Saturday, November 13, 2010

Coffee, Tea, Caffeine and Brain Cancer Risk


Weekly Health Update:


Coffee, Tea, Caffeine and Brain Cancer Risk




"A critical weekly review of important new research findings for health-conscious readers..."





By, Robert A. Wascher, MD, FACS



Dr. Wascher



Updated: 11/7/2010



The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”




COFFEE, TEA, CAFFEINE AND BRAIN CANCER RISK


Coffee and tea are widely enjoyed around the world, and both have been the subject of numerous health claims (most of them unproven). Tea, and green tea in particular, has been the focus of extensive research, with many prior studies suggesting that tea may improve cardiovascular health and, to a much lesser extent, may decrease the risk of some cancers. Much of the published research regarding coffee has, on the other hand, been focused on trying to disprove purported links between coffee consumption and a potential increase in the risk of some cancers. (Fortunately, the overwhelming majority of such research has not identified a strong link between moderate coffee consumption and an increased risk of cancer.)


The European Prospective Investigation into Cancer and Nutrition (EPIC) study is a huge ongoing prospective multinational public health study, and several of this enormous study’s preliminary results have already been published. The EPIC study is focused on potential links between diet, nutritional status, lifestyle, and environmental factors and the incidence of cancer (among other chronic diseases). (EPIC is one of the largest studies of diet and health ever undertaken, and has already recruited 520,000 research volunteers in Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom.) Now, a new update from this historic public health study suggests that increased coffee and tea consumption may be associated with a decreased incidence of malignant brain tumors. This new update from the EPIC study appears in the current issue of the American Journal of Clinical Nutrition.


Following an average duration of follow-up of nearly 9 years, 588 new cases of brain tumors were diagnosed among the EPIC research volunteers. Gliomas, the most common and most aggressive type of brain tumors that occur in adults, were found to be 34 percent less common among people who drank at least 100 milliliters (3.4 ounces) of coffee or tea per day. (Although not statistically significant, this association was also noted to be stronger in men, with a 41 percent lower risk of gliomas in men, as compared to a 26 percent reduction in glioma incidence in women.)


Although it is not clear what causes gliomas of the brain, prior public health studies have at least suggested a link between glioma brain tumors and chronic occupational exposure to high-intensity electrical and magnetic fields, and to rubber and plastics manufacturing. (As I discuss in A Cancer Prevention Guide for the Human Race, there is also some data linking prolonged cell phone use with an increased incidence of gliomas and other brain tumors.)


Other smaller public health studies have also identified an apparent link between increased caffeine intake and a decreased incidence of gliomas, and there is laboratory evidence available suggesting that caffeine may reduce the growth of malignant glioma cells growing in culture dishes. Thus, these new findings from the giant EPIC study further suggest the possibility that coffee, tea, and other caffeinated beverages might be able to reduce the risk of gliomas of the brain.


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GIVE THE GIFT OF HEALTH THIS HOLIDAY SEASON. For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit our premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author



For a different perspective on Dr. Wascher, please click on the following YouTube link:


Texas Blues Jam




Send your feedback to Dr. Wascher at:


rwascher@doctorwascher.net




Dr. Wascher's Biography




Links to Other Health & Wellness Sites




http://doctorwascher.com/





Copyright 2007 - 2010


Robert A. Wascher, MD, FACS


All rights reserved






Dr. Wascher's Archives:

11-7-2010: Coffee, Tea, Caffeine and Brain Cancer Risk


10-28-2010: Diet and Lifestyle Habits that Decrease Colorectal Cancer Risk


10-21-2010: The Silent Epidemic of Surgeon Burnout and Depression


10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk


10-7-2010: Hormone Replacement Therapy (HRT) and Breast Cancer Risk


10-3-2010: Mammograms Between 40 and 49 Years of Age


9-26-2010: Vitamin D, Cardiovascular Disease, Cancer, and Death


9-19-2010: Fruits and Vegetables Improve Memory


9-12-2010: Low-Carb Diet and Risk of Death


9-5-2010: Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death


8-29-2010: New Treatment for Irritable Bowel Syndrome (IBS)


8-22-2010: Lactoferrin Reduces Abdominal (Visceral) Obesity


8-15-2010: Blueberries, Obesity, Diabetes and Metabolic Syndrome


8-8-2010: High LDL Cholesterol in Young Adults and Heart Disease Risk in Middle Age


8-1-2010: Physician Error


7-25-2010: Obesity and Cancer Risk


7-18-2010: Vitamin D Reduces Risk of Cognitive Decline & Dementia


7-11-2010: All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk



6-27-2010: Soy, Curcumin & Prostate Cancer Risk


6-20-2010: Green Tea Epicatechin Reduces Heart Damage & CHF


6-13-2010: Diacylglycerol (Diglyceride) Oil Reduces Obesity


6-6-2010: Important New Advance in the Breast Cancer Treatment: Intraoperative Radiation Therapy


5-30-2010: Medical Research Studies & “Spin”


5-23-2010: Soy & Curcumin Reduce Prostate-Specific Antigen (PSA)


5-16-2010: Coffee & the Risk of Death from Heart Disease & Cancer


5-9-2010: Soy Foods & Stomach Cancer Risk


5-2-2010: Chemotherapy for Breast Cancer & Memory Loss


4-25-2010: Smoking, Teenagers & Tobacco Company Advertising


4-18-2010: Coffee Improves HDL Cholesterol Levels


4-11-2010: Cruciferous Vegetables, Soy & Breast Cancer Risk


4-4-2010: Avodart (Dutasteride) & Prostate Cancer Prevention


3-28-2010: Aspirin & Breast Cancer Survival


3-21-2010: Obesity, Alcohol & Liver Disease


3-14-2010: Nuts, Diet & Obesity


3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides


2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer


2-21-2010: Testosterone Supplements in Frail Elderly Men


2-14-2010: Pancreatic Cancer Risk, Sodas & Juice


2-7-2010: Vitamin D, Cardiovascular Disease & Death


1-31-2010: Concord Grape Juice Improves Memory


1-24-2010: Mozart, Music, Babies & Health


1-17-2010: Breast Cancer, Physical Therapy & Lymphedema


1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery


1-3-2010: Ginkgo Biloba, Memory & Cognitive Health


12-20-2009: CT Scans & Cancer Risk


12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk


12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease


11-29-2009: Exercise & Prostate Cancer Risk


11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer


11-15-2009: Breast Cancer Treatment & Chronic Pain


1-8-2009: Vitamin D & Breast Cancer Risk


11-1-2009: Exercise & Prostate Cancer Risk


10-25-2009: HPV Virus & Risk of Breast Cancer


10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)


10-11-2009: Vitamin D & Falls in the Elderly


10-4-2009: Surgery, NSQIP, Complications & Death


9-27-2009 Stress, Heart Disease, Exercise & Death


9-20-2009: Vitamin D & Colorectal Cancer Survival


9-13-2009: H1N1 Swine Flu Update


9-7-2009: Green Tea, Aging & Lifespan


8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber


8-23-2009: Update on Prostate Cancer and Cryotherapy


8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors


8-9-2009: Breast Cancer Recurrence, Death & Vitamin D


8-2-2009: Honesty, Dishonesty & Brain Function


7-26-2009: Coronary Artery CT Scans & Cancer Risk


7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer


7-12-2009: Breast Cancer & Metformin (Glucophage)


7-5-2009: Prostate Cancer & Green Tea


6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)


6-21-2009: Red Yeast Rice, Statins & Cholesterol


6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)


6-7-2009: Diet, Soy & Breast Cancer Risk


5-31-2009: Diet and Prostate Cancer Risk


5-24-2009: Diabetes, Glucose Control & Death


5-17-2009: Drug Company Marketing & Physician Prescribing Bias


5-10-2009: Hemorrhoids & Surgery


5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)


4-26-2009: Are We Really Losing the War on Cancer?


4-19-2009: Exercise in Middle Age & Risk of Death


4-12-2009: Can Chronic Stress Harm Your Heart?


4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?


3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease


3-15-2009: Depression, Stress, Anger & Heart Disease


3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children


3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children


2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer


2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones


2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum


2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence


1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?


1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors


1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure


1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood


12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps


12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection


12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome


12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival


11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk


11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk


11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?


11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level


11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk


10-26-2008: Smoking & Quality of Life


10-19-2008: Agent Orange & Prostate Cancer


10-12-2008: Pomegranate Juice & Prostate Cancer


10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer


9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?


9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?


9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke


8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles


8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration


8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients


7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer


7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer


7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins


6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer


6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer


6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort


6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer


6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut


5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely


5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers


5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease


5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room


4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function


4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke


4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention


4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)


3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria


3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children


3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer


3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity


3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death


2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis


2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps


2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?


2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer


1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium


1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly


1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer


1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations


12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?


12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease


12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality


12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease


12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer






Dr. Wascher's Home Page





Sunday, November 7, 2010

Diet and Lifestyle Habits: Decrease Colorectal Cancer Risk





Welcome to Weekly Health Update






"A critical weekly review of important new research findings for health-conscious readers..."






By, Robert A. Wascher, MD, FACS




Dr. Wascher



Updated: 10/28/2010


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.



DIET AND LIFESTYLE HABITS THAT DECREASE COLORECTAL CANCER RISK

In the United States, approximately 106,000 people will be newly diagnosed with colorectal cancer in 2010, and nearly 50,000 people will die of this disease. Colorectal cancer remains the third most common cancer (excluding skin cancer) in both men and women, and the third most common cause of cancer death in men and women. Unlike many other types of cancer, an effective method of screening for colorectal cancer is available, in the form of colonoscopy. Fortunately, the incidence of this cancer has been gradually declining over the past 20 years, due in great part to the early detection, and removal, of precancerous polyps from the colon and rectum at the time of colonoscopy.


The links between specific lifestyle choices and the risk of developing certain types of cancer forms much of the basis of my new book, A Cancer Prevention Guide for the Human Race.” The risk of developing colorectal cancer, in particular, has been strongly linked to multiple dietary and other lifestyle factors. Now, a newly published public health research study from Denmark puts a number on the effectiveness of commonly recommended cancer prevention lifestyle strategies in preventing colorectal cancer.


In this study, which appears in the current issue of the British Medical Journal, 55,487 men and women between the ages of 50 and 64 were prospectively followed for an average of 10 years. Each of these Diet, Cancer and Health Cohort Study volunteers completed validated surveys regarding their social status, health status, reproductive history, and daily lifestyle habits. They also completed a food frequency questionnaire that included, among its 193 items, foods known to be associated with colorectal cancer risk (including alcohol). All study participants also underwent physical examinations that included measurements of their height, weight, and waist circumference. During the course of this large prospective public health study, 678 participants were newly diagnosed with colorectal cancer.


All study volunteers were assessed in terms of 5 modifiable lifestyle and dietary factors that have repeatedly been linked to a reduction in colorectal cancer risk: Increased levels of regular physical activity, avoidance of obesity, abstention from tobacco use, minimal intake of alcohol, and the observance of healthy diet habits (including increased fiber intake, decreased dietary fat content, decreased red meat and processed meat consumption, and increased fresh fruit and vegetable intake). Based upon only these 5 simple colorectal cancer risk factors, the adoption of any one of these 5 colorectal cancer prevention factors was associated with a 13 percent decrease in the risk of developing colorectal cancer. Among participants who generally observed all 5 lifestyle and dietary prevention factors, the risk of developing colorectal cancer was reduced by 23 percent. (Of note, while this observed reduction in the risk of colorectal cancer was noted for both colon cancer and rectal cancer, this finding was only statistically significant for cancer of the colon, specifically.)


The results of this large prospectively conducted public health study reaffirm the findings of previous studies, in that the risk of colorectal cancer can be significantly reduced by: Engaging in regular moderate exercise, maintaining a healthy body weight, avoiding tobacco use, minimizing alcohol consumption, and by reducing the intake of red meat and processed meats and fat, while simultaneously increasing the consumption of fresh fruits, fresh vegetables, and whole grain foods. For a more detailed evidence-based guide to colorectal cancer prevention, order or download your copy of “A Cancer Prevention Guide for the Human Race” now.



Click the following link to join Dr. Wascher on Facebook







For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing colorectal cancer, and other types of cancer, order your copy of my new book, A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!




I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit our premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author



For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam



Send your feedback to Dr. Wascher at:

rwascher@doctorwascher.net



Links to Other Health & Wellness Sites




http://doctorwascher.com/




Copyright 2007 - 2010

Robert A. Wascher, MD, FACS

All rights reserved





Dr. Wascher's Archives:

10-28-2010: Diet and Lifestyle Habits that Decrease Colorectal Cancer Risk


10-21-2010: The Silent Epidemic of Surgeon Burnout and Depression


10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk


10-7-2010: Hormone Replacement Therapy (HRT) and Breast Cancer Risk


10-3-2010: Mammograms Between 40 and 49 Years of Age


9-26-2010: Vitamin D, Cardiovascular Disease, Cancer, and Death


9-19-2010: Fruits and Vegetables Improve Memory


9-12-2010: Low-Carb Diet and Risk of Death


9-5-2010: Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death


8-29-2010: New Treatment for Irritable Bowel Syndrome (IBS)


8-22-2010: Lactoferrin Reduces Abdominal (Visceral) Obesity


8-15-2010: Blueberries, Obesity, Diabetes and Metabolic Syndrome


8-8-2010: High LDL Cholesterol in Young Adults and Heart Disease Risk in Middle Age


8-1-2010: Physician Error


7-25-2010: Obesity and Cancer Risk


7-18-2010: Vitamin D Reduces Risk of Cognitive Decline & Dementia


7-11-2010: All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk


7-4-2010: Irritable Bowel Syndrome: Cause Discovered?


6-27-2010: Soy, Curcumin & Prostate Cancer Risk


6-20-2010: Green Tea Epicatechin Reduces Heart Damage & CHF


6-13-2010: Diacylglycerol (Diglyceride) Oil Reduces Obesity


6-6-2010: Important New Advance in the Breast Cancer Treatment: Intraoperative Radiation Therapy


5-30-2010: Medical Research Studies & “Spin”


5-23-2010: Soy & Curcumin Reduce Prostate-Specific Antigen (PSA)


5-16-2010: Coffee & the Risk of Death from Heart Disease & Cancer


5-9-2010: Soy Foods & Stomach Cancer Risk


5-2-2010: Chemotherapy for Breast Cancer & Memory Loss


4-25-2010: Smoking, Teenagers & Tobacco Company Advertising


4-18-2010: Coffee Improves HDL Cholesterol Levels


4-11-2010: Cruciferous Vegetables, Soy & Breast Cancer Risk


4-4-2010: Avodart (Dutasteride) & Prostate Cancer Prevention


3-28-2010: Aspirin & Breast Cancer Survival


3-21-2010: Obesity, Alcohol & Liver Disease


3-14-2010: Nuts, Diet & Obesity


3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides


2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer


2-21-2010: Testosterone Supplements in Frail Elderly Men


2-14-2010: Pancreatic Cancer Risk, Sodas & Juice


2-7-2010: Vitamin D, Cardiovascular Disease & Death


1-31-2010: Concord Grape Juice Improves Memory


1-24-2010: Mozart, Music, Babies & Health


1-17-2010: Breast Cancer, Physical Therapy & Lymphedema


1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery


1-3-2010: Ginkgo Biloba, Memory & Cognitive Health


12-20-2009: CT Scans & Cancer Risk


12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk


12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease


11-29-2009: Exercise & Prostate Cancer Risk


11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer


11-15-2009: Breast Cancer Treatment & Chronic Pain


1-8-2009: Vitamin D & Breast Cancer Risk


11-1-2009: Exercise & Prostate Cancer Risk


10-25-2009: HPV Virus & Risk of Breast Cancer


10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)


10-11-2009: Vitamin D & Falls in the Elderly


10-4-2009: Surgery, NSQIP, Complications & Death


9-27-2009 Stress, Heart Disease, Exercise & Death


9-20-2009: Vitamin D & Colorectal Cancer Survival


9-13-2009: H1N1 Swine Flu Update


9-7-2009: Green Tea, Aging & Lifespan


8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber


8-23-2009: Update on Prostate Cancer and Cryotherapy


8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors


8-9-2009: Breast Cancer Recurrence, Death & Vitamin D


8-2-2009: Honesty, Dishonesty & Brain Function


7-26-2009: Coronary Artery CT Scans & Cancer Risk


7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer


7-12-2009: Breast Cancer & Metformin (Glucophage)


7-5-2009: Prostate Cancer & Green Tea


6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)


6-21-2009: Red Yeast Rice, Statins & Cholesterol


6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)


6-7-2009: Diet, Soy & Breast Cancer Risk


5-31-2009: Diet and Prostate Cancer Risk


5-24-2009: Diabetes, Glucose Control & Death


5-17-2009: Drug Company Marketing & Physician Prescribing Bias


5-10-2009: Hemorrhoids & Surgery


5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)


4-26-2009: Are We Really Losing the War on Cancer?


4-19-2009: Exercise in Middle Age & Risk of Death


4-12-2009: Can Chronic Stress Harm Your Heart?


4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?


3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease


3-15-2009: Depression, Stress, Anger & Heart Disease


3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children


3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children


2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer


2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones


2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum


2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence


1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?


1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors


1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure


1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood


12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps


12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection


12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome


12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival


11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk


11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk


11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?


11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level


11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk


10-26-2008: Smoking & Quality of Life


10-19-2008: Agent Orange & Prostate Cancer


10-12-2008: Pomegranate Juice & Prostate Cancer


10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer


9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?


9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?


9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke


8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles


8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration


8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients


7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer


7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer


7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins


6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer


6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer


6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort


6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer


6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut


5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely


5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers


5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease


5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room


4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function


4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke


4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention


4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)


3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria


3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children


3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer


3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity


3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death


2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis


2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps


2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?


2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer


1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium


1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly


1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer


1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations


12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?


12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease


12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality


12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease


12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer




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Friday, November 5, 2010

The Silent Epidemic of Surgeon Burnout and Depression



Welcome to Weekly Health Update









"A critical weekly review of important new research findings for health-conscious readers..."








By, Robert A. Wascher, MD, FACS



Dr. Wascher





Updated: 10/21/2010









The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.




THE SILENT EPIDEMIC OF SURGEON BURNOUT AND DEPRESSION



Here in the United States, we face momentous, and as yet unclear, changes in the delivery of health care. Approximately 46 million Americans lack any health insurance at this time, and tens of millions of others have grossly inadequate health insurance. Therefore, many millions of Americans are just one major illness away from a financial catastrophe.



In addition to the huge dilemma of how we go about making health care more efficient and more affordable for everyone, the United States, like most countries around the world, is in the midst of a dramatic shift in the average age of its population. As the graying of America continues (not to mention the ongoing epidemic of obesity across all age ranges, as well), the growing need for high quality, comprehensive health care will continue to present major challenges to our health care system here, and in many other countries around the world.



When I graduated from medical school in 1988, health care experts were predicting a huge surplus of physicians in this country, and in response to this concern, medical schools around the United States began cutting back their class sizes, and a de facto moratorium on opening new medical schools was initiated. Fast forward to 2010, and it has since become apparent that these dire predictions of an impending physician glut were absolutely incorrect. As our population grows older, and more diverse, the demand for physicians is increasingly in danger of outstripping the projected supply of doctors, including surgeons.



Aging patients have a higher incidence of illnesses and injuries that require the expertise of surgeons, and general surgeons in particular. Broadly trained and experienced general surgeons are the primary care doctors, and the workhorses, of the surgical world, and they manage an astonishing array of diseases and injuries. Unfortunately, and for a variety of reasons, comprehensive general surgeons are slowly withering in numbers, while the demand for their skills only continues to increase. Generational attitude shifts among recently graduating physicians have seen young new doctors gravitate towards less demanding “boutique” specialties, and away from the more challenging surgical specialties (like general surgery). Even among those young doctors who still elect to pursue residency training in general surgery, more than two-thirds will go on to train and practice in more restricted subspecialty surgery areas. (Disclaimer: As a surgical oncologist, I am one of those subspecialty surgeons. However, I still include a great deal of general surgery care in my practice, and I continue to take general surgery call in our medical center.) Another factor that discourages potential general surgeons is the enormous debt load that most newly minted doctors graduate from medical school with, and the resultant pressure that they feel to train in specialties that do not require the additional 5 to 10 years of training that general surgeons must complete. (Increasingly, new medical school graduates are, instead, seeking out specialties that are more financially lucrative, and require shorter durations of residency training, than general surgery.)



Yet another adverse factor that has harmed the recruitment of new general surgeons is the ongoing and progressive fragmentation of traditional general surgery practice into other subspecialty domains. For young doctors who are attracted to the diverse and clinically challenging sort of surgical practice that has historically made general surgery a highly desirable profession, the increasing practice restrictions imposed upon general surgeons have removed a major incentive to undergo the many years of training necessary to become a comprehensive general surgeon



Against the backdrop of these and other pressures that continue to dwindle the ranks of broadly trained and practicing general surgeons (as well as other critical core surgical specialists), the issue of surgeon burnout has only recently started to receive its due attention. The comprehensive practice of general surgery, and other demanding surgical specialties, can be grueling and exhausting, particularly in the private practice setting where declining reimbursements compel surgeons to work ever longer hours to maintain their income and lifestyle. (Future threatened cuts in reimbursements to surgeons will likely only further exacerbate surgeon workload problems, and eventual surgeon shortages, as new health care reform initiatives begin to roll out in the coming years.)



A newly published research study, which appears in the current issue of the Journal of the American College of Surgeons, reveals a very disturbing picture of burnout, exhaustion, and depression among surgeons, and the potentially adverse consequences of distressed surgeons on patient outcomes.



In this study, nearly 8,000 surgeon members of the American College of Surgeons responded to a detailed survey, which included self-assessments of their practice details, a validated depression screening tool, and validated assessments of both burnout and overall quality of life. The results of these surgeon surveys were, in a word, depressing.



Among the surgeons who reported working less than 60 hours per week, 30 percent described themselves as burned-out with their profession. Among surgeons who worked 60 to 80 hours per week, 44 percent felt burned-out, and among those surgeons who put more than 80 hours per week, 50 percent experienced significant feelings of burnout. In addition to the number of hours spent in clinical practice per week, the number of nights spent performing overnight surgery call was a highly significant predictor of surgeon burnout. These two surgeon workload factors were also highly statistically significantly linked to clinical depression, difficulties in finding a reasonable home-work balance, and increased conflicts at both home and at work. Additionally, the rates of both personal emotional exhaustion and feelings of depersonalization towards patients were directly associated with working more than 80 hours per week, and with performing 2 or more night calls per week.



Excessive hours spent in clinical practice, as well as performing 2 or more overnight calls per week, also correlated with a significant increase in the number of self-reported medical and surgical errors committed by exhausted and burned-out surgeons. Nearly 11 percent of surgeons who worked more than 80 hours per week admitted to committing medical or surgical errors, compared to about 7 percent of surgeons who worked less than 60 hours per week.



Surgeons who either worked more than 80 hours per week, or who took more than 2 night calls per week, were also significantly more likely to express regret regarding their choice of specialty, and more likely to indicate that they would not choose to become surgeons if they had an opportunity to choose their specialty all over again.



The results of this survey of surgeons across the United States have been generally confirmed by other similar studies, recently. These disturbing findings, as reported by surgeons themselves, paints a picture of a large population of highly essential physician specialists who are, increasingly, feeling burned-out, depressed, emotionally exhausted, regretful of their career choices, and progressively more prone to both depersonalizing their relationships with their patients and to committing more medical and surgical errors. In short, my chosen profession appears to be a profession that is, frankly, approaching a state of crisis.



Because of these enormous (and growing) pressures and stresses that are being experienced by many surgeons, including general surgeons, many public health experts are viewing the current and future surgical workforce with considerable consternation. As more and more surgeons hang up their white coats and put away their scalpels early in their careers, and as more and more newly graduated doctors shy away from the more demanding surgical specialties, our country appears to be headed for a potentially catastrophic mismatch between the demands of an aging population for surgical care and the diminishing pool of physicians who are willing to shoulder the heavy responsibilities, and significant stresses, of surgical practice.



It is my hope that the governmental agencies responsible for implementing current and future health reforms will pay close attention to this study, and others like it. If hard-working surgeons cannot sustain reasonable income levels (against the decades of grueling training required, and the hundreds of thousands of dollars in educational loans that most young doctors acquire) without working themselves into a state of exhaustion, burnout, and divorce, the ranks of general surgeons, and other core surgical specialists, will continue to become thinner and thinner. Ultimately, if things do not change, and soon, you and I might find it difficult to obtain access to high quality surgical care, particularly for emergency illnesses and injuries….






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Copyright, 2010

All Rights Reserved

Robert A. Wascher, MD, FACS