Cancer Archive

The decision depends on several factors, including your breast cancer risk, life expectancy, and personal preferences.

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As you get older, your body isn't the only thing that's changing. So are the guidelines for taking care of it. Breast cancer screening guidelines are a case in point. The current U.S. Preventive Services Task Force (USPSTF) guidelines recommend a mammogram every two years for women ages 50 to 75 with an average risk of developing breast cancer. For older women, the USPSTF said there isn't enough evidence of the potential risks and benefits of mammography on which to base a recommendation.

Although breast cancer is a leading cause of death in older women, women over 75 haven't been included in studies of mammography. However, there is evidence that most breast cancers detected in older women are relatively slow growing and easily treated. While a mammogram performed today might detect a cancer that would not spread or metastasize for several years, the percentage of women who survive to that point decreases with each passing year.

Research we're watching

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In Hans Christian Andersen's classic fairy tale, the ugly duckling stands out from the flock because he's destined to become a swan. In dermatology, the "ugly duckling" is a mole that doesn't look like the rest of the moles on a person's body, and is often suspected to be a melanoma.

A team of French researchers decided to test whether finding an ugly duckling among all of a patient's moles is as effective a way of identifying melanoma as applying diagnostic criteria — like size, shape, color, and irregularity — to each mole separately. For the study, nine dermatologists studied images of 2,089 individual moles from 80 people. The images were presented to the dermatologists two different ways on two different days. On one day, they evaluated each image separately; on another, they looked for the ugly ducklings among the complete set of moles from each patient. They were able to flag the melanomas accurately both times. However, they were able to decrease the number of moles biopsied when they used the ugly duckling system.

Research we're watching

For many women with breast cancer, hair loss is the most distressing side effect of chemotherapy. Although cooling the scalp with ice packs has been tested, the technique has had limited success. However, a newer approach — wearing a cap connected to a cooling system that gradually reduces scalp temperature — has been more successful, according to two reports in the Feb. 14, 2017, Journal of the American Medical Association.

In one study, 67 of 106 women with stage I or stage II breast cancer who used the FDA-approved DigniCap during their treatment with taxane (Taxol and others) lost less than half of their hair. In comparison, 16 women who underwent the same treatment but did not wear the cooling cap lost all of their hair.

News briefs

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Carrying around extra weight is a known risk factor for developing some cancers. But exactly which kinds of cancer are associated with obesity is debated. A study published Feb. 28, 2017, in The BMJ aimed to narrow it down. European researchers combed through about 100 large reviews of observational studies that looked for links between being overweight and getting cancer.

Out of 36 kinds of cancer evaluated, the researchers found strong evidence for a link to obesity for 11—in the colon, rectum, biliary tract (liver and gallbladder), pancreas, breast, endometrium (uterine lining), ovary, kidney, and the gastric cardia (the junction of the esophagus and stomach); a certain type of esophageal cancer (adenocarcinoma); and one type of bone marrow cancer (multiple myeloma). The researchers said there may be links between obesity and other cancers, but so far the evidence is relatively weak.

The earlier one starts tanning, the longer the lifetime skin damage and the higher the skin cancer risk. As the number of people with skin cancer increases, it has become especially important to convey to teenagers the message that tanning is an unhealthy choice, whether it’s outdoors or in a tanning bed.

News briefs

Red meat is associated with an increased risk for developing cardiovascular disease, diabetes, and some types of cancer. Now, a study published online Jan. 9, 2017, by the journal Gut suggests that eating red meat is associated with an increased risk for developing diverticulitis. This occurs when tiny pouches in the wall of the large intestine become inflamed, potentially causing cramps, diarrhea, constipation, and even rectal bleeding. We don't really know what causes diverticulitis, so researchers explored possible dietary links. They analyzed health and diet information reported by more than 46,000 men (ages 40 to 75) over 26 years. Men who ate the most red meat per week (about 13 servings) were 58% more likely to develop diverticulitis during the study period, compared with men who ate the least red meat per week (1.2 servings). The association was strongest for unprocessed red meat like steak. However, the risk for developing diverticulitis was 20% lower when people in the study substituted poultry or fish for a serving of unprocessed red meat each day. The findings don't prove that red meat causes diverticulitis, but other studies have suggested red meat may be a factor in diverticular disease.

Ask the doctor

Q. I smoked for more than 20 years, but gave it up about 15 years ago. Am I still at risk for lung cancer or other health problems?

A. Not smoking is the best health move any man can make. The good news is that the benefits of quitting smoking begin almost immediately after your final cigarette, although the risk of smoking-related cancers may take years to decline.

Don't take constipation sitting down. Lifestyle changes can help you find relief.

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Constipation may be unpleasant and embarrassing, but it should never be ignored. About one-third of adults ages 60 and older report at least occasional constipation, which can leave them feeling bloated, uncomfortable, and sluggish.

"It's an incredibly common problem, especially among older men, but it's important to address and manage, as it can affect your nutrition and quality of life," says Dr. Judy Nee, a gastroenterologist with Harvard-affiliated Beth Israel Deaconess Medical Center.

Ask the doctor

Q. I have been smashed, squashed, pulled, and tugged annually for 25 years. Why isn't there a better way to take a mammogram?

A. We hear you! Compression mammography has been the "gold standard" for decades for one reason — it works. Flattening the breast makes ductal tissue easier to distinguish and reduces the amount of radiation required to do so. Studies have demonstrated that it is the most effective approach to breast cancer screening.