Education
Selenium
Selenium is a trace mineral in the human diet. There is also little knowledge in society about the impact of this element on human health. It is definitely not as popular as magnesium or zinc, although it is equally necessary in our diet. Humanity became aware of the existence of selenium over two centuries ago, when it was isolated by the Swedish chemist Jacob Brezelius. What more do we know about him now? First of all, it is an essential component of enzymes involved in oxidation-reduction processes and cytochrome, thanks to which it protects cell membranes, and therefore the cells themselves, against oxidative stress. Hence its beneficial effect on the immune system. People suffering from any thyroid disorder have certainly come across information about its key role in the metabolism of this gland's hormones. The problem of male infertility allowed us to draw attention to the role of selenium in proper spermatogenesis, where this ingredient is necessary for the formation of sperm with proper structure and the desired motility. Less known properties of selenium include its influence on the proper functioning of the muscular system, including the heart muscle. They are so important that in regions of the world exposed to extreme deficiencies of this element, we are dealing with a specific cardiomyopathy (Keshan disease). We will also find information confirming the impact on the low birth weight of newborns whose mothers were deficient in this microelement. There are interesting reports about the effect of selenium on the nervous system, where deficiencies manifest themselves in mood declines. And finally, related to the antioxidant effect, it influences the development/inhibition of some cancer diseases, e.g. prostate, lung or colon cancer. Selenium deficiency may manifest itself through: - hair loss and brittle nails, - nervous system disorders (low mood, depression), - fatigue, - weakness of skeletal muscles and heart muscle, - weakened immunity, - thyroid abnormalities, - male fertility disorders. Where to look for selenium? The element is taken from the soil by plants, which become food for herbivorous animals. Theoretically, both animal and plant food can be its source. Foods recommended for deficiencies are most often: offal (kidneys), eggs, dairy products, sea fish, mushrooms, garlic and Brazil nuts. The latter, generally considered to be the richest source, obviously do not come from our region, and when buying them we may not be 100% sure whether they actually come from areas rich in this element. In practice, in Polish latitude, we deal with low selenium content in the soil, which results from the geographical location. The rocks from which the soil is formed in our native areas are very low in selenium. Additionally, the acidic nature of these soils makes it difficult for plants to absorb the said mineral. Supplementation may be the solution to replenish the deficiencies. The preparations available on the market include both organic forms (l-selenomethionine) and inorganic forms, e.g. sodium selenate. The daily recommended intake of selenium for adults is 55 mcg. However, supplements may contain a dose almost four times higher, up to 200 mcg. When supplementing selenium, it is worth remembering that it is a trace element for humans, which means that there is a small difference between a therapeutic and toxic dose. Therefore, despite potential deficiencies, when deciding on supplementation, it should be used very carefully, in accordance with the dictum of Paracelsus Everything is poison and nothing is poison. Only the dose makes a substance not a poison. Marta Wcześniak BIBLIOGRAPHY: Piotrowska "Content of selenium in cultivated soils of Poland", Roczniki Gleboznaczne T XXXX, No. 1, Warsaw 1984 Golonko, B. Matejczyk "Two faces of selenium, selected aspects of the biological activity of selenium" Civil and Environmental Engineering 9 (2018) Ratajczak, M. Gietka-Czemel "The role of Selenium in the human body" Advances in Medical Sciences 2016 XXXIX(12) Resolution No. 7/2021 of the Team for Dietary Supplements of 28/10/2021
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Painkillers and health
Year by year, sales statistics of painkillers increase, according to many of them, in recent years by up to 250%! Pain is an inherent part of the human experience, and pain medications are often the first choice for relieving symptoms. However, their excessive and regular use may have adverse consequences for human health. It is worth understanding the different types of painkillers, their potential side effects and the causes of pain in order to approach the topic responsibly. Types of Painkillers: NSAIDs (non-steroidal anti-inflammatory drugs): Examples are ibuprofen, diclofenac. They have anti-inflammatory and analgesic effects by inhibiting enzymes responsible for inflammation. They may cause gastrointestinal problems. SIDE EFFECTS: May cause gastrointestinal problems, ulceration, bleeding. Paracetamol: Has an analgesic and antipyretic effect. Its excess can damage the liver. SIDE EFFECTS: Too high a dose or given for too long may damage the liver. Opioids: Strong painkillers such as morphine or oxycodone. They can lead to addiction and have a depressing effect on the respiratory system. SIDE EFFECTS: Risk of addiction, respiratory depression, drowsiness. DON'T IGNORE THE PAIN! Pain can be a signal from the body that something is wrong. Pain symptoms in the head, joints, spine or abdomen may be caused by various reasons, such as injuries, infections, chronic diseases or improper habits. Ignoring pain can worsen your condition and delay proper diagnosis. DO YOU EXPERIENCE PAIN REGULARLY? Consult a doctor - pain is intense, frequent or persistent, it is worth consulting a doctor to rule out serious health problems. ATTENTION! Don't overuse painkillers: Use medications only as directed by your doctor or as directed on the package. Adopt healthy habits - a healthy diet, regular physical activity and avoiding stress can help reduce pain; in many cases, recurrent weakness, nausea or headaches result from DEHYDRATION or lack of adequate food during the day. Remember that a healthy approach to pain involves recognizing its cause, not just masking the symptoms with painkillers. When in doubt, it is always a good idea to consult your doctor to ensure that you receive appropriate medical care. Mata Wcześniak Bibliography: American Heart Association. (2020). Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). National Institute on Drug Abuse. (2020). Opioids. Mayo Clinic. (2021). Pain Medications: Prescription pain relievers, OTC pain relievers and topical products. Harvard Health Publishing. (2019). The hazards of too much acetaminophen. Mayo Clinic. (2021). Pain Management: Pain basics. Harvard Health Publishing. (2020). When Pain Relievers Cause More Headaches.
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Sleep disorders and their impact on the course and control of diabetes
Diabetes is a very common disease nowadays. It is called a civilization disease or a non-communicable epidemic of the 21st century. About 3 million people suffer from the disease in Poland, and approximately 440 million in the world, which translates into 1.6 million deaths annually due to it. The disease increases mortality but also deteriorates the quality of life. Diabetes that is improperly treated and poorly controlled causes very serious complications, mainly cardiac ones - more frequent heart attacks, strokes, atherosclerosis of arterial vessels, and, as a consequence of these changes, an increase in the number of lower limb amputations, cases of kidney failure, and diabetic retinopathy. Peripheral polyneuropathy is a very painful symptom, affecting mainly the feet and significantly worsening the patient's quality of life. Currently, an individual approach to a patient with diabetes is emphasized, because each case is different. Each patient struggles with diabetes at different stages and degrees of advancement, uses different antidiabetic drugs or insulin therapy, has a different lifestyle, work pattern, ability to perform physical activity or follow an appropriate diet, which is so important in diabetes. Despite increasingly better treatment methods, modern drugs and insulins, new insulin pumps and continuous glucose monitoring (CGM) systems, good diabetes control and avoiding hyper- or hypoglycemia are still influenced by many elements of the patient's daily life. Regularity, repetition, consistency of eating, working and resting times, avoiding excessive stress, worrying, living in a hurry, as well as the ability to get good and healthy sleep are very important. The latest diabetes recommendations of the PTD emphasize the role of sleep, its duration and quality on the course of diabetes. Sleep disorders affect diabetes in two ways. On the one hand, they worsen its balance, causing morning hyperglycemia, increased insulin resistance, and certain neurological disorders that persist during the day regarding concentration, memory, and emotion. On the other hand, diabetes, especially insulin therapy or traditional, older drugs such as sulfonylurea derivatives, generate glycemic disturbances at night and impair the quality of sleep. Sleep disorders in patients with diabetes and their adverse impact on health parameters The journal Diabetologia conducted a meta-analysis on the incidence of sleep disorders in type 2 diabetes and their impact on factors such as glycemic control, micro and macrovascular complications, depression, mortality and quality of life. The authors, based on the available literature in the PubMed database, asked the extent to which the treatment of sleep disorders in patients with type 2 diabetes can improve the mentioned health factors. The review included both observational and experimental studies. The results showed that insomnia (39%), obstructive sleep apnea (55-86%), and restless legs syndrome (8-45%) occurred more often than in the general population without diabetes. Moreover, it has been shown that sleep disorders have a significantly negative impact on glycemic control and increase the percentage of glycated hemoglobin HbA1c. The reason for the increase in glycemia after a bad night's sleep is believed to be an increase in the amount of stress hormones, mainly cortisol, which causes metabolic disorders, insulin resistance, slower metabolism, difficulty maintaining optimal body weight, and additional snacking at night or in the morning. Repeated sleepless nights increase your cardiovascular risk. It has been proven that people who sleep little have higher levels of CRP (acute phase protein), which causes a greater risk of inflammation, weakened immunity, a greater risk of obesity, diabetes, hypertension, depression, and cancer. Already the first sleepless night causes memory and concentration disorders, weakened reflexes and the ability to react, anticipate, make decisions and various emotional disorders. Each additional one increases the risk and intensity of the above-mentioned disorders. Such a person may have impaired driving skills, limited assessment of the consequences of actions and reduced foresight, which may contribute to an increased risk of road accidents or accidents at work. The body returns to full balance only after three consecutive nights of sleep. Treating sleep disorders may therefore play an important role in preventing the progression of diabetes. Conventional therapies such as weight loss, education, and cognitive behavioral therapy appear to be effective in improving sleep and health outcomes in patients with diabetes. Sleeping medications should only be used in more severe cases and for short periods of time. For this purpose, you can use herbal medicines that have a relaxing and sleep-inducing effect, as well as melatonin. In conclusion, it can be stated that because the treatment of sleep disorders can prevent deterioration of diabetes control, sleep disorders should be recognized and treated in patients with diabetes in order to ultimately improve health and quality of life. Diabetes and drug therapy as factors worsening sleep quality A diabetic patient using insulin therapy, especially intensive 3-4 injections a day, and also treated with an insulin pump or older generation drugs, such as sulfonylurea derivatives, is more exposed to fluctuations in glycemia at night, which may manifest as: Hyperglycemia, i.e. too high blood glucose level >180 mg, with symptoms of difficulty falling asleep, more frequent urination - nocturia and large amounts of urine excreted (polyuria), Hypoglycemia, i.e. too low glycemia level <70 mg/dl. It may cause waking up at night or waking up with heavy sweats, deterioration of sleep quality, problems with waking up, feeling tired, dull, and irritable during the day. To avoid these problems, you should choose the appropriate meal for dinner, especially the amount of carbohydrates in the meal, and adjust the appropriate dose of insulin depending on the glycemia before the meal, e.g. around 6:00 p.m., and basal insulin, usually administered around 10:00 p.m. Currently, with advanced devices for measuring CGM (Continuous glucose monitoring system), new insulin pumps with a hybrid system and closed loop, significant nocturnal hypo- or hyperglycemia is becoming less common, and patients have a better quality of life and avoid dangerous complications of diabetes. . To ensure comfortable sleep, remember the basic rules, such as the appropriate temperature in the bedroom (about 18 degrees Celsius), airing the room, properly selecting a sleeping pillow and mattress, and using headbands or earplugs. In the evening, it is important to turn off multimedia and avoid intense exercise late at night. It is worth remembering about fixed sleep times and avoiding shift work at night. To sum up, detecting and treating sleep disorders is not usually part of standard patient care in a diabetes office, which is often due to the time limit of such a visit, but drawing attention to this problem in the doctor's office and ensuring the patient's good sleep contributes significantly to improving diabetes control. , and sometimes to prevent it and reduce the risk of other diseases and health problems mentioned in this article. Krzysztof Chabros Diabetologist specialist Literature: Urszula Cieślik-Guerra, Sleep disorders as a risk factor for type 2 diabetes, " Fam Med Prim Care Rev11.3 (2009), pp. 574-576. Clinical recommendations for the management of patients with diabetes 2022. Position of the Polish Diabetes Association. Current Topics in Diabetes, 2022;2 (1) p. 26.
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How a psychologist can help a person suffering from cancer
The area of psychological assistance for a person with cancer is quite wide, and depending on the type of disease, the scope of this support may vary. Cancer is not only a series of disorders within the body and the complexity of the treatment process, but it is also a very stressful event with significant psychosocial consequences related to the physical, emotional, spiritual and interpersonal dimensions. This disease affects, to a greater or lesser extent, all aspects of functioning, including those related to existence (e.g. confrontation with mortality). These are changed by diagnosis and treatment, recovery and long-term survival, relapse or transition to palliative and end-of-life care. Hearing a diagnosis of cancer is life-changing and a source of significant mental and emotional stress. High levels of psychological stress over long periods of time in cancer patients can lead to anxiety, depression, or both [1]. A frequently experienced condition is the fear of cancer recurrence. The problems that a person affected by cancer may experience mental problems not only by affecting the health-related quality of life [2], but may also have economic consequences [3]. What can a cancer patient expect from a psychologist in such a situation? First of all, it should be remembered that the variety of stages of the disease experienced and the goals of a given person must be accompanied by various forms of psychological impact. The scope of support that an oncology patient can receive includes: psychological counseling - activities aimed at helping in finding new strategies for coping with experienced difficulties; crisis interventions - multi-faceted help for a person in a psychological crisis or other serious life problems; and psychotherapy [4]. The support of a psychologist can be helpful not only when there is a lack of support from family or friends. Research and scientific literature indicate an overall benefit in reducing the severity of mental health symptoms (depression, anxiety [5]), somatic symptoms (pain [6]) and in improving the overall quality of life, well-being, and the process of returning to work [7, 8 ] and thoughts related to the experience [9-11]. There is increasing evidence supporting the use of mind-body therapies as effective supportive care strategies during cancer treatment, although many of them remain under-researched [12]. A psychologist as an outsider, i.e. not emotionally involved in the relationship with the patient, can share a different perspective than the one the patient shares with his or her loved ones. Moreover, it may be easier to discuss difficult topics with him, such as suicidal thoughts or fear of death. Actions on the part of the psychologist may include: support in dealing with emerging emotions; support in managing anxiety related to required medical procedures; adaptation to the disease, its stages and changes in well-being; dealing with the topic of the finiteness of life; learning relaxation; support during remission; and working with the patient's family. Psychologist help for me and my family Cancer does not only affect the sick person. The patient's family also goes through the process of illness and treatment: partner, children, friends, other loved ones. The threat that such a disease poses to a given family can be understood in the light of how different members, individually but also as a team, understand specific stressful situations, their identity and the identity of their family, and the general way of perceiving the world [13, 14]. Neither patients nor their families can ever return to the situation before the disease [15]. Effective coping with breakup and loss often depends on the felt support from others. Providing psychological support can help identify adaptive, functional and maladaptive mechanisms of coping with the situation [16]. Instead of a summary Cancer affects not only the sick person, but also the people closest to the patient. The fear of potentially losing a loved one can be as overwhelming as the disease itself. Not every oncology patient has to seek the help of a psychologist, but if you or someone close to you find yourself in a situation that is a great mental burden for you, do not hesitate to seek such help. Ida Garstecka Bibliography Linden, W., Vodermaier, A., Mackenzie, R., Greig, D., (2012) Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 141:343–351. [ Pubmed ] Dunne, S., Mooney, O., Coffey, L., Sharp, L., Desmond, D., Timon, C., O'Sullivan, E., Gallagher, P., (2107) Psychological variables associated with quality of life following primary treatment for head and neck cancer: a systematic review of the literature from 2004 to 2015. 26 , 149- 160. [ PubMed ] Carlson, LE, Bultz, BD, (2004) Efficacy and medical cost offset of psychosocial interventions in cancer care: making the case for economic analyses. Psychooncology . 13: 837- 849. [ PubMed ] Czabała, C., Sęk, H., Psychological support. (2000) In: J. Strelau (ed.) Academic handbook. (pp. 605-622) Gdańskie Wydawnictwo Psychologiczne [ Google Scholar ] Zainal, NZ, Booth, S., Huppert, FA, (2013) The effectiveness of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. 22 (7):1457–65 [ PubMed ] Johannsen, M., Farver, I., Beck, N., Zachariae, R., (2013) The effectiveness of psychosocial intervention for pain in breast cancer patients and survivors: a systematic review and meta-analysis. Breast Cancer Res Treat. 138(3):675–90 [ PubMed ] Hunter, E.G., Gibson, R.W., Arbesman, M., D'Amico, M., (2017) Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions. Am J Occup Ther . 71 (2):7102100030p1–7102100030p11. [ Pubmed ] Hunter, E.G., Gibson, R.W., Arbesman, M., D'Amico, M., (2017) Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to- Work Interventions. Am J Occup Ther. 71 (2) [ PubMed ] Barrera, I., Spiegel, D., (2014) Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression. Int Rev Psychiatry. 26 (1):31–43. [ Pubmed ] Spiegel, D., (2012) Mind matters in cancer survival. Psychooncology . 21 (6):588–93. [ Pubmed ] Galway, K., Black, A., Cantwell, M., Mills, M., Donnelly, M., (2012) Psychosocial interventions to improve quality of life and emotional well-being for recently diagnosed cancer patients. Cochrane Database Syst Rev. 11 : CD007064. [ Pubmed ] Greenlee, H., DuPont-Reyes, M.J., Balneaves, L.G., Carlson, L.E., Cohen, M.R., Deng, G., Johnson, J.A., Mumber, M., Seely, D., Zick, S.M., Boyce, L.M., Tripathy, D., (2017) Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin 67 (3):194–232. [ Pubmed ] McLean, LM, Jones, JM, Rydall, AC, Walsh, A., Esplen, MJ, Zimmermann C., Rodin GM (2008) A couples intervention for patients facing advanced cancer and their spouses. Psycho-Oncol 17 :1152–1156 Baider, L., Ever-Hadani, P., Goldzweig, G., Wygoda, M., Peretz, T. (2003) Is perceived family support a relevant variable in psychological distress? A sample of prostate and breast cancer couples. J Psychosome Res 55 :1–8 Baider, L., Cooper, C.L., Kaplan De-Nour, A. (2000) Cancer and the family, Wiley Goldzweig, G., Hubert, A., Walach, N., Brenner, B., Perry, S., Andritsch, E., Baider, L. (2009) Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome. Crit Rev Oncol Hematol 70 :71–82
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Medicine or dietary supplement? What to choose?
Mr. Magister, I would like some magnesium "in the form of a MEDICINE". A conversation at the pharmacy window often begins with this phrase. Then the patient begins a long analysis of the composition and packaging to be 100% sure that there is no inscription "dietary supplement" on it. The pharmacist often avoids talking about this topic, but should still be prepared to talk to the patient. The problem of distinguishing and comparing drugs and dietary supplements is quite difficult. Both product categories are placed on adjacent stands and have similar, and often the same, composition. So what is the mystery and why do patients try so hard to buy a drug and not a dietary supplement? Let's start with individual definitions. A medicinal product is a substance or mixture of substances presented as having properties for the prevention or treatment of diseases occurring in humans or animals or administered for the purpose of making a diagnosis or for the purpose of restoring, improving or modifying the physiological functions of the body through pharmacological, immunological or metabolic action. (Pharmaceutical Law of September 6, 2001, Chapter 1 Art.2 Point 32.) The definition contained in the Act clearly states that a drug (medicinal product) prevents, cures, improves or modifies the physiological functions of the body. Whereas: Dietary supplement - a food intended to supplement a normal diet, being a concentrated source of vitamins or minerals or other substances having a nutritional or other physiological effect, single or combined, placed on the market in a form enabling dosing, in the form of: capsules, tablets, dragees and in other similar forms, sachets with powder, ampoules with liquid, dropper bottles and other similar forms of liquids and powders intended for consumption in small, measured unit quantities, excluding products having the properties of a medicinal product within the meaning of the provisions of pharmaceutical law. (UST AWA of August 25, 2006 on food and nutrition safety, SECTION I, Art. 3 point 3, ppk39) According to this definition, a dietary supplement is a food that is intended to supplement the normal diet with vitamins, minerals and "other" substances. At first glance you can see the difference, but is it really? Looking at the last part of the definition: excluding products with the properties of a medicinal product within the meaning of pharmaceutical law, we reach the point where it is impossible to distinguish a dietary supplement from a drug. What is the difference between a medicinal product containing 2000 IU of vitamin D3 in the form of cholecalciferol and a dietary supplement containing exactly the same in the same form, but in capsules? There are several differences between a drug and a dietary supplement, but neither side achieves a clear competitive advantage. The first issue concerns legal aspects. Various institutions register both product groups. Drug registration is handled by URL (Drug Registration Office). It does this on the basis of many tests and certificates. However, the Chief Pharmaceutical Inspector is responsible for marketing authorization in the country. Dietary supplements are also officially registered by the Chief Sanitary Inspector (GIS) on the basis of an application submitted by the entrepreneur. Therefore, it is not the law that supplements are not subject to control, because the GIS may refuse to register or, in case of uncertainty, may ask for an opinion from the URL. The registration procedure for dietary supplements is shorter and easier to carry out, which is why many drug manufacturers register their next products in this category. The second thing is the doses of individual ingredients. Based on the dose definitions, substances in a drug have a curative or preventive effect, while in a supplement they have a nutritional effect. No less surprising is the fact of the existence of vitamin C - a drug in doses of 200 and 500 mg in the presence of the same vitamin - a supplement in doses of 1000 and 2000 mg. Questions arise about the body's actual needs, the dose that produces a therapeutic or nutritional effect, and the dose that is too high to be safe. Another aspect concerns the origin of the ingredients contained in the products. Due to high standardization requirements and the purity of substances, synthetic substances obtained through chemical reactions are often used in medicinal products. Dietary supplements often contain ingredients of natural origin, which seems to be a healthier solution and more adapted to the living organism. They also contain plant ingredients and their extracts. Sometimes dietary supplements contain plant ingredients that are not found in our climate or in Europe, but which have a proven positive effect on health and fitness. Further differences concern promotion and advertising. No elements of the packaging, names or advertising of supplements may suggest medicinal properties. Each package must also have the description "DIETARY SUPPLEMENT". Every day we are attacked by advertisements for medicines and supplements, so much so that it is difficult to know what and whether it is worth buying to support our health. We consume large amounts of medicines and dietary supplements every day. This is due to the fact that the availability of supplements is very high, advertising in the media is intense, and society is taught to respond to changes in its health by purchasing new preparations. Supplements are used to improve the condition of hair, nails, skin, eyes, joints, etc. We supplement vitamins, minerals and herbs using multi-ingredient products. Therefore, it is important to know the exact composition of a given preparation. There is a high probability that several preparations will contain the same ingredients and by taking a whole range of products we will provide too high doses of the mentioned vitamins or minerals. It is also worth remembering that the most important source of supplementation is food, i.e. what we eat. So how should you approach the use of supplements to make it safe? Let us remember that choosing a drug as a safe form will not always meet the nutritional and health needs of the body. On the other hand, not all supplement manufacturers meet the quality standards of their products. Taking this summary into account, you should follow a few rules to achieve the appropriate nutritional effect while maintaining safety. Here are the rules worth following Let's choose high-end supplements - there are several leading companies on the market. Some of them can be found on our website. Companies with extensive experience, certified products and production standards such as GMP, ISO, etc. The most advantageous offers are provided by companies that grow medicinal herbs themselves and produce vitamin and mineral ingredients instead of mass purchases from suppliers. Let's use only those substances that we need - it's best to discuss the selection of ingredients with a specialist. Do not use supplements recommended by third parties. The appropriate selection of supplements in oncological diseases and post-oncological therapies is extremely important. Many ingredients have the ability to stimulate excessive cell growth. If possible, use single-component or multi-component preparations. We will then avoid the possibility of duplicating doses of the same substance. Let's ask a specialist when and how to take a given product. Often, the absorption of the substance and the effect of the entire preparation depend on the time of day or the meal we take. In light of these assumptions, I believe that the use of dietary supplements can be safe and bring good results. By choosing only medicinal products, we will not achieve long-term effects and visible results. A well-balanced and well-thought-out combination of medicine and dietary supplement can achieve very good results. Let's take the medicines that are necessary for us, let's take the dietary supplements that we need, but let's not forget about proper nutritious food, including fruit and vegetables. Krzysztof Juszkiewicz
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When is it worth visiting a gastroenterologist?
Digestive health plays a key role in an individual's overall health. Our digestive system is not only responsible for the absorption of nutrients, but also plays an important role in the immune system and metabolism. However, its improper functioning can lead to a variety of health problems. Therefore, understanding the importance of digestive health and being aware of signals that may indicate the need to consult a gastroenterologist are extremely important for maintaining full health and well-being. Symptoms that may indicate the need to visit a gastroenterologist are usually related to gastrointestinal problems and can be diverse. Among them stand out: Abdominal pain, which may occur in various places and have a different nature (dull, stabbing, cramping). If the pain persists for a long time or occurs regularly, it may be a sign that there is a problem in the digestive system that requires evaluation by a specialist. Heartburn, i.e. burning or burning sensation in the esophagus and chest area. Its frequent occurrence may indicate gastroesophageal reflux disease, i.e. the reflux of stomach contents into the esophagus, leading to damage to the mucous membrane. Recurrent damage and inflammation predispose to cancer processes, therefore faster diagnosis and initiation of treatment are associated with a better prognosis. Bloating, nausea, vomiting, diarrhea or constipation may indicate various conditions such as irritable bowel syndrome, inflammatory bowel disease, intestinal infections or other digestive disorders. Sudden and unintentional weight loss. If you noticeably lose weight despite maintaining a normal appetite and a healthy lifestyle, this may be a reason to consult a gastroenterologist. Weight loss can be caused by various digestive disorders, such as inflammatory bowel disease, celiac disease, colon cancer or other serious disorders, but cancer can also be the cause. Changes in stool consistency may be an important signal of health problems other than cancer. If continuous diarrhea or constipation is observed, as well as changes in the color, consistency or appearance of the stool, consultation with a gastroenterologist is recommended. This may suggest not cancer but problems such as irritable bowel syndrome, Crohn's disease, ulcerative colitis or other diseases that require diagnosis in a doctor's office. Prevalence of cancer of the digestive system in the family. Separate recommendations for such patients are currently in force and are still being developed. These most often include suggestions for accelerated tests detecting early signals of these diseases and performing an extended panel of genetic tests. Therefore, the presence of cancer or autoimmune diseases in the family should prompt other relatives to take appropriate preventive measures and monitor their health. Environmental factors such as diet, lifestyle, stress factors and infections also play an important role in the occurrence of digestive system cancers. Eating habits and lifestyles may be similar within families, contributing to a similar environment that may promote the development of these conditions. Regular examinations and practicing healthy eating and lifestyle habits can help prevent or detect these diseases early. ATTENTION! If any symptoms occur, it is extremely important not to delay visiting a gastroenterologist. Early recognition and treatment of serious digestive problems, including cancer, can be crucial to continuing to lead a healthy life. Adam Trzciński
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The role of physical activity in cancer prevention
Exercise can increase motivation to change lifestyle, improve aerobic capacity, improve physical fitness, control fatigue and improve quality of life [1], and this is just a part of their beneficial effects on the human body at all ages. It is estimated that almost half of cancer cases can be prevented by changing lifestyle, including physical activity [2], which is one of the four pillars of health. In a report by The World Cancer Research Fund (WCRF) published in 2020, the organization indicates that it plays a significant role in cancer prevention [3] . The main benefits of physical activity include regulating body weight, improving the efficiency of the circulatory and respiratory systems, as well as strengthening muscles and bones. Blood flow and tissue oxygenation are also increased, which translates into greater energy and vitality. Additionally, exercise has a real impact on mental health because regular exercise can reduce symptoms of depression, anxiety and stress by releasing hormones that can improve mood and feelings of overall well-being. Physical activity also improves cognitive functions, i.e. memory, concentration and the ability to focus, and significantly increases the quality of sleep by regulating the circadian rhythm. Regular exercise can help you fall asleep faster and enable deeper sleep, and it also lowers blood pressure, reducing the risk of heart disease. The multi-year European Prospective Investigation into Cancer and Nutrition (EPIC) study of over 500,000 people found that regular physical activity was associated with a lower risk of many types of cancer, such as colorectal cancer, breast cancer, pancreas and endometrial cancer [4]. A meta-analysis based on 170 studies confirmed that regular physical activity is associated with a reduced risk of colorectal cancer. It was observed that people engaging in regular physical exercise had a 24% lower risk of developing this type of cancer compared to people leading a sedentary lifestyle [5]. A study published in the British Journal of Cancer and conducted by the European Prospective Investigation into Cancer and Nutrition - EPIC found that regular physical activity can reduce the risk of breast cancer in postmenopausal women. Women who performed at least 7 hours of moderate physical activity per week had a 13% lower risk of developing breast cancer compared to those who were physically inactive [6]. Systematic physical activity, which can be freely chosen from a wide range of possibilities, from walks in nature, through team games, to individual training in the gym, provides great support in cancer prevention. It is a permanent element of a healthy lifestyle, which is modified depending on possibilities, needs and preferences. In addition to the obvious physical benefits it brings, it has a real impact on improving mood and well-being. Its beneficial effect on the body is multidimensional, so it is worth including it permanently in your weekly plan. Zuzanna Pilipiuk Qiaoyun Wang, Wenli Zhou, (2020) Roles and molecular mechanisms of physical exercise in cancer prevention and treatment, J Sport Health Sci. 2021 Mar;10(2):201-210. doi: 10.1016/j.jshs.2020.07.008. Epub 2020 Jul 30. Christine M Friedenreich, Charlotte Ryder-Burbidge, Jessica McNeil, (2021). Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biological mechanisms, Mol Oncol. 2021 Mar;15(3):790-800. doi: 10.1002/1878-0261.12772. Epub 2020 Aug 18. Steven K Clinton, Edward L Giovannucci, Stephen D Hursting, (2020). The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions, Żuławski, W., Rutkowski, A., & Dziki, A. (2015). Influence of physical activity on the risk of colorectal cancer in the population of the European countries. Contemporary Oncology, 19(1), 7-13. Keum, N., & Giovannucci, E. (2019). Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nature Reviews Gastroenterology & Hepatology, 16(12), 713-732. Steindorf, K., Ritte, R., Eomois, P. P., Lukanova, A., Tjonneland, A., Johnsen, N. F., ... & Schütze, M. (2013). Physical activity and risk of breast cancer overall and by hormone receptor status: the European prospective investigation into cancer and nutrition. International Journal of Cancer, 132(7), 1667-1678.
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The impact of cancer on sexuality
Cancer can have a very diverse impact on a person's sexuality. It depends on many factors, including the type and stage of the disease, the type of treatment used and the individual characteristics of the patient and psychological support - both from specialists and the patient's relatives. Cancer may affect physical and hormonal changes in the body, decreased energy, chronic fatigue, changes in appearance, stress, emotional changes or self-esteem, body image and interpersonal relationships. All the areas indicated above may have a greater or lesser impact on sexuality. Some types of cancer and treatments can lead to physical changes that may affect sexual function. They can, but they don't have to - remember that each case is different, so generalizations are subject to a large margin of error. However, to use specific examples, surgery to remove genital organs may have a significant impact on experiences related to sexuality. Other treatments - such as radiotherapy (especially in the genital area) or chemotherapy - may be equally important and may result in pain, vaginal dryness or erection problems. The desire and appetite for physical intimacy and sex may also decrease [1] . Some types of cancer and their treatment may affect hormone levels. Examples of treatments that influence hormonal changes include removal of the ovaries, surgical treatment of breast cancer or targeted hormonal therapy. This type of treatment may affect both the level of desire and sexual function [2] . Cancer and its treatment usually lead to decreased energy and increased fatigue. It is often accompanied by changes in appearance, such as weight loss, hair loss, or scars after surgery. It is worth remembering that sexuality has various dimensions and may also include building a sense of security and attractiveness. Sex is not prohibited for cancer patients - unless it is a cancer related to the reproductive organs. Undoubtedly, it may be difficult for loved ones to realize that a person suffering from cancer often feels unattractive and defective. The change in self-perception affects the feeling of increasing stress and deepening depression of mood. This is a difficult moment both for the sick person and for their loved ones. A person suffering from oncology has every right to closeness - it is worth talking about their needs and concerns [3] . It may be helpful to formulate messages as direct as possible - e.g. "you can touch me", "don't be afraid to touch me, it doesn't hurt me", "it's important to me, I want you to keep touching me", or "I want you to as little as possible has changed between us. I have to go to the doctor, I have to take medications, but let everything else be as it used to be, I need your touch as much as before (or even more than before).” Cancer may affect self-esteem, body image, interpersonal relationships, and perception of one's sexuality. Some patients may feel a sense of loss, fear of rejection, shame, difficulty communicating with a partner or difficulties in finding their way in a new reality after the diagnosis. It is important that patients talk to their doctors about all problems related to sexuality - there are various strategies, therapies and treatment methods that may be helpful in dealing with the new challenges presented by the disease. Many patients also use the help of psychologists, sexologists or patient support groups [4] . Problems related to sexuality affect the quality of life and should not be treated marginally. Sexual health is important, and when problems arise, it is worth contacting specialists and asking for help. Monika Kaszuba [1] Dębska G., Samochowiec J. (2017). Sexual problems in the course of cancer. Psychiatria Polska, 51(6), pp. 1127-1138 [2] Lemańska A., Skrzypulec-Pinta V., Łuszczak M, et al. (2013). Sexual function in women after breast cancer treatment. “Medycyna Ogólna i Nauki o Zdrowiu”, 19(4), pp. 395-400 [3] Kowalski P., Filipiak M., Krajewski P. (2016) . Reproduction and sexuality of oncology patients. Nursing Polish, 2(60), pp. 175-178 [4] Sobolewski M., (2018). Sexuality of patients with cancer of the reproductive organs - recommendations of the European Society of Oncology (ESMO) and other scientific societies. Ginekologia Polska, 89(2), pp. 103-107
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Anti-cancer diet – is there a miracle diet?
Society's growing awareness of the impact of lifestyle on health means that when we are at increased risk of cancer or when we experience oncological disease in our immediate environment, we look for a way to help protect ourselves against cancer. In addition to realizing the need for early diagnosis, one of the first associations is often a change in the current lifestyle, including eating habits. And rightly so, because according to data published by the World Health Organization, as many as 30-40% of all cancer cases could be avoided by giving up stimulants (nicotine, alcohol), improving the quality of the diet, increasing physical activity and maintaining a healthy weight. The Cancer Research Foundation (WCRF) also drew attention to dietary factors as important in cancer prevention, which devoted as many as 8 out of 10 main recommendations for cancer prevention to elements related to diet. Similarly, the World Cancer Report 2020 emphasizes that both the quantity (e.g. energy value, dietary fiber content) and the quality of consumed food products and meals are important in dietary cancer prevention. Is there one universal anti-cancer diet model? When looking for the answer to this question, many people get lost in the thicket of information available on the Internet or popular mass media. A large number of publications on this topic, repeated dietary myths and nutritional recommendations not supported by scientific evidence make it difficult to decide on the optimal diet. It also happens that you may come across nutritional recommendations that are not only unjustified, but may even pose a threat to the health of the people using them, such as in the case of highly restrictive diets that eliminate selected dietary macronutrients or significantly deviate from the principles of the so-called rational nutrition. Therefore, first of all, it should be clearly noted that an anti-cancer diet is a way of eating that, on the one hand, provides ingredients with a potential protective effect, and on the other - limits or even eliminates those with proven carcinogenic effects. This is a diet model that is not specific and limited only to cancer, but serves to improve the health of the general population, e.g., at the same time protects against the development of obesity, cardiovascular diseases, or type 2 diabetes. In contrast, highly individualized dietary assumptions support for oncological therapy (because there is no diet that in itself "cures cancer"), the main principles of the anti-cancer diet apply in many clinical situations, can be used by a wide range of recipients and, importantly, are safe. Principles of an anti-cancer diet in a nutshell The current state of scientific knowledge allows us to conclude that the most beneficial in this respect is a diet pattern based mainly on plant products, rich in whole grain products, non-starchy vegetables, fruits and legumes. Plant products are the main source of substances with anti-carcinogenic properties and reducing the risk of recurrence - dietary fiber, vitamins and minerals, and bioactive natural substances, including: phytoestrogens, polyphenols, phytosterols and monoterpenes. WCRF recommends that plant products be consumed in at least 5 main meals and that their amount per day should not be less than 400g. In the case of dietary fiber, its daily intake should not be lower than 30g. According to WCRF, animal products should be significantly restricted in the diet - mainly red meat. Its consumption should not exceed 3 servings per week (350-500 grams per week). The consumption of processed meat should be reduced to the minimum necessary, and if possible, this type of food products should be completely excluded from the diet. In fact, the anti-cancer diet does not involve giving up dairy products, poultry or fish, but it clearly indicates that their share in the daily menu cannot dominate the amount of plant products. Similarly to a "healthy, rational diet", people who want to reduce the risk of cancer are recommended to significantly limit or even give up the consumption of processed foods high in saturated and trans fats and sugar. Excluding sweetened drinks from the diet is another feature of the anti-cancer diet. These drinks, by providing simple sugars, also increase the amount of calories consumed and result in an increase in body fat. Many previous studies have proven that some cancers, including cancer of the oral cavity, esophagus, stomach, pancreas, liver, large intestine, breast and endometrium, may result from excess body weight, hence it is also important to ensure that the energy value of the diet was tailored to the real needs of the body. In the case of alcohol, complete abstinence is recommended. Bearing in mind that no food product contains all potentially anticarcinogenic ingredients, make sure to diversify your diet. Only by eating a variety of foods can you provide complementary ingredients with anti-cancer potential. To sum up, it is worth emphasizing once again that there is no single, ideal for everyone and 100% effective model of an anti-cancer diet, but there is strong evidence that a diet based on products of plant origin (various colored vegetables and fruits, whole grain products, legumes) , in which the supply of meat (especially red), processed products (e.g. instant food, fast food, rich in E-additives), simple sugars and alcohol is eliminated, may protect against the development of cancer. The goal of effective dietary health prevention is to permanently improve eating behavior, so when looking for the perfect anti-cancer diet, do not expect a "miracle diet", but focus on a well-thought-out, rational one, tailored to your capabilities and goals, and long-term improvement of eating habits in the direction of the principles described above. Małgorzata Moszak World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018 Key TJ, Bradbury KE, Perez-Cornago A, et al. Diet, nutrition, and cancer risk: what do we know and what is the way forward? BMJ. 2020 Mar 5;368:m511. Wild CP, Weiderpass E, Stewart BW, editors (2020). World Cancer Report: Cancer Research for Cancer Prevention. Lyon, France: International Agency for Research on Cancer. Available from: http://publications.iarc.fr/586. License: CC BY-NC-ND 3.0 IGO.
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