Healthcare, medicine & pharmaceuticals

Too much medical information

The world of health information is bewildering now, as Google opens up thousands of results for any symptom you care to key in. The trouble is, the more you know, the more you know how little you know. How can a person stay healthy in the information age?

A site like PubMed carries about 19 million studies, many of which are not well designed with trustworthy statistical methods and randomised controlled trials. Some are high quality and you can trust them, but you might not understand them. Meanwhile, medical guidelines seem to fluctuate with the weather, for example, should you mammogram before 50 or not? Should you eat butter or olive oil? It’s hard to trust the experts when they don’t agree.

A decade later, the Human Genome Project has still not made it any easier to make practical changes in one’s health. Even if you know you have a certain gene, that doesn’t mean you can do anything about it. If you are at risk for cancer, you might choose to lose weight, eat more fruit and vegetables, or exercise a lot, but this doesn’t guarantee anything. The ubiquitous phrase “talk to your doctor”, won’t help much because she’s as overworked as you are.

Michael Pollan, food writer, said: “Eat food. Not too much. Mostly plants.” The Center for Disease Control and Prevention (CDC) says children need an hour of varied physical exercise each day, but adults can probably get away with 2.5 hours per week plus some basic muscle strengthening twice a week. Thomas Goetz, in his book The Decision Tree, offers three basic rules for good health: Early is better than late (prevention); Let data do the work (monitor your basic stats); Trust in openness (ask your doctor and your friends).

In essence, it means taking personal responsibility for your health. The old days of consulting the doctor when you have a problem are gone. Everything now is based on your lifestyle and your choices (and perhaps your insurance). These days nobody’s an expert. And if they are, you probably can’t afford them.

 

Long distance (from your head) phone calls

If you read the fine print with your BlackBerry, you will discover that it should be held at least 2.5 cms from your head. Apple recommends 1.5 cms for its iPhone. The same goes for keeping them in your pocket. Considering Americans chat on their phones 2.26 trillion minutes annually, it would be interesting to get a ruler out.

A new book, Disconnect, by Devra Davis at University of Pittsburgh, delves deeper into the thorny issue of radiation. It says that incidence of brain cancer has not gone up since mobiles came in. But the average obscures the frightening increase among 20-29 year olds and the drop among older people. Children are particularly vulnerable because radiation penetrates more deeply into the brain than in adults. But there are no studies on children and mobile phones.

Radiation, or radiofrequency exposure, is measured as the specific absorption rate (SAR). This should be no more than 1.6 watts per kilogram. San Francisco has passed an ordnance that forces manufacturers to declare their SARs so consumers can make an informed decision. Naturally, the industry trade group, CTIA - The Wireless Association claims that all FCC approved phones are safe.

None of the results from mobile phone studies is yet conclusive. While the experts are still arguing about radiation from mobile phones, you can wear wired headsets, speakers, or use texting to protect your head. If one day mobiles (over 4 billion and rising across the world) are proved to be damaging to your health, telcos may become the new tobacco companies but on an even greater scale. As for the human and societal consequences...

Ethical use for illegal drugs

The line between illegal drugs and medicine has always been fine, witness the history of opium for pain relief. Yet our zero tolerance attitude to schedule 1 (or Class-A) drugs ignores their possible, ethical use in medicine. Some researchers are now investigating how the relaxing effects of cannabis and the highs of LSD or ecstacy (MDMA), can be used in cancer treatment or psychotherapy.

There are trials in the US and Switzerland using LSD and psilocybin (in magic mushrooms), to see whether they can relieve terminal cancer patients with anxiety and depression. The Beckley Foundation and Imperial College London (UK) is researching how psilocybin can help people who have experienced trauma recall distant memories. It can even be used to help treat tobacco addiction, according to Johns Hopkins University in Baltimore.

Cannabis is another story, as its relaxing effect has already been used to handle the symptoms of multiple sclerosis. McGill University in Montreal is working with patients in chronic pain to see if cannabis or placebo can alleviate it. Most patients felt less pain and slept better after smoking the highest dose of cannabis.

Supporters argue that these drugs are not addictive or dangerous in therapeutic doses. Moreover, many legal drugs in medicine can be used in addictive or dangerous ways. So the chances of receiving government funding are still rather slight. The Beckley Foundation (UK) and the Multidisciplinary Association for Psychedelic Studies (US) continue to work for the cause. Anyone who has experienced chronic pain that was relieved by smoking cannabis will wonder what all the fuss is about. Isn’t medicine in the business of relieving symptoms? Perhaps it’s time to lose some of those out of date 1970s attitudes.

From stomach to breast, using stem cells

Imagine if you could take the fat from your stomach and put it inside your breasts instead. If you’ve had breast cancer, this could be very appealing. An American biotech company, Cytori Therapeutics, has found a way to remove fat cells using liposuction and re-use them in women who want to restore the shape of their breasts after lumpectomy. This is stem cell technology at the cutting edge.

There are three steps to the process. First, the surgeon harvests fat from the woman’s abdomen using approximately 8-10 syringes. About 160cc of injected tissue can boost breast size by 1.6 cup sizes. Second, the fat is injected into the proprietary Celution System. This washes the fat cells with enzymes, separates fat cells from stem and regenerative cells, and produces a liquid suspension that can be injected. Third, a tool called Celbrush, is used to deposit the cells in the breast, very slowly, about 0.5cc at a time. Within 48 hours, new capillaries and blood vessels will move through the new cells.

In Japan, a cosmetic surgeon has begun a study of the Celution System for making healthy women’s breasts bigger. A new breast could cost about $US2,000 to $US2,800, translating to a possible $US1 billion market. The difference between this kind of treatment and silicone is that the effect is natural and soft. And of course, it trims the abdomen or hips as well. It sounds like every woman’s dream, if she wants to pay for it.

Heavy petting

Many people believe that having pets is good for them, because they provide company, relief, or security. There is evidence to suggest that having pets is better for your health, though it may be that healthy people choose to have pets. The new science of anthrozoology is busy studying the interaction between humans and animals. One of its compelling questions is whether interacting with animals can alleviate human suffering.

An early study of 92 people (1980) found 6% of pet owners died within 12 months of a heart attack, compared to 28% of non-pet owners. Since then, several studies found children brought up with pets are less likely to get asthma, pet owners visit the doctor less often, and Chinese women who owned dogs slept more soundly. But many studies show pets have no effect whatsoever and many are not published. Others show that pets have a deleterious effect, for example, higher rates of depression and pain medication. Moreover, people with dogs don’t exercise more, even though they think they will.

We are inclined to think that, if you are in love with your dog or cat or budgie, then it is probably doing you good. There can never be enough love in the world. (Ahh!) Then again, if your wife is missing out because of the dog, then that’s another story.