It can be awkward when a patient asks you about a report in their favourite tabloid detailing an amazing research breakthrough or a ‘cutting-edge’ new treatment / test and you don’t know what they are talking about! So this section fills you in on the facts…
Is exercise the secret to beating prostate cancer? Just 5 hours a week can boost survival chances by a THIRD
The Daily Mail – 18 April 2016
Regular readers of this section will know that articles relating to lifestyle and diet in reference to prostate cancer are very frequent and indeed very popular with patients. This story pertains to an article that has a new message to carry and it is a message that will definitely change my advice in clinic. We all often give generalised advice to patients who want to do everything possible to keep themselves healthy after a prostate cancer diagnosis; we advise a balanced diet and some exercise, but an abstract presented at the American Association for Cancer Research 2016 Annual Meeting gives new evidence for exactly what that ‘some exercise’ should probably entail.
A research team based in Atlanta, led by epidemiologist Ying Wang, has looked at 10,067 men who were part of the ‘Cancer Prevention Study II Nutrition Cohort’. All of the men had been diagnosed with non-metastatic prostate cancer at the time of enrolment and were aged 50-93. During the study period 600 men died of prostate cancer. As part of the study the men reported on their physical activity and exercise and it is this data that forms the basis of the abstract.
The research team found that patients who exercised more than 17.5 hours per week pre-diagnosis had a 30% reduction in prostate cancer specific mortality. Importantly, the analysis also showed that a similar mortality reduction (34%) even if the exercise increase was only commenced post-diagnosis. Looking at specific types of exercise: whilst four to six hours of walking per week pre-diagnosis was associated with a one-third risk reduction in mortality, this was not the case post-diagnosis. This has given rise to the suggestion quoted in the Daily Mail article that for maximal health benefits walking alone is not sufficient as exercise. This would certainly lead me to explain to patients that they need to do something beyond walking, even if it is just gardening or swimming.
More evidence links heartburn drugs to serious kidney problems
Reuters – 22 April 2016
Surprisingly, this health story has not yet been more widely picked up on by the tabloids. Reuters report on a new publication in the Journal of the American Society of Nephrology. A research team led by Ziyad Al-Aly, looked at the US National Veteran’s Affairs database for 20,000 men newly started on a proton-pump inhibitor (e.g. lansoprazole) and compared against 173,000 men taking H2 blockers (e.g. ranitidine). Over a five-year follow-up, men taking a regular proton-pump inhibitor exhibit a 30% increased risk of developing chronic kidney disease (CKD) or of eGFR falling below 60ml/min. Furthermore, the risk seems dosage dependent; men taking the PPI drugs for the longest duration had the highest risk of developing CKD. This is data we should all be mindful of the next time we review someone with a raised serum creatinine.
Prostate awareness ‘dangerously low’ in British men
BBC News – 22 April 2016
This national news story concerns the release of data from a recent survey carried out by Prostate Cancer UK. Prostate Cancer UK surveyed 1900 men and found that 17% had never heard of the prostate, 54% did not know where it was located in the body and 92% had no understanding of the function of the prostate. As Prostate Cancer UK quite rightly points out, there is a risk here of potentially ‘lethal ignorance’, if men do not know they have a prostate they will not know any warning signs of prostate cancer either. We have to remember that the patients we see in clinic are often a self-selecting population who are seeking reassurance about a risk they already understand. Prostate Cancer UK are launching a new advertising campaign to raise awareness amongst men.
Revolting: One in TEN men wear a single pair of pants for a WEEK without washing them
Daily Express – 21 April 2016
Sometimes the tabloid health stories are, I think, good. They have the potential to inform and empower the public to improve their health. Other times, I really wish the information in the story had not been made public at all. In the case of this story in the Daily Express, it is not that fact that 10% of men do not change their underwear that bothers me, it is the fact that the other 90% have just had it highlighted that they can also get away with it. As a person who regularly comes into close proximity to other men’s underwear in clinic, I wish I had sought some sort of super-injunction against this story coming out.