Doe Exercise Really Make You Smarter?

What You Need to Know: Recently, some scientists have begun to question whether the apparently beneficial effects of exercise on thinking might be a placebo effect. The benefits of aerobic exercise are not a placebo effect.

Background: Exercise seems to be good for the human brain, with many recent studies suggesting that regular exercise improves memory and thinking skills. Studying this issue is challenging, as there is no placebo for exercise and no way to blind people about whether they are exercising.

Study: An interesting new study asks whether the apparent cognitive benefits from exercise are real or just a placebo effect – that is, if we think we will be “smarter” after exercise, do our brains respond accordingly? Researchers at Florida State University (USA) came up with a clever way to evaluate this: They focused on expectations, on what people anticipate that exercise will do for thinking. If people’s expectations jibe closely with actual benefits, then at least some of the improvements are probably a result of a placebo effect (and not exercise).

Researchers asked half of the study population to estimate how much stretching and toning (three times per week) might improve various measures of thinking, including memory and multitasking. The other volunteers were asked the same questions, but about a regular walking program. In actual experiments, stretching and toning have little if any impact on cognitive skills. Walking, on the other hand, improves thinking. But the survey respondents believed the opposite, estimating that the stretching and toning program would be more beneficial for the mind than walking.

The results from the study suggest that the benefits of aerobic exercise are not a placebo effect. This study was small and involved a self-selected group of people who like completing online surveys. Still, the data suggest exercise really does change the brain and may improve thinking. We should now turn to 1) looking more closely, at a molecular level, at how exercise remodels the brain; and 2) get more of us to exercise. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: NY Times 25 November 2014

Omega-3 Fatty Acids: How to Get Your Heart Healthier

What You Need to Know: Increasing the amount of omega-3s in your diet, whether from fish or flax, will likely decrease your risk of getting heart disease.

Background: A substantial amount of evidence exists supporting the heart-health benefits of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), marine-derived omega-3 fatty acids. However, much less evidence exists to demonstrate the positive effects of alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid.

  • EPA and DHA can be found in seafood and fish oil, and are often consumed in the form of dietary supplements. ALA is found in flaxseed and its oil, vegetable oils, and some nuts, and is now available in supplement form. Other sources of ALA, EPA and DHA are fortified foods such as orange juice, eggs, peanut butter, margarine and bread, among others. While there are many other omega-3 fortified foods in the marketplace, most are relatively low in omega-3 fatty acids.
  • Omega-3 fatty acids are considered essential for human health, but the body does not produce them — therefore they must be consumed in order to maintain appropriate levels.

The Study: In reviewing existing literature on the subject, the researchers conclude that ALA is likely just as effective in preventing cardiovascular disease as EPA and DHA.

My Take: The current evidence suggests that ALA decreases cardiovascular risk. You consider increasing the amount of ALA you consume. Still, we need prospective, randomized trials to determine the optimal amount.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: J. A. Fleming, P. M. Kris-Etherton. The Evidence for -Linolenic Acid and Cardiovascular Disease Benefits: Comparisons with Eicosapentaenoic Acid and Docosahexaenoic Acid. Advances in Nutrition: An International Review Journal, 2014; 5 (6): 863S DOI: 10.3945/an.114.005850

Breast Cancer Spread: A New Test to Predict Metastases

What You Need to Know: A new test (MetaSite Breast) may be commercially available in late 2015. It relies on the tumor microenvironment of metastasis (TMEM) score, something found to be linked to the potential for breast cancer spread (metastasis).

Background: Historically, the most powerful prognosticators for breast cancer included the number of underarm (axillary) nodes involved, size of the primary tumor, and measures of proliferation such as grade. More recent tests for prognosis are based on gene signatures found within the tumors.

Seed and Soil Story: The story of how TMEM fits into the mechanism of tumor metastasis is not a simple one. In their editorial, Dr Jain and colleagues discuss the “seed and soil” theory of metastasis originally proposed by Paget more than 100 years ago, in which the “seed” is a tumor cell, and its ability to thrive depends on the “soil” of the tumor microenvironment. According to the editorial, when the tumor travels to its metastatic site (congenial soil), it carries along with it some of the the original “soil” in which it grew.

Although TMEM is focussed on a trio of cells — tumor cells, macrophages, and endothelial cells lining blood vessels — that are present at the extravasation site, Dr Jain’s editorial indicates that preclinical models of metastasis provide evidence that heterotypic clumps of cells that travel to other sites may additionally contain other cells from the original soil in which it grew — fibroblasts, myeloid cells, and stromal cells.

These observations from animal models suggest that tumor metastasis does not conform to the standard view that “single cancer cells crawl into the blood vessels, adhere downstream to the endothelium, and then transmigrate in a manner similar to leukocytes.”

  • The MetaSite Breast test could be available commercially late next year. It relies on determining the tumor microenvironment of metastasis (TMEM) score, and a group of researchers from the Albert Einstein College of Medicine in New York City have shown that it is possible to correlate this score with the potential for breast cancer metastasis.
  • Tumor microenvironment of metastasis (TMEM), consisting of direct contact between a macrophage, an endothelial cell, and a tumor cell, has been associated with metastasis in both rodent mammary tumors and human breast cancer.

My Take: Currently used gene signatures (including MammaPrint and OncoType DX) are associated with the probability of distant disease recurrence and are in clinical use as prognosticators. These signatures are primarily driven by genes reflecting the amount of cancer cell proliferation and the presence (or absence) or hormone receptors in the tumor. Now we have the exciting promise of adding in characteristics of the tumor microenvironment to offer better prognoses. I think this approach represents a fundamental change in how we approach cancer. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

References: 

  • Thomas E. Rohan, et al. JNCI J Natl Cancer Inst Volume 106, Issue 8
  • Solicited editorial: Dan G. Duda, Marek Ancukiewicz, Steven J. Isakoff, Ian E. Krop, Rakesh K. Jain. jnci.oxfordjournals.org. July 31, 2014.

Weight-Reduction: Does Diet Type Matter?

What You Need to Know: Although there are statistically significant differences between various diets, the differences are not clinically significant. If you are going to diet for weight loss, choose a good one with which you will stick.

Background: In the USA, approximately two-thirds of the population is overweight or obese. It would be best if we could recommend an optimal diet. Here we have many choices: The Atkins diet, the Ornish diet, Zone, South Beach, Jenny Craig, etc.

The Study: Johnston and colleagues performed a meta-analysis (study of a collection of studies) of 48 weight-loss trials (with 7.286 subjects). The authors categorized the diets as low-fat or low-carbohydrate.

Although the researchers found statistically significant differences when comparing the studies, they appear to be of little clinical significance. At the 1 year follow-up mark, those on low-carbohydrate diets had a mean weight loss of 7.99 kilograms, versus 7.27 kg on low-fat diets.

I’m Dr. Michael Hunter. And don’t forget the exercise, preferably no less than the equivalent of a brisk walk for 150 minutes per week (for example, 30 minutes for 5 days per week minimum).

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

In Breast Cancer Survivors, Depression Lingers

What You Need to Know: Women who survive breast cancer face a higher risk of depression that can linger, according to a new study published online in the Journal of Clinical Oncology.

The Study: Researchers in Copenhagen looked at data on nearly two million Danish women between 1998 and 2011, all of whom were initially free of cancer. During the study period, they found 44,494 women were diagnosed with breast cancer.

  • The risk of having to check into a hospital for severe depression was 70 percent higher for the breast cancer patients in the first year after diagnosis than their cancer-free peers. The breast cancer patients were also three times more likely to use antidepressants during the first year after diagnosis.
  • The women diagnosed with breast cancer used antidepressants more than their peers up to eight years after their diagnosis. The researchers found that patients at highest risk included women aged 70 or older, those with node-positive breast cancer, and those with other serious health problems. The type of surgery or treatment had no effect on depression risk.

“Cancer is feared, as it may metastasize, recur, and even kill you,” lead researcher Christoffer Johansen, M.D., of the Danish Cancer Society Research Center in Copenhagen, told HealthDay.

My Take:  Cancer can be a frightening disease, and many patients become overwhelmed when facing it. Treatment may also induce depression. Some individuals become overwhelmed, and become depressed. Approximately 20 percent of cancer patients experience a clinical depression during the first five years as cancer survivors. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Suppli, Nis P., et al. “Increased Risk for Depression After Breast Cancer: A Nationawide Population-Based Cohort Study of Associated Factors in Denmark, 1998-2011.” Journal of Clinical Oncology. doi: 10.1200/JCO.2013.54.0419. October 27, 2014.

Different Brain Tumors Have the Same Origin

What You Need to Know: Glioma is a common name for serious brain tumors. Different types of glioma are usually diagnosed as separate diseases and have been considered to arise from different cell types in the brain. Now researchers at Uppsala University, together with American colleagues, have shown that one and the same cell of origin can give rise to different types of glioma. This is important for the basic understanding of how these tumors are formed and can contribute to the development of more efficient and specific glioma therapies.

The most common primary, malignant brain tumors in adults, called glioma, are formed from cells in the brain that are not nerve cells. These are serious tumors that lack highly effective treatment, and relapses are common. There are different types of glioma, classified according to an established system based on which cell type the tumor arises from. The most common gliomas are astrocytoma, which have their name from astrocytes, and oligodendroglioma, which are believed to arise from oligodendrocytes. Patients with astrocytoma have a poorer prognosis than oligodendroglioma patients, and the two tumor types are considered separate clinical diagnoses.

“Since the tumor types look different and have different prognoses it has been assumed that they arise from different cells of origin in the brain, but the fact is that the exact cell of origin has not been determined for any glioma. We have for a long time been interested in finding out more about the origin of gliomas and how it is associated with the genetic alterations that cause the tumor,” says lead researcher Lene Uhrbom.

In collaboration with colleagues in the United States, Uhrbom’s research group has studied glioma development in mice. Using tumor models for both astrocytoma and oligodendroglioma, which are very similar to human tumors, they showed that one and the same cell type, called oligodendrocyte precursor cells, could give rise to both tumor forms.

The researchers discovered that it is not the cell of origin but rather the genetic aberrations that control which tumor type is formed. By analysing gene activity in a large number of human astrocytoma and oligodendroglioma they could also conclude that the tumors are more similar to one another than was previously believed. This supports their finding that the glioma diagnoses can have the same origin.

“We saw that the same kind of more differentiated cell of origin, which has previously only been shown to give rise to oligodendroglioma, also can give rise to astrocytoma. New findings such as these increase our understanding of the basic mechanisms that cause glioma,” says Lene Uhrbom.

I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Uppsala University. “Different brain tumors have the same origin, new findings show.” ScienceDaily. ScienceDaily, 28 October 2014. <www.sciencedaily.com/releases/2014/10/141028214055.htm>.

Would A Lottery Ticket Tempt You to Get Colon Cancer Screening?

What You Need to Know: Convincing patients to do an often dreaded colon cancer screening test could just take a little extra nudge – like a chance to win $50. Patients who were told they had a 1-in-10 chance of winning $50 were more likely to complete home stool blood tests that help screen for colon cancer, according to a new study.

“Our study is another example of how modest financial incentives may go a long way in improving health behaviors and health care quality,” says author Jeffrey Kullgren, M.D., M.S. M.P.H. “Integrating a small lottery incentive into usual care is a low cost tool with potential to promote patients’ use of a service proven to saves lives by catching cancer early.”

Background: Officially called a fetal occult blood test, the home kit requires patients to take a sample of their bowel movement and mail it to a lab. The test helps detect hidden, microscopic blood in stool that may be an early sign of abnormal growths (polyps) or cancer in the colon. It is the least expensive way to screen for colon cancer and is recommended annually for people over the age of 50, but only about one-third of patients who are prescribed the home kit actually complete it.

The Study: Researchers wanted to see what price might help reverse the trend, looking at whether flat dollar amounts of up to $20, a chance to win $50 or raffle for $500 could be an effective incentive. The $50 lottery approach had the greatest impact, increasing the test completion rate by 20 percent. The study was done at the Philadelphia (USA) Veterans Affairs Medical Center among 1,549 patients who were prescribed the blood stool test.

“Fecal occult blood tests are inexpensive and an effective way to find colon cancer early and save lives. It’s up to the patient, however, to do this test at home and unfortunately completion rates are low,” says Kullgren, who is also a member of U-M’s Institute for Healthcare Policy and Innovation.

My Take: Low cost incentives may help us to improve our ability to prevent chronic diseases. This approach is worthy of more exploration in a number of health areas. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: University of Michigan Health System. “Need to encourage patients to screen for colon cancer? Try a lottery.” ScienceDaily. ScienceDaily, 17 November 2014. <www.sciencedaily.com/releases/2014/11/141117174330.htm>.