July 30th, 2008 by Dr. Val Jones in Health Tips, News
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New research suggests that people who live in “walkable” neighborhoods weigh about 6-10 pounds less than those who live in pedestrian-unfriendly communities. Scientists at the University of Utah calculated the body mass index (BMI) of about half a million Salt Lake county residents from a state drivers license database. They then compared the “pedestrian friendliness” of the zip codes associated with the various BMIs.
They found that people who live in more densely populated zip codes (designed to be more friendly to pedestrians) tended to have lower BMIs. This research has not yet been published, so I can’t comment on the details of the study. However, it makes intuitive sense that walking more can make people lighter on their feet.
The study authors mentioned that city planners used to design communities with pedestrian activities in mind, but since the 1950’s this practice has become less common. Many new housing developments are built around the assumption that vehicles are the main form of transportation, making that a self-fulfilling prophecy.
Earlier this year I participated in an 8 week walking program promoted by the Department of Health and Human Services. At their recommendation, I purchased a pedometer with a goal of achieving 10,000 steps per day. It was an eye-opening experience for me (left to my own devices, I naturally walked about 2000 steps per day – and I don’t own a car). Americans simply don’t get the amount of exercise that they need to be healthy. We are seeing the result of our sedentary lifestyle in our country’s increasing overweight and obesity rates.
All I can say is that I’m struggling along with the rest of us – doing what I can to increase my activity level and walk as much as possible. I’m lucky to live in an area where walking is fun and easy to do. I have the utmost sympathy for those who are striving to become more active against the odds. Why not join my weight loss group and we can commiserate? There are over 2600 people in there, encouraging one another to get fit! Don’t let your zipcode determine your destiny.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 25th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
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I had the chance to interview Drs. Carmona, Satcher, and Novello about the current state of America’s war on cancer. I’ll post each conversation in a separate blog entry. This post explores Dr. Carmona’s views on diagnostic testing and early intervention.
Dr. Val: You said that screening tests could improve outcomes in 90% of people with cancer. Tell me more about that.
Dr. Carmona: First of all, a lot of people don’t know they have cancer until really late in the game. They show up asking things like “How come this thing is growing on my chest?” or “Why does my stomach hurt?” With appropriate screening tests targeted especially towards people who have risk factors (that one can determine by asking them about family history and environmental risk factors) you can capture about 90% of cancers at an early stage. Diagnosing cancer early is the key to improving outcomes and the chance for cure.
Dr. Val: Which are the most important cancer screening tests that people are not accessing now?
Dr. Carmona: All of them. Routine breast exams, mammograms, rectal exams, colonoscopies are the most commonly missed screening exams. And science is advancing at such a rate that we’ll soon be able to test for cancer with biomarkers – that is, blood tests that will determine whether or not cancer is present or if a person is at a higher genetic risk for cancer.
We already know about the BRCA1 and BRCA2 genes that predispose women towards breast cancer, but most physicians still don’t test for them. We need to make sure that we use all the science available to us, and set up a system that ensures that all patients get the appropriate screening tests at the appropriate time intervals. If we did that, 90% of patients diagnosed with cancer could expect improved outcomes.
Dr. Carmona is the Vice Chairman of Canyon Ranch, and President of the Canyon Ranch Institute.
Next post: Dr. Satcher on health disparities in cancer treatment.
*See the National Call To Action On Cancer Prevention and Survivorship*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 20th, 2008 by Dr. Val Jones in Expert Interviews
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This is part 2 of an interview with urologist Mark Schoenberg. Please click here for part one of the interview.
Dr. Val: How is bladder cancer treated?
Dr. Schoenberg: Bladder cancer can be grouped into two categories: non-invasive disease and invasive disease. About 80-90% of the time the cancer is formed by the cells of the inner lining of the bladder, ureters, and kidneys and is non-invasive. This type of bladder cancer doesn’t spread or invade the bladder wall, so it doesn’t threaten the life of the patient, but it can recur.
Non-invasive cancers are usually removed surgically via a scope that is inserted into the bladder via the urethra, and then afterwards there are a variety of medicines that can be infused into the bladder. Those medicines are like a kind of weed killer for bladder cancer.
Unfortunately up to 20% of patients have invasive tumors at the time that they are diagnosed. Once the bladder cancer has spread outside the bladder wall, surgery is needed to remove the primary tumor and then IV chemotherapy and sometimes radiation therapy are needed to treat the life threatening, metastatic disease.
Dr. Val: Is there any way to screen for bladder cancer?
Dr. Schoenberg: Unfortunately at this time urine tests for bladder cancer are very expensive, and they don’t detect cancer reliably. However, many researchers (including myself) are currently on a hunt for specific bladder cancer markers that are inexpensive and reliable. Once we find such a marker or group of markers, it would make sense to begin screening — at the very least — high risk groups such as smokers or people with occupational exposures to chemicals.
Dr. Val: What are the most promising advancements in bladder cancer treatment? Is there new research in the pipeline that could improve its diagnosis or treatment?
Dr. Schoenberg: There are two different areas of research interest in bladder cancer. The diagnostics arena — finding cancer more efficiently, effectively, and less invasively — and the therapeutics arena — developing new tools, drugs, and agents to get rid of cancer cells.
On the diagnostic front, molecular diagnostic researchers are looking at abnormal cancer proteins and DNA that can be detected in urine samples. Because of this research, in the next 5-10 years it wouldn’t surprise me if we no longer had to rely on cystoscopes for the diagnosis of bladder cancer. Also we’d like to develop molecular and genetic profiles in order to risk-stratify people more successfully (i.e. figure out who is at greater risk for bladder cancer, and make sure they get tested).
On the treatment front, there are a number of companies developing targeted therapies for bladder cancer. It’s possible that these therapies will reduce the risk of progression and recurrence in people with bladder cancer.
Unfortunately, bladder cancer has only attracted a fraction of the research dollars that other cancers have in patients in the same demographic (like pancreatic cancer). In fact, NIH funding for bladder cancer research is pitifully small and shrinking, despite the fact that there are 600,000 Americans who have bladder cancer right now. Not only that, but bladder cancer is one of the most expensive cancers to treat – because it requires repeated cystoscopies, catheter-based infusions, repeat surgeries, and sometimes chemo and radiation. Bladder cancer treatment costs Americans about 1 billion dollars a year.
Dr. Val: Why isn’t bladder cancer receiving the research funding it deserves?
Dr. Schoenberg: Successful cancer groups have highly visible champions for the disease – like Lance Armstrong for testicular cancer, or Susan G. Koman for breast cancer. Research funding seems to be strongly influenced by highly visible people getting out there and making a ruckus. We need powerful spokespeople to help Diane Quale at the Bladder Cancer Association Network to get the word out.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 17th, 2008 by Dr. Val Jones in Uncategorized
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I’m really looking forward to this medical blog meeting in DC. Here is the media release – I hope to see you there!
On Tuesday, July 29, the Kaiser Family Foundation is sponsoring a discussion about the growing influence of blogs on health news and policy debates. Only in the past few years has the blogosphere become mainstream. In the health policy arena, we now see policymakers, journalists, researchers and interest groups utilizing this new media tool to deliver information to their audiences.
The briefing will highlight how the traditional health policy world has embraced blogging and will feature a keynote address by U.S. Department of Health and Human Services Secretary Michael Leavitt, the first cabinet officer to author an official blog, followed by a moderated discussion with a variety of health policy bloggers and a media analyst.
Questions to be explored with the panelists include: Why do individuals and organizations blog? How does blogging impact the broader work of an organization? Are there different standards used when blogging versus other writing? Have blogs impacted the news business significantly? What kind of influence are blogs having on political and policy debates?
Welcome and Introduction Drew Altman, President and Chief Executive Officer, Kaiser Family Foundation
Keynote Address The Honorable Michael O. Leavitt Secretary, U.S. Department of Health and Human Services
Panel Discussion Vicky Rideout (moderator) Vice President, Kaiser Family Foundation and Director, Kaiser Forum on Health Journalism and the News Business
Jacob Goldstein, Wall Street Journal
Michael Cannon, Cato Institute
Ezra Klein, American Prospect Magazine
John McDonough, Office of Senator Edward Kennedy and formerly of Health Care for All in Massachusetts
Tom Rosenstiel, Center for Excellence in Journalism
WHEN: Tuesday, July 29, lunch served at 12:30 p.m. and program begins at 1:00 p.m. Add this event to your Outlook Calendar (Please note that all times are ET). WHERE: Barabara Jordan Conference Center , 1330 G Street, NW , Washington , DC . For those who cannot attend, the event will be webcast live. RSVP: If you plan to attend the event, please send your name and affiliation to rsvp@kff.org.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 16th, 2008 by Dr. Val Jones in Celebrity Interviews, Patient Interviews
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Bob Schieffer is broadcast journalism’s most experienced Washington reporter. He has covered Washington for CBS News for more than 30 years, and has been the anchor for Face The Nation (one of the longest-running news programs in the history of television) since 1991. I had the privilege of interviewing him about his bladder cancer at the CBS studios today. It is Bob’s sincere hope that his story will inspire others to seek medical help at the first sign of bladder cancer, and also gain comfort from knowing that they are not alone.
This is part two of our interview series. Click here for part one.
Dr. Val: Do you have any advice for patients facing bladder cancer?
Schieffer: Bladder cancer is a very insidious disease, you can have it for a long time without knowing that you have it. At the first sign of blood in the urine, you need to go to the doctor. I think men are often reluctant to go to the doctor, and their tendency may be to attribute blood in their urine to a muscle strain of some kind. But waiting is a dangerous proposition. When I think of my own situation, I realize that even waiting another week or two could have put me into a whole different risk category and I might not be where I am today.
Cancer research is such an evolving field – that if you can keep yourself alive today, there may be a cure tomorrow. That’s the good news about this. The bad news is that we spend about as much on cancer research in a year as we do on one day in Iraq. I don’t know anyone in the cancer community who doesn’t believe that if we invested enough money in it we’d find cures.
Dr. Val: Was it hard for you to speak publicly about your cancer?
Schieffer: Tony Snow and I became really good friends, and we both felt that we had an obligation to talk about our conditions in order to promote cancer awareness. Hamilton Jordan was also a good friend of mine, and he devoted his life to raising awareness. He survived 5 cancers though the 6th one got him. I was a very private person before all this started, and when Hamilton found out I had cancer he called me and said that I really needed to get out and talk about it because I have the opportunity to have an impact on so many people.
As it turned out, I went on Don Imus’ radio show one morning and talked about it, and soon afterwards Wolf Blitzer asked me to be on his show on CNN. I must have received 600 emails from people thanking me for talking about my situation – some were glad to know how to recognize potential bladder cancer, and others told me they no longer felt alone in their cancer experience because they knew that I was going through it too. At that point, I thought to myself that speaking out about my cancer might have been the most important thing I’ve done so far as a journalist. If one person goes to see their doctor when they first notice blood in their urine, then I may have had a part in saving a life.
Bladder cancer is a “below the belt” disease and people are reluctant to talk about it. I think it’s really important to help people get past this barrier. It is nothing to be ashamed of, there’s nothing wrong with you as a person – it’s just that a certain percent of us are going to get bladder cancer.
Dr. Val: How do people get plugged in to the cancer community to get the help they need?
Schieffer: What I’ve noticed is that when you get cancer, you become acqainted with everyone else who has it. There’s a kind of natural networking that occurs when you participate in meetings and events. However, I’d encourage people affected by bladder cancer to go to the Bladder Cancer Advocacy Network. The founder, Diane Quale, left her job as an attorney to create the advocacy group after her husband was diagnosed with bladder cancer. She has raised hundreds of thousands of dollars for the cause, although sadly her husband lost his battle with bladder cancer a few weeks ago.
Hamilton Jordan told me this, “You have to take control of your disease. Nobody is going to be more interested in it than you. It’s your life, so you’re the one who has the most invested in this. Just Google ‘bladder cancer’ and learn as much as you can about it.”
When you go to a doctor, especially with cancer, it’s invaluable to get a second opinion. I got a second opinion from a wonderful physician at Johns Hopkins, Dr. Mark Schoenberg. And Dr. Schoenberg told me this: “A doctor is like a good craftsman. A good craftsman is always happy to show his work to other craftsmen. It’s the guy who isn’t really sure what he’s doing who doesn’t want to discuss his work with somebody else in the field.”
Dr. Val: What’s your bottom line about cancer?
Schieffer: Cancer is not something to be embarrassed about. It’s something that happens to us and needs to be dealt with. When the doctor tells you that you have cancer, it is not the death sentence that it once was. Cancer research is advancing every day and we’re finding new ways to fight the disease. There’s no need to say, “I have cancer — this is it” but rather, “I have cancer and what do I need to do about it?” And then you have to do it.
*Visit the bladder cancer center at Revolution Health*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
