Author: noorali

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Anal Cancer Can be Misdiagnosed as Hemorrhoids

Anal Cancer

You may recall, Farrah Fawcett, one of the Charlie’s Angels, was diagnosed with anal cancer in 2006. Three years later she died.

There is no need to panic. Anal cancer is fairly uncommon. It accounts for about one to two per cent of gastrointestinal cancers. About 4,000 new cases of anal cancer are diagnosed each year in the U.S.A., about half in women. Approximately 600 people will die of the disease each year.

In Canada, incidence of anal canal tumours is approximately 515 cases per year with annual incidence rate of 1.3 per 100,000 population. Review of cancer registry by researchers has shown that the incidence of anal cancer in Canada is increasing.

Anal cancers can be just outside the anus (perianal) or inside the anus. The anal canal extends from the anal verge to the upper border of the anal sphincters, and is approximately four to five cm in length. The skin for a five cm radius around the anal verge is called the perianal skin or anal margin.

What are the risk factors for developing anal cancer?

We do not know the exact cause of most anal cancers. But we know certain risk factors are linked to anal cancer. Most people with anal cancer are over 50 years old. Having anal warts significantly increases the risk. Anal warts are caused by infection with the human papilloma virus (HPV).

Persons who participate in anal sex are at an increased risk. Use of condoms is highly recommended to reduce the risk. Harmful chemicals from smoking increase the risk as well. People with weakened immune systems, such as transplant patients who must take drugs to suppress their immune systems and patients with HIV (human immunodeficiency virus) infection, are at a somewhat higher risk.

People with long-standing anal fistulas or open wounds are at a slightly higher risk. People who have had pelvic radiation therapy for rectal, prostate, bladder or cervical cancer are at an increased risk.

What are the symptoms of anal cancer?

Mostly they are no different than symptoms of hemorrhoids. That is why patients should stop saying, “Doctor, my hemorrhoids acting up again.” When you see your doctor, say what symptoms you have and let him/her make the diagnosis.

Most patients will complain about bleeding, itching, feeling of a lump, may have pain, narrowing of stools, discharge and staining of underwear and in advanced cases there may be enlarged groin lymph glands.

Biopsy is required to confirm the diagnosis. Treatment of anal cancer depends on the extent of the problem and may include surgery, radiotherapy and chemotherapy. Anal cancer can be prevented or picked up in early stages by eliminating the risk factors mentioned earlier and having your butt checked out on a regular basis. Follow the protocol for screening for anal, rectal and colon cancer. For more information, visit my website: www.nbharwani.com.

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Marriage is Associated with Lower Risk of Death for Men

Since 1858, we have known that mortality rates are lower for married individuals compared to people who are single. Why? We don’t know. We don’t even know why there is excess mortality among the unmarried. Of course, there are many hypotheses.

Recently published article in the Canadian Medical Association Journal (CMAJ September 20, 2011) shows that death rate among married men experiencing a heart attack was lower than women or single man in the same situation. Why? Earlier presentation for medical care appears to be one reason.

The authors of the article studied 4403 eligible patients who were diagnosed to have a heart attack. The mean age was 67.3 years, and 37 per cent of them were women. Overall, 75 per cent of married patients, 68 per cent of single patients, 68 per cent of divorced patients and 70 per cent of widowed patients presented within six hours of the onset of chest pain. This shows that being married was associated with lower odds of delayed presentation.

The authors of the article say that marriage has long been known to offer health benefits and is associated with a lower risk of death relative to people who are not married. The effect is more pronounced among men than among women. However, the specific mechanisms responsible for the lower rate of cardiovascular deaths in married persons (especially men) are not known.

One hypotheses proposed is that wives would be more likely than husbands to assume the caregiver role and that the beneficial effect of marriage would therefore be stronger among men than among women.

One British study says, “Although it is known that the length of a person’s life depends on a mixture of economic and social factors, the relative importance of these is still debated.” They concluded that that marriage has a more important effect on longevity than income does. For men, the effect of being married is positive and substantial. For women, the influence of marriage is smaller. Exactly how marriage works its magic remains mysterious, say the authors of the British study.

Here are some more statistics from other scientific studies:

  • Single men have mortality rates that are 250 per cent higher than married men
  • Single women have mortality rates that are 50 per cent higher than married women
  • Married women are 30 per cent more likely to rate their health as excellent or very good compared to single women
  • Married men may have better immune systems as well, either from support or from nagging to monitor blood pressure, cholesterol, weight, etc… and may be at less risk to catch colds
  • Married men are half as likely to commit suicide as single men, and one third as likely as divorced men.
  • Widowed men under 45 are nine times more likely to commit suicide as married men
  • Single men drink twice as much as married men, and one out of four say their drinking causes problems. Only one of seven married men says the same.

There are lot more statistics to suggest that having a partner is a good idea for your health, not to mention that it makes good economic sense. The rest, I leave that to your imagination.

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Had Your Butt Checked Out Lately?

 

 

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Role of Probiotics in Health and Disease

About a month ago, I wrote that there is some evidence to advise patients to take probiotics when they are on antibiotics. This is to prevent antibiotic-associated colitis. The probiotic suggested was Bio-K. I understand patients are having trouble finding Bio-K. My pharmacist tells me that they can order one if the patient can wait for a day or so. So talk to your pharmacist and I am sure they can get one for you.

Bacterial content of Bio-K are Lactobacillus acidophilus CL 1285 and Lactobacillus casei LBC80R. Research has shown that these bacteria reduce the incidence of antibiotic-associated diarrhoea.

There is increasing trend towards the use of probiotics by patients suffering from certain kinds of illnesses and by the public in general. In fact, Ipsos Reid poll conducted this year revealed that 72 per cent of Canadians believe that probiotics improve their health.

Probiotics are bacteria that help maintain the natural balance of bacteria in the intestine. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system.

The word probiotics is a compound of a Latin and a Greek word. It means “favourable to life.” Probiotics, as defined by the Food and Agricultural Organization of the United Nations (FAO), are live microorganisms administered in adequate amounts which confer a beneficial health effect on the host.

The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt, is the best known. Probiotic yogurt was first launched in Canada in 2004. Yeast is also a probiotic substance. Probiotics are also available as dietary supplements.

There are a number of products available in the market. It is difficult to know which one to use. An article in the Medical Post (April 19, 2011) provides some guidelines and I will try and summarize that here.

For diarrhoea, try Danone’s Activia and DanActive. Bio-k has been mentioned earlier. DanActive has also been shown to reduce the duration of respiratory infection. Bio-K and DanActive should be routinely used in the hospitals where the incidence of diarrhoea and respiratory infection is high.

It would be nice to find a probiotic which will help two fairly common conditions affecting our gut – inflammatory bowel disease and irritable bowel syndrome. But there are no solid recommendations in the Medical Post article. That means more research is required. Probiotics in the form of chewing gum and lozenges are being investigated for oral hygiene.

So, don’t spend your money on probiotics just because your friend or neighbour says it is a good idea. Probiotics do not fix all your problems. Do your own research. Go on the internet. Check Health Canada website. Eat yogurt regularly – it has many other benefits – before you spend your precious dollar.

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