Posted in cancer, Entertainment, Health, news

Shannen Doherty Reveals Her Stage 4 Breast Cancer Diagnosis

The 48 year-old 90210 star revealed on Good Morning America that her breast cancer has returned.

Originally diagnosed in 2015, she went into remission within 2 years.  Unfortunately, it returned last year fairly aggressively.

She had hoped to keep the news private, but a concurrent lawsuit with State Farm involving damages to her house during the 2018 Woolsey Fire was going to cause her condition to be revealed in court papers and she would rather her fans, “hear it from her.”

She states, “Our life doesn’t end when we get that diagnosis. We still have some living to do.”

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Cynthia Nixon have also revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females.

How common is breast cancer?

1 in 8 women will develop invasive breast cancer over the course of their lifetime. According to Breastcancer.org, an estimated 276,000 cases of invasive breast cancer are expected to be diagnosed in women in the US this year with 48,500 cases of non-invasive breast cancer.

42,000 women and 500 men are expected to die this year of breast cancer.

 

What are the risk factors for breast cancer?

Risk factors for breast cancer include:

  • Age greater than 50
  • Family History
  • BRAC1 and BRAC2 genetic mutations
  • Alcohol use
  • Never been pregnant or becoming pregnant for the first time over 35 years old
  • Early menarche at age 11 or younger
  • Obesity, especially after menopause
  • Dense breasts
  • Lack of physical activity
  • Use of oral contraceptives
  • Previous “precancerous” tumors such as atypical hyperplasia
  • DES exposure
  • Previous radiation therapy

How is breast cancer staged?

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

 

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

85% of breast cancer cases occur in women with NO family history.

 

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

 

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

 

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Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician

 

Posted in cancer, Entertainment, Health, news, Politics, Radio

Rush Limbaugh Reveals He Has Advanced Lung Cancer

69 year-old Rush Limbaugh has revealed on air that he has “advanced” lung cancer and will be undergoing treatment.

He was diagnosed in January after he was exhibiting symptoms of shortness of breath.

The conservative talk show icon will take some time off for treatment but still hopes to continue broadcasting.

“I wish I didn’t have to tell you this, and I thought about not trying to tell anybody, I thought about trying to do this without anybody knowing, because I don’t like making things about me,” he said. But “there are going to be days that I’m not going to be able to be here, because I will be undergoing treatment, or I’m reacting to treatment.”

https://video.foxnews.com/v/6129307883001#sp=show-clips

Early lung cancer can be silent.  As it progresses, however, symptoms such as chronic cough, wheeze, blood in sputum, lethargy and weight loss can ensue.

Limbaugh was known for his affinity for cigars.  It is unclear how much he smoked.

Although lung cancer risk drops dramatically the longer one avoids tobacco products, the resulting tissue damage, injury to one’s immune response, and genetic mutations may persist.  Moreover, lung cancer can occur even in non-smokers.

Lung cancer is the number one cause of cancer related death in the US for both men and women, surpassing breast and colon cancer.

According to the American Cancer Society, they estimate in 2020 there will be 228,820 new cases and 135,720 deaths from lung cancer.

Prognosis depends on the stage of cancer at time of diagnosis.  According to American Lung Association:

The five-year survival rate for lung cancer is 56 percent for cases detected when the disease is still localized (within the lungs). However, only 16 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 5 percent.

This is a developing story.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician

Posted in cancer, disease, Health, medications, news

California to Decide if Acetaminophen Products Need “Cancer Risk” Label

In compliance with Proposition 65, the Safe Drinking Water and Toxic Enforcement Act of 1986, California may have to enforce retailers to label acetaminophen-containing products as having potential “cancer risk.”

Proposition 65 requires the state to maintain a list of chemicals that can cause cancer, birth defects or reproductive harm. Businesses must also provide warnings if their products sold contain compounds included on the list.  If they don’t, they can be subject to a $2500 fine per violation per day.

There are over 900 chemicals currently on the list of toxic substances, and state regulators reviewed 133 studies to see if acetaminophen needs to be included.

Although acetaminophen use has been linked to liver disease (see below), and pediatric asthma, autism and ADHD if exposed perinatally, cancer studies have been far and few between.

However, in 2011, a study published in the Journal of Clinical Oncology, found “high use of acetaminophen was associated with an almost two-fold increased risk of incident hematological malignancies” such as myeloid neoplasms, non-Hodgkin lymphoma and plasma cell disorders.  By “high use” they described taking acetaminophen more than 4 times a week for over 4 years.  The cancer risk was still deemed as rare, but statistically significant.

A designation of being included in the Proposition 65 “list” is controversial as its hopes of educating the public could cause fear in the use of a medication has has been deemed relatively safe as opposed to other products used for similar illnesses (i.e. using acetaminophen for pain relief instead of an opioid), while at the same time open companies up to lawsuits if one alleges their medical condition came from an acetaminophen-containing product.

TYLENOL® poisoning, more common than we think

Acetaminophen (paracetamol in Europe) has long been known to cause liver failure. But now researchers reveal why its the number one cause of acute liver failure.  And even more troubling, many people don’t realize they are overdosing on this common medication.

What does the liver do?

The liver filters and detoxifies blood.  Additionally it breaks down and stores cholesterol and lipids and produces proteins. The liver also produces bile that gets stored in the gall bladder to help digest food after eating.  It is one of the few organs in the body that can regenerate itself when tissue is damaged.  So its troubled scientists how drug toxicity could irreversibly damage the liver to the same degree hepatitis, cirrhosis and cancer do.   Researchers from the University of Edinburgh studied human and mouse liver cells and now know why.

What is liver failure?

In order for the liver cell to work, it needs to work in concert with the cells surrounding it but work in separate groupings, each with a different function.  Excessive acetaminophen (the main ingredient in Tylenol) disrupts these cell connections, called “tight junctions”, hence the cells don’t function properly.  “Failure” of an organ, such as “liver failure”, “heart failure”, and “renal failure” occur when the cells of the organ aren’t healthy enough to allow the organ to function.

Signs and symptoms of liver failure include:  jaundice (yellow color to skin and eyes), fatigue, weakness, easy bleeding, nausea, diarrhea, confusion to name a few.

Knowing the mechanism of injury to the hepatocytes, liver cells, may allow scientists to create a means to repair liver cells that can’t be repaired themselves.  Or design a pain reliever that doesn’t damage the liver.

How much acetaminophen is toxic?

Taking more than 4 grams a day could be considered and “overdose” and toxic.  Frighteningly, this level is commonly consumed on a daily basis.  Over the counter an “extra strength” dose contains 500 mg of acetaminophen.  So if a person takes 1-2 pills every 4-6 hours, they can easily take 4 grams a day. Add a pain medication such as Vicodin or Percocet which contain acetaminophen, or a cough and cold remedy, or even an over the counter sleeping aid which may contain it as well, and its no surprise so many end up in the emergency room.

The following is a list of over the counter medications that may contain acetaminophen (provided by knowyourdose.org)

Some Common Over-the-Counter Brand Name Drugs That Contain Acetaminophen

Actifed®
Alka-Seltzer Plus®
Anacin®
Cepacol®
Contac®
Coricidin®
Dayquil®
Dimetapp®
Dristan®
Excedrin®
Feverall®
Formula 44®
Goody’s® Powders
Liquiprin®
Midol®
Mucinex®
Nyquil®
Panadol®
Robitussin®
Saint Joseph® Aspirin-Free
Singlet®
Sinutab®
Sudafed®
Theraflu®
Triaminic®
TYLENOL® Brand Products
Vanquish®
Vicks®
*And store brands

Some Common Prescription Drugs That Contain Acetaminophen (or APAP)

Butalbital®
Endocet®
Fioricet®
Hycotab®
Hydrocet®
Hydrocodone Bitartrate®
Lortab®
MIDRIN®
NORCO®
Oxycodone®
Percocet®
Phenaphen®
ROXICET ™
Sedapap®
Tapanol®
Tramadol
TYLENOL® with Codeine
Tylox®
Ultracet®
Vicodin®
Zydone®
*And generic drugs

 

We recommend discussing all your medication, especially over the counter, with your medical provider, and to not assume just because its available without a prescription, its safe in any dose.

                                                                                                         

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is Board Certified Family Physician

Posted in breast, cancer, Health, news

October is Breast Cancer Awareness Month

ABOVE:  DR. DALIAH UNDERGOING A 3-D MAMMOGRAM TO SCREEN FOR BREAST CANCER

 

Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Cynthia Nixon have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women.  It’s the second most common cause of cancer death in females.

#Shirtsoff.jpg

#SHIRTSOFF #BREASTCANCERAWARENESSMONTH

 

How common is breast cancer?

1 in 8 women will develop invasive breast cancer over the course of their lifetime. According to the American Cancer Society, an estimated 268,000 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,000 cases of non-invasive breast cancer, a rise from last year.

41,700 women and 500 men are expected to die this year of breast cancer.

 

What are the risk factors for breast cancer?

Risk factors for breast cancer include:

  • Age greater than 50
  • Family History
  • BRAC1 and BRAC2 genetic mutations
  • Alcohol use
  • Never been pregnant or becoming pregnant for the first time over 35 years old
  • Early menarche at age 11 or younger
  • Obesity, especially after menopause
  • Dense breasts
  • Lack of physical activity
  • Use of oral contraceptives
  • Previous “precancerous” tumors such as atypical hyperplasia
  • DES exposure
  • Previous radiation therapy

How is breast cancer staged?

Breast cancer is staged based on size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body.  Prognosis varies greatly on the stage.

 

Screen-Shot-2012-09-27-at-9.59.51-AM.png

IMAGE ABOVE FROM JOHNSTON HEALTH

 

Is family history a huge factor?

85% of breast cancer cases occur in women with NO family history.

 

Screening of breast cancer

Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74.  However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.

 

FullSizeRender (1)

3-D MAMMOGRAM IMAGE

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in cancer, Health, medications, news

Ranitidine Being Evaluated For Cancer Causing Chemical

The FDA has announced that samples of ranitidine, an H2 Blocker used for stomach upset, reflux and ulcers sold generically and under the brand name of Zantac, were found to have the contaminant N-nitrosodimethylamine (NDMA).  This is one of the chemicals that prompted the generic ARB blood pressure medication recalls last year.

There have been no reports of users becoming ill and no recall has been suggested at this time. In animals, NDMA is known to cause liver and lung cancer.  In humans its carcinogenic risk is unknown, however the CDC states it may cause liver function impairment and cirrhosis.

The FDA writes:

The FDA is not calling for individuals to stop taking ranitidine at this time; however, patients taking prescription ranitidine who wish to discontinue use should talk to their health care professional about other treatment options. People taking OTC ranitidine could consider using other OTC medicines approved for their condition. There are multiple drugs on the market that are approved for the same or similar uses as ranitidine.
Consumers and health care professionals should report any adverse reactions with ranitidine to the FDA’s MedWatch program to help the agency better understand the scope of the problem:

The investigation is ongoing and more needs to be looked at when it comes to this manufacturing process suspected to result in these “impurities” being made.

Last year NDEA was also found in the generic  blood pressure medications that were the subject of recall, however has not yet been suggested as being being present in ranitidine.

N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) was the third chemical detected resulting in the latest two recalls of losartan, an angiotensin receptor blocker commonly used to treat hypertension (high blood pressure).  It is believed to have been created during the manufacturing process of the generic drug.

pills.jpg

NMBA, according to Toronto Research Chemicals, is a known carcinogen in a wide range of animal species.

Last Fall, ScieGen Pharmaceuticals, Inc. recalled certain lots of irbesartan, a similar angiotensin receptor blocker used in blood pressure management.

The recalls initially began last summer when FDA recalled a number of lots of valsartan due to an “impurity”, N-nitrosodimethylamine (NDMA) that is known to cause cancer in animals.  Weeks later they additionally found traces of N-nitrosodiethylamine (NDEA).

According to Reuters, earlier last summer, the MHRA, Medicines and Healthcare Products Regulatory Agency, located in the UK, said the appearance of the impurity, N-nitrosodimethylamine (NDMA), came after a change in the process for making valsartan at one facility owned by Zhejiang Huahai Pharmaceuticals, a company in Linhai, China.

With NDEA, data is limited, but due to its classification as a nitrosamine and its prevalence in tobacco smoke it is classified as a probable human carcinogen.

According to New Jersey Department of Health’s website, NDEA has been linked to liver, lung and gastrointestinal tract cancer in animals.

Losartan, valsartan and irbesartan are medications in the class of angiotensin receptor blockers (ARBs) used for high blood pressure and congestive heart failure.

Those taking either tablet for their blood pressure are urged to not abruptly stop their medication but rather check with their medical provider and pharmacy to see if their particular prescription is involved in the recall.

I suspect more recalls will follow as processes may be similar across multiple pharmaceutical facilities and NMBA, NDMA and NDEA are byproducts that may not be individually unique to just one “brand” of medication manufacturing.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in cancer, Entertainment, Health, news

Eddie Money Dies at Age 70 After Battling Esophageal Cancer

70 year-old music legend, Edward Mahoney “Eddie Money”, who last month revealed in a video released by his realty TV series “Real Money” that he had stage 4 esophageal cancer, has sadly passed.

Per Variety: A statement provided by his family reads: “The Money Family regrets to announce that Eddie passed away peacefully early this morning. It is with heavy hearts that we say goodbye to our loving husband and father. We cannot imagine our world without him. We are grateful that he will live on forever through his music.”

 

He recently underwent heart valve surgery and reports say he also battled pneumonia.

Despite the cancer having had spread to his liver, lymph nodes and stomach, he appeared optimistic in a recent interview saying cancer has come a long way since the 1950’s and 60’s and “everyday above ground is a good day.”

What is esophageal cancer?

Esophageal cancer can occur anywhere along the gullet/food pipe.  There are different types such as adenocarcinoma (lower portion near the stomach), more commonly seen in Caucasians, and squamous cell carcinoma (middle to upper esophagus) more commonly seen in African Americans.  It’s the 6th common cause of cancer death worldwide and comprises 1% of all cancers diagnosed in the US.

According to the American Cancer Society, estimates for 2019 include:

  • ABOUT 17,650 NEW ESOPHAGEAL CANCER CASES DIAGNOSED (13,750 IN MEN AND 3,900 IN WOMEN)
  • ABOUT 16,080 DEATHS FROM ESOPHAGEAL CANCER (13,020 IN MEN AND 3,060 IN WOMEN)

a-medical-illustration-of-esophageal-cancer-original.jpg

 

What are the symptoms of esophageal cancer?

Early esophageal cancer may not exhibit any signs. However if it progresses, symptoms may include any of the following:

  • abdominal pain
  • heartburn
  • feeling full despite not eating
  • nausea
  • vomiting blood
  • weight loss
  • loss of appetite
  • chest pain
  • cough

 

What are the risk factors for esophageal cancer?

Although esophageal cancer appears to afflict men more than women, risk factors  include:

  • Smoking
  • Alcohol use
  • Frequent imbibing of hot liquids
  • Obesity
  • Chronic GERD or heartburn that may have led to esophagus lining changes such as Barrett’s Esophagus disease
  • Vitamin deficiency
  • Drinking liquids that contain lye, an alkaline  chemical present in many soaps
  • Prior radiation to the chest

 

What is the prognosis of esophageal cancer?

If caught early and localized, the 5-year survival rate is over 45%. However, if it has spread, the 5 year survival rate can range any where from 5-20%.

 

How is esophageal cancer treated?

There are a variety of treatments for esophageal cancer including surgery, chemotherapy and radiation.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in cancer, Health, news, Sports

Golden Knights Shea Theodore Reveals He Has Testicular Cancer

The 24 year old defenseman for the Golden Knights is recovering from surgery after being diagnosed with testicular cancer.

Shea Theodore in a story in the Player’s Tribune stated that during routine screening an hCG hormone test came up positive which commonly is seen in pregnant women, but could also be a sign of testicular cancer. This triggered his doctors to look for an abnormality.  A testicular ultrasound confirmed a 5mm X 5 mm lump, half the size of a pencil eraser and was set up for surgery.

He writes:

After the surgery, when the doctors were able to do a biopsy on the mass in my testicle, they found that it was a mixed germ cell tumor: embryonal and seminoma, stage I. While the embryonal component can be very aggressive and spread to abdominal lymph nodes, mine was caught early because of the comprehensive blood testing they conduct at the Worlds. 

Stage I testicular cancer (not spread beyond the testicles), found early has a 99% survival rate after 5 years.

This is a developing story…..

 

Testicular cancer is the most common type of cancer to affect young men, aged 15-44.

Yet the USPSTF has reviewed the evidence for screening for testicular cancer and has recommended AGAINST routine screening.

However, many medical providers still urge young men to do self testicular checks monthly.

Symptoms of testicular cancer may include any of the following:

  • Testicular lump
  • Testicular pain or heaviness
  • Testicular swelling
  • Numbness or tingling in the area of the testicle
  • Breast swelling
  • Back pain
  • Abdominal or groin pain
  • and more

 

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The earlier testicular cancer is found, the higher the survival rate.  This year, cancer.net predicts 9,310 men will be diagnosed with testicular cancer in the US.

 

 

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.