Resolutions for the New Year Health Page
by Dr. Walter Chin
Stabroek News
December 30, 2001

With the New Year almost here, it would be useful for everyone to make, and implement, some medical aims for 2002.

All women should re-solve to perform breast self-examination every month. Younger women should do this in the week following a menstrual period when the breasts are less likely to be swollen and quite tender. Post-menopausal women can do this on the first of the month or another easy day to remember. Self-examination takes no more than 10 minutes, and anyone can learn to do it. A large percentage of breast lumps are discovered by women themselves, and the rate of discovery is highest among women who practise regular self-examination.

The more frequent the self-examination, the greater the likelihood of detecting cancer at an early stage. In addition to breast self-examination, women over 40 should also resolve to have a physician examine their breasts once this year, and annually.

For women aged 40 to 49 years, mammography should be considered if one has not been done during 2000. Early diagnosis of cancer through mammography can substantially improve the rate of cure. Women who have a family history of breast cancer will need to be particularly vigilant.

Women should resolve to have a cervical (Pap) smear every one to three years after the age of 19, but annually if they have been sexually active since the age of 16 years.

If there is a history of abnormal smears, the smear may have to be repeated more frequently. Smoking, and having multiple partners, increases the risk of developing cancer of the cervix. Schedule a Pap smear for approximately two weeks after the first day of your menstruation; and beginning two days prior to the test, refrain from sexual intercourse.

If all women between the ages of 20 and 70 have annual Pap tests, deaths from cervical cancer, a major cause of cancer deaths among women in Guyana, could be drastically reduced, even wiped out.

As diabetes can remain undiagnosed for too long, with the increased risk of the development of complications (among them cataracts, blindness, diabetic foot sometimes leading to amputation of a limb, kidney failure, heart disease), middle- aged women and men should resolve to have a blood sugar test carried out early in 2002.

This can lead to the diagnosis of Type II diabetes, the kind of diabetes that usually starts in middle age and after.

Early detection of Type II, and the start of appropriate treatment, can help to reduce the complications of the disease.

The blood pressure must be checked in 2002 and annually. If a raised blood pressure has been detected, there must be a resolve to have it treated, and to comply with treatment, including recommended life-style changes, so that the blood pressure becomes normal, and remains normal.

For those who are middle-aged, a lipid profile, to assess the cholesterol level, should be done. If the cholesterol is high, and in particular if the low-density lipo-protein (the bad cholesterol) is high, treatment will be needed.

A change in diet alone is usually inadequate, so that drug treatment will be necessary.

One of the statin group of drugs, which have been shown to be very effective in lowering the cholesterol level and preventing heart attacks, will have to be prescribed.

Cancer of the colon, one of the common cancers in both men and women in Guyana, is still unfortunately diagnosed when it is already well established. It is recommended that a stool test for blood should be done from the age of 50. Although not a particularly precise and accurate test for colon cancer, traces of blood in the stool are one of the early warning signs of colon cancer.

Cancer of the testis is seen in men from the late teens to around 35 years of age. It is not a particularly common form of cancer, but if diagnosed early is highly curable.

The best way to diagnose it early is to perform a self-examination once a month.

This is done by examining each testicle with both hands, the thumbs on top and the index and middle fingers underneath, and rolling each testicle gently between the thumbs and fingers.

Feel for any abnormal lumps, usually the size of a pea, on the front or sides of the testis. It should be known that having one testicle larger than the other is not necessarily abnormal. Any unusual swelling should prompt an immediate visit to a doctor.

Cancer of the prostate is the commonest cancer among men in Guyana. All men over 50 should make a resolution to have a PSA (prostate specific antigen) test done in 2002. This test should be repeated annually. To ensure the accuracy of the test, all sexual activity should be curtailed one week prior to the test. A high PSA can help to identify men who may need to have further tests for cancer of the prostate. Everyone should resolve to indulge in at least 30 minutes of vigorous exercise three to four times weekly in 2002.

There is enough evidence to strongly suggest that regular physical activity can prevent the onset of some types of cancer, in addition to strengthening the heart and lungs, keeping weight off, and improving mood and energy. Numerous studies have shown that those who exercise regularly have a substantially lower risk - as much as 50 per cent - of developing colon cancer. It is postulated that exercise accelerates the movement of material through the colon, so that cancer-causing substances do not have time to linger in the body, and cause trouble. Other studies showed that women who exercise regularly each week reduce their risk of developing breast cancer by 10 to 20 per cent, depending on the number of hours of exercise. Those with more hours had a greater reduced risk.

Those who demonstrated a lower cancer risk walked briskly, jogged and performed aerobics. Preliminary studies now suggest that exercise can have an effect on lung cancer.

These studies show that unfit men are about twice as likely to die from lung cancer than fit men. Scientists also suspect that exercise may also play a role in lowering the chances of prostate, non-Hodgkin's lymphoma, ovarian, testicular and uterine cancers. Cancer risk, in general, can be lessened even among those who start exercising in middle age or later. So, even for those in their 50s, it is not too late to start exercising.

Everyone should resolve to switch to a healthy diet. Such a diet involves cutting down on the eating of salt, and consuming a diet high in fruits, vegetables and low-fat dairy products, and low in red meats and sweet, sugary foods.

For those with high blood pressure, this diet can help to reduce the blood pressure. Even for those young people with a normal blood pressure, adopting these changes on a long-term basis may help to prevent the rise in blood pressure that occurs with increasing age.

The combination of changing to a healthy diet and exercising regularly also has another important health benefit - the possible prevention of Type II diabetes. These same measures would also lessen the incidence of heart disease and some forms of cancer.

Lastly, and not least important, everyone who smokes should resolve to stop smoking in 2002. Have a Healthy 2002.