia.
looking for signs or symptoms that the disease might be progressing, such as fatigue, increased pain, or decreased bowel and bladder function.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Prostate Cancer "What is Prostate Cancer?"



Prostate Cancer Defined

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong -- cells become abnormal and form more cells in an uncontrolled way.

These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Prostate cancer occurs when a malignant tumor forms in the tissue of the prostate, a gland in the male reproductive system. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive.

The prostate is about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate's main function is to make fluid for semen, a white substance that carries sperm.

Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 65 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age.

Sometimes, cancer cells break away from a malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body.

When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer -- not bone cancer. Doctors sometimes call this "distant" disease.

Today, more men are surviving prostate cancer than ever before. Treatment can be effective, especially when the cancer has not spread beyond the region of the prostate.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070412

Shingles "What is Shingles?"



Shingles - About Shingles

Shingles is very common. Fifty percent of all Americans will have had shingles by the time they are 80. While shingles occurs in people of all ages, it is most common in 60- to 80-year-olds.

Shingles is a painful skin disease caused by a reactivation of the chickenpox virus. It is distinctive because it affects only one side of the body. The early signs of shingles usually develop in three stages: severe pain or tingling, possibly itchy rash, and blisters that look like chickenpox.

The name shingles comes from the Latin word cingulum, which means "belt" or "girdle." The scientific name for the virus that causes shingles is varicella-zoster, combining the Latin word for "little pox" with the Greek word for "girdle." Another name for shingles is herpes zoster.

The virus that causes shingles is a herpes virus. Once you are infected with this kind of virus, it remains in your body for life. It stays inactive until a period when your immunity is down.

If you have had chickenpox, shingles is not contagious. Nothing will happen to you if you are exposed to someone who has shingles. If you have never had chickenpox, however, avoid contact with anyone who has shingles; the fluid from their open blisters is infectious. You will not get shingles, but you could get chickenpox if exposed.

If you have not had chickenpox and you come into contact with someone who has shingles, ask your doctor whether you should get a chickenpox vaccination.

Unlike chickenpox, with shingles, the virus is NOT transmitted by someone breathing or coughing on you. You have to come in contact with the blister fluid itself. Once the blisters scab over, the contagious period is ended.

The pain of shingles can be debilitating. If it is severe and persists for months or years, it is called postherpetic neuralgia. And unfortunately, persistent pain is a common symptom in people over 60.

Outbreaks that start on the face or eyes can cause vision or hearing problems. Even permanent blindness can result if the cornea of the eye is affected.

Bacterial infection of the open sores can lead to scarring. In a very small number of cases, bacteria can cause more serious conditions, including toxic shock syndrome and necrotizing fasciitis, a severe infection that destroys the soft tissue under the skin.

The burning waves of pain, loss of sleep, and interference with even basic life activities can cause serious depression.

In patients with immune deficiency, the rash can be much more extensive than usual and the illness can be complicated by pneumonia. These cases are more serious, but they are rarely fatal.

If you are basically healthy, shingles usually resolves without complications. You are not likely to ever get it again!
More importantly, the new shingles vaccine may one day make shingles a rare disease.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Shingles "My Experience with Shingles"



Shingles -Causes and Risk Factors

Shingles is caused by a germ called varicella-zoster virus -- the one that gave you chickenpox when you were a child. As you recovered from chickenpox, the sores healed and the other symptoms went away, but the virus remained. It is with you for life.

The virus hides out in nerve cells, usually in the spine. But it can reactivate. Somehow, the virus gets a signal that your immunity has become weakened. This triggers the reactivation.

In the reactivation, the virus follows a nerve path called a dermatome. The nerve path begins at specific points in the spine, continues around one side of the body, and surfaces at the nerve endings in the skin. The pattern of the rash reflects the location of that nerve path.

The leading risk factor for shingles is a history of having had chickenpox. One out of every five people who have had chickenpox is likely to get shingles.

Another risk factor is aging. As we age, our natural immunity gradually loses its ability to protect against infection. The shingles virus can take advantage of this and reactivate.

Conditions that weaken immunity can also put people at risk for shingles. Shingles is especially dangerous for anyone who has had cancer, radiation treatments for cancer, HIV infection, or a transplant operation.

Most cases of shingles occur in adults. Only about 5 percent of cases occur in children. With children, immune deficiency is the primary risk factor, but children who had chickenpox before they were one year old may also get shingles before they become adults.

There have been studies of adults who had chickenpox as children and were later exposed to children who had chickenpox. Interestingly, that exposure apparently boosted the adult's immunity, which actually helped them avoid getting shingles later in life.

Stress is another factor that may contribute to outbreaks. While stress alone does not cause the outbreaks, shingles often occurs in people who have recently had a stressful event in their lives.

Symptoms and Diagnosis

An outbreak of shingles usually begins with a burning, itching, or tingling sensation on the back, chest, or around the rib cage or waist. It is also common for the face or eye area to be affected.

Some people report feeling feverish and weak during the early stages. Usually within 48 to 72 hours, a red, blotchy rash develops on the affected area. The rash erupts into small blisters that look like chickenpox. The blisters seem to arrive in waves over a period of three to five days.

The blisters tend to be clustered in one specific area, rather than being scattered all over the body like chickenpox. The torso or face are the parts most likely to be affected, but on occasion, shingles breaks out in the lower body. The burning sensation in the rash area is often accompanied by shooting pains.

After the blisters erupt, the open sores take a week or two to crust over. The sores are usually gone within another two weeks. The pain may diminish somewhat, but it often continues for months -- and can go on for years.

Shingles can be quite painful. Many shingles patients say that it was the intense pain that ultimately sent them to the doctor. They often report that the sensation of anything brushing across the inflamed nerve endings on the skin is almost unbearable.

A typical shingles case is easy to diagnose. The doctor might suspect shingles if

the rash is only on one side of the body

the rash erupts along one of the many nerve paths, called dermatomes, that stem from the spine

The doctor usually confirms a diagnosis of shingles if the person also

reports a sharp, burning pain

has had chickenpox

has blisters that look like chickenpox

is elderly.

Some people go to the doctor because of burning, painful, itchy sensations on one area of skin, but they don't get a rash. If there is no rash, the symptoms can be difficult to diagnose because they can be mistaken for numerous other diseases.

In cases where there is no rash or the diagnosis is questionable, doctors can do a blood test. If there is a rash, but it does not resemble the usual shingles outbreak, skin scrapings from the sores can also be used.


The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070411

Macular Degeneration "Living with Macular Degeneration"



Macular Degeneration - Defined

Age-related macular degeneration, also known as AMD, is an eye disease that affects the macula, a part of the retina. The retina sends light from the eye to the brain, and the macula allows you to see fine detail.

AMD blurs the sharp central vision you need for straight-ahead activities such as reading, sewing, and driving. AMD causes no pain.

In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. AMD is a leading cause of vision loss in Americans 60 years of age and older.

There are two forms of age-related macular degeneration -- dry and wet.

AMD Defined - Wet AMD

Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye.

An early symptom of wet AMD is that straight lines appear wavy. If you notice this condition or other changes to your vision, contact your eye care professional at once. You need a comprehensive dilated eye exam.

With wet AMD, loss of central vision can occur quickly. Wet AMD is considered to be advanced AMD and is more severe than the dry form.

AMD Defined - Dry AMD

Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision in the affected eye can be lost gradually.

The most common symptom of dry AMD is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.

One of the most common early signs of dry AMD is drusen. Drusen are yellow deposits under the retina. They often are found in people over age 60. Your eye care professional can detect drusen during a comprehensive dilated eye exam.

Dry AMD has three stages -- early AMD, intermediate AMD, and advanced dry AMD. All of these may occur in one or both eyes.

People with early dry AMD have either several small drusen or a few medium-sized drusen. At this stage, there are no symptoms and no vision loss.

People with intermediate dry AMD have either many medium-sized drusen or one or more large drusen. Some people see a blurred spot in the center of their vision. More light may be needed for reading and other tasks.

In addition to drusen, people with advanced dry AMD have a breakdown of light-sensitive cells and supporting tissue in the macula. This breakdown can cause a blurred spot in the center of your vision.

Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing faces until they are very close to you.

If you have vision loss from dry AMD in one eye only, you may not notice any changes in your overall vision.

With the other eye seeing clearly, you can still drive, read, and see fine details. You may notice changes in your vision only if AMD affects both eyes. If you experience blurry vision, see an eye care professional for a comprehensive dilated eye exam.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Macular Degeneration "Coping with Macular Degeneration"



Macular Degeneration - Symptoms and Diagnosis

AMD is detected during a comprehensive eye exam that includes a visual acuity test, a dilated eye exam, and tonometry.

The visual acuity test is an eye chart test that measures how well you see at various distances.

In the dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Then, your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

With tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
Your eye care professional also may do other tests to learn more about the structure and health of your eye.

During an eye exam, you may be asked to look at an Amsler grid, shown here. You will cover one eye and stare at a black dot in the center of the grid.

While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD.

Because dry AMD can turn into wet AMD at any time, you should get an Amsler grid from your eye care professional. You could then use the grid every day to evaluate your vision for signs of wet AMD.

If your eye care professional believes you need treatment for wet AMD, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your eye. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

Macular Degeneration - Treatments and Research

Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage.

The National Eye Institute's Age-Related Eye Disease Study found that taking certain vitamins and minerals may reduce the risk of developing advanced AMD.

Wet AMD can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment.

Laser surgery uses a laser to destroy the fragile, leaky blood vessels. Only a small percentage of people with wet AMD can be treated with laser surgery. Laser surgery is performed in a doctor's office or eye clinic.

The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary. In some cases, vision loss may progress despite repeated treatments.

With photodynamic therapy, a drug called verteporfin is injected into your arm. It travels throughout the body, including the new blood vessels in your eye. The drug tends to stick to the surface of new blood vessels.

Next, the doctor shines a light into your eye for about 90 seconds. The light activates the drug. The activated drug destroys the new blood vessels and leads to a slower rate of vision decline.

Unlike laser surgery, verteporfin does not destroy surrounding healthy tissue. Because the drug is activated by light, you must avoid exposing your skin or eyes to direct sunlight or bright indoor light for five days after treatment. Photodynamic therapy is relatively painless. It takes about 20 minutes and can be performed in a doctor's office.

Photodynamic therapy slows the rate of vision loss. It does not stop vision loss or restore vision in eyes already damaged by advanced AMD. Treatment results often are temporary. You may need to be treated again.

Wet AMD can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor.

You will need multiple injections that may be given as often as monthly. The eye is numbed before each injection. After the injection, you will remain in the doctor's office for a while and your eye will be monitored. This drug treatment can help slow down vision loss from AMD and in some cases improve sight.

If you have lost some sight from AMD, don't be afraid to use your eyes for reading, watching TV, and other routine activities. Normal use of your eyes will not damage your vision further.

If you have lost some sight from AMD, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision.
Many community organizations and agencies offer information about low vision counseling and training and other special services for people with visual impairments.

The National Eye Institute is conducting and supporting a number of studies to learn more about AMD.

For example, scientists are
studying the possibility of transplanting healthy cells into a diseased retina
evaluating families with a history of AMD to understand genetic and hereditary factors that may cause the disease
looking at certain anti-inflammatory treatments for the wet form of AMD

This research should provide better ways to detect, treat, and prevent vision loss in people with AMD.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070410

Stroke "What Happens During a Stroke"



Stroke Prevention and Diagnosis
Stroke is preventable and treatable. A better understanding of the causes of stroke has helped people make lifestyle changes that have cut the stroke death rate nearly in half in the last two decades.

While family history of stroke plays a role in your risk, there are many risk factors you can control:
If you have high blood pressure, work with your doctor to get it under control. Managing your high blood pressure is the most important thing you can do to avoid stroke.


If you smoke, quit.

Risk factors you can control:
If you have diabetes, learn how to manage it. Many people do not realize they have diabetes, which is a major risk factor for heart disease and stroke.


If you are overweight, start maintaining a healthy diet and exercising regularly.

Risk factors you can control:
If you have high cholesterol, work with your doctor to lower it. A high level of total cholesterol in the blood is a major risk factor for heart disease, which raises your risk of stroke.

Physicians have several diagnostic techniques and imaging tools to help diagnose stroke quickly and accurately. The first step in diagnosis is a short neurological examination, or an evaluation of the nervous system.

When a possible stroke patient arrives at a hospital, a health care professional, usually a doctor or nurse, will ask the patient or a companion what happened and when the symptoms began. Blood tests, an electrocardiogram, and a brain scan such as computed tomography or CT, or magnetic resonance imaging or MRI, will often be done.

One test that helps doctors judge the severity of a stroke is the standardized NIH Stroke Scale, developed by the National Institute of Neurological Disorders and Stroke at the National Institutes of Health, or NIH. Health care professionals use the NIH Stroke Scale to measure a patients neurological deficits by asking the patient to answer questions and to perform several physical and mental tests.

Other scales include the Glasgow Coma Scale, the Hunt and Hess Scale, the Modified Rankin Scale, and the Barthel Index.

Health care professionals also use a variety of imaging devices to evaluate stroke patients. The most widely used imaging procedure is the computed tomography or CT scan, also known as a CAT scan. A CT scan creates a series of cross-sectional images of the head and brain.

Because it is readily available at all hours at most major hospitals and produces images quickly, the CT scan is the most commonly used diagnostic technique for acute stroke. A CT scan also has unique diagnostic benefits. It will quickly rule out a hemorrhage, and can occasionally show a tumor that might mimic a stroke.

A CT scan may even show evidence of early infarction -- an area of tissue that is dead or dying due to a loss of blood supply. Infarctions generally show up on a CT scan about six to eight hours after the start of stroke symptoms.

If a stroke is caused by hemorrhage, or bleeding into the brain, a CT scan can show evidence of this almost immediately after stroke symptoms appear. Hemorrhage is the primary reason for avoiding certain drug treatments for stroke, such as thrombolytic therapy, the only proven acute stroke therapy for ischemic stroke.

Thrombolytic therapy cannot be used until the doctor can confidently diagnose the patient as suffering from an ischemic stroke because this treatment might increase bleeding and could make a hemorrhagic stroke worse.

Another imaging technique used for stroke patients is the magnetic resonance imaging or MRI scan. MRI uses magnetic fields to detect subtle changes in the content of brain tissue. One effect of stroke is the slowing of water movement, called diffusion, through the damaged brain tissue, and MRI can show this type of damage within the first hour after the stroke symptoms start.

MRI and CT are equally accurate for determining when hemorrhage is present. The benefit of MRI over a CT scan is more accurate and earlier diagnosis of infarction, especially for smaller strokes. Also, MRI is more sensitive than CT for detecting other types of brain disease, such as brain tumor, that might mimic stroke. However, MRI cannot be performed in patients with certain types of metallic or electronic implants, such as pacemakers for the heart.

Although increasingly used in the emergency diagnosis of stroke, MRI is not immediately available at all hours in most hospitals, where CT is used for acute stroke diagnosis. Also, MRI takes longer to perform than CT, and may not be performed if it would significantly delay treatment.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Stroke "Warning Signs and Risk Factors"



Warning Signs and Risk Factors - Warning Signs

If you suffer a stroke, you may not realize it at first. The people around you might not know it, either. Your family, friends, or neighbors may think you are unaware or confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke and know how to act fast.

Warning signs are clues your body sends to tell you that your brain is not receiving enough oxygen. If you observe one or more of the following signs of a stroke or "brain attack," don't wait. Call a doctor or 911 right away!

These are warning signs of a stroke:
sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
sudden confusion, trouble speaking or understanding
sudden trouble seeing in one or both eyes

Warning signs of a stroke:
sudden trouble walking, dizziness, loss of balance or coordination
sudden severe headache with no known cause

Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Sometimes the warning signs may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks, or TIAs, are sometimes called "mini-strokes."

Although brief, TIAs identify an underlying serious condition that isn't going away without medical help. Unfortunately, since they clear up, many people ignore them. Don't ignore them. Heeding them can save your life.

What should you do? Dont wait for the symptoms to improve or worsen. If you believe you are having a stroke or someone you know is having a stroke, call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Warning Signs and Risk Factors - Risk Factors

A risk factor is a condition or behavior that increases your chances of getting a disease. Having a risk factor for stroke doesn't mean you'll have a stroke. On the other hand, not having a risk factor doesn't mean you'll avoid a stroke. But your risk of stroke grows as the number and severity of risk factors increase.

High blood pressure, also called hypertension, is by far the most potent risk factor for stroke. If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Here are some ways to reduce blood pressure:
Maintain proper weight.


Avoid drugs known to raise blood pressure.

Ways to reduce blood pressure:
Cut down on salt.


Eat fruits and vegetables to increase potassium in your diet.


Exercise more.

Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.

Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure, carbon monoxide reduces the amount of oxygen your blood can carry to the brain, and cigarette smoke makes your blood thicker and more likely to clot.

Your doctor can recommend programs and medications that may help you quit smoking. By quitting -- at any age -- you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.

Heart disease, including common heart disorders such as coronary artery disease, valve defects, irregular heart beat, and enlargement of one of the heart's chambers, can result in blood clots that may break loose and block vessels in or leading to the brain. The most common blood vessel disease, caused by the buildup of fatty deposits in the arteries, is called atherosclerosis, also known as hardening of the arteries.

Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. A high level of total cholesterol in the blood is a major risk factor for heart disease, which raises your risk of stroke. Your doctor may recommend changes in your diet or medicines to lower your cholesterol.

Experiencing warning signs and having a history of stroke are also risk factors for stroke. Transient ischemic attacks, or TIAs, are brief episodes of stroke warning signs that may last only a few moments and then go away. If you experience a TIA, get help at once. Most communities encourage those with stroke's warning signs to dial 911 for emergency medical assistance.

If you have had a stroke in the past, it's important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by drawing on body systems that now do double duty. That means a second stroke can be twice as bad.

Having diabetes is another risk factor for stroke. You may think this disorder affects only the body's ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain.

Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Treating diabetes can delay the onset of complications that increase the risk of stroke.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Stroke "Act Quickly"



About Stroke - What is Stroke?

Stroke occurs in all age groups, in both sexes, and in all races in every country. It can even occur before birth, when the fetus is still in the womb.

Learning about stroke can help you act in time to save a relative, neighbor, or friend. And making changes in your lifestyle can help you prevent stroke.

A stroke is serious, just like a heart attack. A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot. When this happens, the brain cells in the immediate area begin to die.

Some brain cells die because they stop getting the oxygen and nutrients they need to function. Other brain cells die because they are damaged by sudden bleeding into or around the brain. The brain cells that don't die immediately remain at risk for death. These cells can linger in a compromised or weakened state for several hours. With timely treatment, these cells can be saved.

New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital as soon as possible after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital as quickly as possible are critical.

There are two kinds of stroke. The most common kind of stroke is called ischemic stroke. It accounts for approximately 80 percent of all strokes. An ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain.

Blockages that cause ischemic strokes stem from three conditions:
the formation of a clot within a blood vessel of the brain or neck, called thrombosis


the movement of a clot from another part of the body, such as from the heart to the neck or brain, called an embolism


a severe narrowing of an artery in or leading to the brain, called stenosis

The other kind of stroke is called hemorrhagic stroke. A hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain.

One common cause of a hemorrhagic stroke is a bleeding aneurysm. An aneurysm is a weak or thin spot on an artery wall. Over time, these weak spots stretch or balloon out due to high blood pressure. The thin walls of these ballooning aneurysms can rupture and spill blood into the space surrounding brain cells.

Artery walls can also break open because they become encrusted, or covered with fatty deposits called plaque, eventually lose their elasticity and become brittle, thin, and prone to cracking. Hypertension, or high blood pressure, increases the risk that a brittle artery wall will give way and release blood into the surrounding brain tissue.

About Stroke - Effects of a Stroke

Stroke damage in the brain can affect the entire body -- resulting in mild to severe disabilities. These include paralysis, problems with thinking, trouble speaking, and emotional problems.

A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness, or hemiparesis. The paralysis or weakness may affect only the face, an arm, or a leg, or it may affect one entire side of the body and face.

A stroke patient may have problems with the simplest of daily activities, such as walking, dressing, eating, and using the bathroom. Movement problems can result from damage to the part of the brain that controls balance and coordination. Some stroke patients also have trouble swallowing, called dysphagia.

Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory.

In some cases of stroke, the patient suffers a neglect syndrome. The neglect syndrome means that the stroke patient has no knowledge of one side of his or her body, or one side of the visual field, and is unaware of the problem. A stroke patient may be unaware of his or her surroundings, or may be unaware of the mental problems that resulted from the stroke.

Stroke victims often have a problem forming or understanding speech. This problem is called aphasia. Aphasia usually occurs along with similar problems in reading and writing. In most people, language problems result from damage to the left hemisphere of the brain.

Slurred speech due to weakness or incoordination of the muscles involved in speaking is called dysarthria, and is not a problem with language. Because it can result from any weakness or incoordination of the speech muscles, dysarthria can arise from damage to either side of the brain.

A stroke can also lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression.

Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a serious behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide. Post-stroke depression is treated as any depression is treated, with antidepressant medications and therapy.

Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke. These sensations may be due to many factors, including damage to the sensory regions of the brain, stiff joints, or a disabled limb.

An uncommon type of pain resulting from stroke is called central stroke pain or central pain syndrome or CPS. CPS results from damage to an area called the thalamus. The pain is a mixture of sensations, including heat and cold, burning, tingling, numbness, and sharp stabbing and underlying aching pain.

The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Unfortunately, since most pain medications provide little relief from these sensations, very few treatments or therapies exist to combat CPS.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

20070407

Breast Cancer "Surviving Breast Cancer"



Breast Cancer Testing And Diagnosis

Most cancers in their early, most treatable stages do not cause any symptoms. That is why it's important to have regular tests to check for cancer long before you might notice anything wrong.

When breast cancer is found early, it is more likely to be treated successfully. Checking for cancer in a person who does not have any symptoms is called screening. Screening tests for breast cancer include, among others, clinical breast exams and mammograms.

During a clinical breast exam, the doctor or other health care professional checks the breasts and underarms for lumps or other changes that could be a sign of breast cancer. A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel.

Several studies show that mammography screening has reduced the number of deaths from breast cancer. However, some other studies have not shown a clear benefit from mammography.

Scientists are continuing to examine the level of benefit that mammography can produce. For the time being, the National Cancer Institute recommends the following:
If you are a woman in your 40s, you should have mammography screening every one to two years.

If you are a woman age 50 and older, you should have mammography screening every one to two years.
If you are a woman who is at higher than average risk for breast cancer, you should seek expert medical advice about whether to begin screening before age 40 and how often to have screening mammography.

Between 5 and 10 percent of mammogram results are abnormal and require more testing. Most of these follow-up tests confirm that no cancer was present.

If needed, the most common follow-up test a doctor will recommend is called a biopsy. This is a procedure where a small amount of fluid or tissue is removed from the breast to make a diagnosis. A doctor might perform fine needle aspiration, a needle or core biopsy, or a surgical biopsy.

With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab.

For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous.

In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells.

Doctors are studying another type of surgical biopsy that removes less breast tissue. It is called an image-guided needle breast biopsy, or stereotactic biopsy. If approved for general use, it would become an important surgical tool.

Eighty percent of U.S. women who have a surgical breast biopsy do not have cancer. However, women who have breast biopsies are at higher risk of developing breast cancer than women who have never had a breast biopsy.

Other techniques used to find cancer include a new way of reading mammograms called digital mammography. Magnetic resonance imaging, or MRI, and ultrasound are two other techniques which researchers think might detect breast cancer with greater accuracy.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Breast Cancer "Radiation Treatment"



Breast Cancer Treatment And Research

There are many treatment options for women with breast cancer. The choice of treatment depends on your age and general health, the stage of the cancer, whether or not it has spread beyond the breast, and other factors.

Treatment and Research - Planning Treatment

If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better outcomes.

People with cancer often are treated by a team of specialists. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others.

Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it.

Some breast cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective.

Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Women with breast cancer who are interested in taking part in a clinical trial should talk to their doctor.

The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. Click here to see a list of the current clinical trials on breast cancer. A separate window will open. Click the "x" in the upper right hand corner of the "Clinical Trials" window to return here.

Treatment and Research - What is Staging?

Once breast cancer has been found, it is staged. Staging means determining how far the cancer has progressed. Through staging, the doctor can tell if the cancer has spread and, if so, to what parts of the body. More tests may be performed to help determine the stage. Knowing the stage of the disease helps the doctor plan treatment.

Staging will let the doctor know
the size of the tumor and exactly where it is in the breast
if the cancer has spread within the breast
if cancer is present in the lymph nodes under the arm
if cancer is present in other parts of the body

Here are the stages of breast cancer
Stage 0 — This is very early breast cancer that has not spread within or outside the breast. Doctors often refer to this type of cancer as in situ or non-invasive cancer.

Stage I and stage II also are early stages of breast cancer. Stage I means that the tumor has not spread beyond the breast. In stage II, the tumor may be larger and may have spread to the lymph nodes.

Stage III is called locally advanced cancer. Here the tumor has spread beyond the breast to lymph nodes or to other tissues near the breast.

Stage IV is metastatic cancer. In this stage the cancer has spread beyond the breast and the underarm lymph nodes to other parts of the body, most often the bones, lungs, liver, or brain.

The choice of treatment is based on many factors. For stage I, II or III cancers, the main goals are to treat the cancer and reduce the chance it will come back, either at the place where the tumor first occurred or elsewhere in the body. For stage IV cancer, the goal is to improve symptoms and prolong survival.

Treatment and Research - Standard Treatments

There are a number of treatments for breast cancer, but the ones women choose most often — alone or in combination — are surgery, radiation therapy, chemotherapy, and hormone therapy.

Here is what the standard cancer treatments are designed to do:
Surgery takes out the cancer.
Hormone therapy keeps cancer cells from getting the hormones they need to survive and grow.

Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors.
Chemotherapy uses anti-cancer drugs to kill cancer cells.

Treatment for breast cancer may involve local or whole body therapy. Doctors use local therapies, such as surgery or radiation, to remove or destroy breast cancer in a specific area. Whole body, or systemic, treatments like chemotherapy, hormonal, or biological therapies are used to destroy or control cancer throughout the body. Some patients have both kinds of treatment.

If you have early-stage breast cancer, one common treatment available to you is a lumpectomy combined with radiation therapy. A lumpectomy is surgery that preserves a woman's breast.

In a lumpectomy, the surgeon removes only the tumor and a small amount of the surrounding tissue. The survival rate for a woman who has this therapy plus radiation is similar to that for a woman who chooses a radical mastectomy, which is complete removal of a breast.

If you have breast cancer that has spread locally — just to other parts of the breast — your treatment may involve a combination of chemotherapy and surgery. Doctors first shrink the tumor with chemotherapy and then remove it through surgery. Shrinking the tumor before surgery may allow a woman to avoid a mastectomy and keep her breast.

In the past, doctors would remove a lot of lymph nodes near breast tumors to see if the cancer had spread. Some doctors are also using a method called sentinel node biopsy. Using a dye or radioactive tracer, surgeons locate the first or "sentinel" lymph node closest to the tumor, and remove only that node to see if the cancer has spread.

If the breast cancer has spread to other parts of the body, such as the lung or bone, you might receive chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. Radiation therapy may also be useful to control tumors in other parts of the body.

Treatment and Research - Latest Research

Several new technologies offer hope for making future treatment easier for women with breast cancer. Using a special tool, doctors can today insert a miniature camera through the nipple and into a milk duct in the breast to examine the area for cancer. In the future, doctors may use this tool to deliver treatment.

Researchers are testing another technique to help women who have undergone weeks of conventional radiation therapy. Using a small catheter — a tube with a balloon tip — doctors can deliver tiny radioactive beads to a place on the breast where cancer tissue has been removed. This can reduce the therapy time to a matter of days.

New drug therapies also are on the horizon. Findings from several clinical trials show that the chemotherapy drug paclitaxel combined with the drugs cyclophosphamide and doxorubicin can help women with tumors that have spread to other parts of the body.

This mix of drugs may increase the length of time you will live or the length of time you will live without cancer. It may someday prove useful for some women with localized breast cancer after they have had surgery.

New research shows women with early-stage breast cancer who took the drug letrozole, an aromatase inhibitor, after they completed five years of tamoxifen therapy significantly reduced their risk of breast cancer recurrence.

Also, other new research found a test that can predict both the risk of breast cancer recurrence and who is most likely to benefit from chemotherapy such as letrozole. Herceptin® is another drug commonly used to treat women who have a certain type of breast cancer. This drug slows or stops the growth of cancer cells by blocking Her-2, a protein found on the surface of some types of breast cancer cells.

Approximately 20 percent of breast cancers produce too much Her-2. These "Her-2 positive" tumors tend to grow faster and are generally more likely to return than tumors that do not overproduce Her-2.

Cancer treatments like chemotherapy can be systemic, meaning they affect whole tissues, organs, or the entire body. Herceptin®, however, is the first drug used to target only a specific molecule involved in breast cancer.

Results from two recent clinical trials show that those patients with early-stage Her-2 positive breast cancer who received Herceptin® in combination with chemotherapy had a 52 percent decrease in risk in the cancer returning compared with patients who received chemotherapy treatment alone.

In an attempt to further specialize breast cancer treatment, The Trial Assigning Individualized Options for Treatment, or TAILORx, was recently initiated by NCI. This study will enroll 10,000 women to examine whether appropriate treatment can be assigned based on genes that are frequently associated with risk of recurrence of breast cancer.

The goal of TAILORx is important because the majority of women with early-stage breast cancer are advised to receive chemotherapy in addition to radiation and hormonal therapy, yet research has not demonstrated that chemotherapy benefits all of them equally.

TAILORx seeks to examine many of a woman's genes simultaneously and use this information in choosing a treatment course, thus sparing women unnecessary treatment if chemotherapy is not likely to be of substantial benefit to them.

Several methods show promise in reducing the risk of breast cancer. In October 1998, the U.S. Food and Drug Administration, or FDA, approved the drug tamoxifen to lower the chance of cancer in high-risk women.

The approval of tamoxifen followed a clinical trial sponsored by the National Cancer Institute that included more than 13,000 pre-menopausal and post-menopausal women. All of the women were considered at high risk for breast cancer.

One group of women took the drug tamoxifen and another took a placebo — an inactive pill that looked like tamoxifen. The results of the study showed a 49 percent decrease in breast cancer among women who took tamoxifen.

Tamoxifen does have side effects. The most serious in some women are an increased risk of endometrial cancer, uterine sarcoma, and an increased risk of blood clots. Women at high risk for breast cancer may want to consult their doctor to see if tamoxifen may help them.

The Study of Tamoxifen and Raloxifene (STAR) is a more recent clinical trial sponsored by the National Cancer Institute. STAR enlisted nearly 20,000 women to compare tamoxifen to the drug raloxifene for effectiveness in reducing of breast cancer risk.

Raloxifene, marketed as Evista®, has been approved for use to lower the risk of and treat osteoporosis.

Initial results of the STAR trial show that raloxifene works as well as tamoxifen in reducing breast cancer risk for postmenopausal women at increased risk of the disease. Both drugs decrease risk by about 50 percent.

In addition, women enrolled in STAR who were assigned to take raloxifene had fewer uterine cancers, blood clots, and cataracts than those taking tamoxifen.
However, taking raloxifene raised the risk of blood clots and fatal strokes in women already at risk.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Breast Cancer "Genetic Risk Factors"



Breast Cancer Causes And Risk Factors

No one knows why some women develop breast cancer and others do not. Although the disease may affect younger women, three-fourths of all breast cancer occurs in women age 50 or older.

Researchers often talk about breast cancer in two ways: in situ and invasive. In situ refers to cancer that has not spread beyond its site of origin. Invasive applies to cancer that has spread to the tissue around it.

Older age and the following risk factors increase a woman's chance of getting breast cancer. Risk factors are conditions or agents that increase a person's chances of getting a disease.
Breast cancer among one or more of your close relatives, such as a sister, mother, or daughter, increases the risk.

Having no children or having your first child in your mid-thirties or later increases the risk.
Having your first menstrual period before age 12 increases the risk.
Gaining weight after menopause, especially after natural menopause and/or after age 60.

Race can be a factor. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease.
Five percent to 10 percent of all breast cancers are thought to be inherited.

When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer.

Warning signs of breast cancer:
A lump or thickening in or near the breast or in the underarm area.
A change in the size or shape of the breast.
Nipple discharge or tenderness, or the nipple is pulled back or inverted into the breast.

Warning signs of breast cancer:
Ridges or pitting of the breast. The skin looks like the skin of an orange.
A change in the way the skin of the breast, areola, or nipple looks or feels. For example, the skin may be warm, swollen, red, or scaly.

You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible.

Some women believe that as they age, health problems are due to "growing older." Because of this myth, many illnesses go undiagnosed and untreated. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Talk to your doctor.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.

Breast Cancer "Four Methods Of Treating Breast Cancer"



Breast Cancer Defined

The body is made up of many types of cells. Normally, cells grow, divide and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way.

These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Breast cancer occurs when malignant tumors form in the breast tissue.

Breast cancer is one of the most common cancers in American women. It is more common among older women than younger women. Men can get breast cancer too, although they account for only one percent of all reported cases.

When cancer grows in breast tissue and spreads outside the breast, cancer cells are often found in the lymph nodes under the arm. If the cancer has reached these nodes, it means that cancer cells may have spread, or metastasized, to other parts of the body.

When cancer spreads from its original location in the breast to another part of the body such as the brain, it is called metastatic breast cancer, not brain cancer. Doctors sometimes call this "distant" disease.

Breast cancer is not contagious. A woman cannot "catch" breast cancer from other women who have the disease. Also, breast cancer is not caused by an injury to the breast. Most women who develop breast cancer do not have any known risk factors or a history of the disease in their families.

Today, more women are surviving breast cancer than ever before. Over two million women are breast cancer survivors.

There are several ways to treat breast cancer, but all treatments work best when the disease is found early.

Every day researchers are working to find new and better ways to detect and treat cancer. Many studies of new approaches for women with breast cancer are under way. With early detection, and prompt and appropriate treatment, the outlook for women with breast cancer can be positive.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.

Copyright Information: Public domain information with acknowledgement given to the U.S. National Library of Medicine.