In the News and on My Mind

I am committed to sharing with you some of the highlights in medicine and science on a regular basis.  I will give you a HEALTHY  DOSE of what is on my mind as well. Here are a few headlines that caught my eye this week:

LOW VITAMIN D LEVELS MAY INCREASE RISK OF BREAST CANCER SPREADING AND CANCER DEATH

A small Canadian study of 512 women with breast cancer found that women who were deficient in vitamin D had a greater risk of their cancer spreading and greater risk of death from breast cancer. Many (76%) of the women were vitamin D deficient. 

ON MY MIND: More and more research studies are finding that low levels may play a role in dementia, heart disease, bone and muscle weakening with aging, some cancers and even the development of autoimmune disease.

Most people who live in cold climates do not get enough vitamin D because the sun intensity for many parts of the year is not sufficient to trigger the skin to produce vitamin D, the body’s main way of getting this critical hormone-type vitamin. The use of protective sunscreens blocks vitamin D production, the pigment melanin in darker skin also blocks vitamin D production, and with aging our skin produces less of the vitamin even with the help of the sun.

Great food sources of vitamin D include fatty cold-water fish such as salmon and cod. Fortified cereals and milk products contain much less. Most of us should increase our vitamin D consumption to 1000 IU or more daily, optimally with vitamin D3 or cholecalciferol, the most active form. A typical multivitamin has 400 IU, a glass of milk has only 100 IU, and a tablespoon of cod liver oil has a whopping 1250 IU! Seniors and others who have reason to be concerned should talk to their doctors about getting a simple blood test for vitamin D.  To learn more about vitamin D read my Healthy Dose: In the News and on my mind “More News about Vitamin D and other Stories” and today’s segment with Dr. Tim Johnson on Good Morning America, “Low Vitamin D May Mean Worse Breast Cancer”.

MORE WOMEN OPTING FOR MASTECTOMIES

A recent study from the Mayo Clinic has found that more women with early breast cancer are opting for mastectomy rather than lumpectomy. Although the precise reason for this is not known, doctors suspect that the rising use of the much more sensitive MRI to detect hidden cancers and the use of genetic testing to find women at increased risk of cancers may be responsible for a woman’s decision. Women who have a mastectomy have a lower chance or recurrence of cancer in the remaining breast tissue although there is no overall survival benefit.  

ON MY MIND: The fact that more women with early breast cancer are undergoing mastectomy today than previously suggests to me that women are taking a more proactive approach to identifying their risk of breast cancer and cancer recurrence. The fact that more women are opting for prophylactic mastectomy to prevent breast cancer altogether strengthens my conviction that women in the end are in the best position to make these difficult but potentially life-saving choices. All too often in the past, women were discouraged from considering preventive mastectomy because it was considered radical and disfiguring.  Hopefully more and more women are sharing in the decisions how best to prevent, diagnose and treat breast cancer with their physicians so that they can take the steps that make the most sense for them.

MOST PEOPLE 60 AND OLDER SHOULD BE VACCINATED AGAINST SHINGLES

The CDC’s leading advisory group on immunizations recommends unanimously that most people 60 years of age and older should be vaccinated against shingles with a single dose of the vaccine called Zostavax. Shingles is a painful eruption of skin blisters caused by a flare-up of the previously dormant chicken pox virus called herpes zoster. Some patients with shingles can have severe and debilitating pain long after the skin blisters heal. The vaccine can help to reduce the chances of developing shingles and lessen the severity of the disease. Because the vaccine contains a live but weakened form of the virus, it should not be given to people who have weakened immune systems. 

ON MY MIND: Unanimous approval by the CDC advisory committee is good news because insurance companies are now likely to reimburse for this costly but effective vaccine to prevent or lessen the severity of shingles. A recent study showed that less than 2% of eligible patients have been vaccinated and I suspect this is primarily because of the cost of the vaccine (about $150.00).  Other vaccinations to ask about during your next doctor visit: pneumonia vaccine for people 65 and over, diphtheria, tetanus and pertussis vaccine once every 10 years for everyone, and every fall, the flu shot for most of us over age 50.  Click here to print out an adult vaccination record that will help you keep track of your vaccines.  

CHIARI MALFORMATIONS AND AUTISM CAN CO-EXIST 

GMA Weekend featured the heart-wrenching story of a three-year old boy who couldn’t sleep. He was eventually diagnosed with Chiari malformation and underwent surgery to decompress the brain.  Click here to watch the segment The Boy Who Couldn’t Sleep featured on GMA. 


In response to the story, I received a number of e-mails from parents with children who had both Chiari malformation and autism. Parents wanted to know if there is a causal relationship between the two brain disorders. According to Dr. Paulo Bolognese of The Chiari Institute on Long Island, the two conditions can occur together but that Chiari I Malformation (CMI) is not a cause of autism. He believes the symptoms of autism can be worse because of the Chiari malformation – a condition that warrants proper diagnosis and treatment. To learn more, please visit The Chiari Institute 

Wishing you good health, 

Dr. Marie Savard 


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