Lung Cancer

Lung Cancer Facts & Tips for Prevention

Lung cancer is one of the most common cancers in the world⁠.

In 2015, it was estimated that approximately 26,600 Canadians would be diagnosed with lung cancer.  That is more than any other type of cancer.

In addition to this, more people die from lung cancer than breast cancer, colorectal cancer and prostate cancer combined.

There are two major types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)⁠.

Non-small cell lung cancer accounts for about 85 percent of lung cancers, small cell lung cancer about 15 percent.⁠

NSCLC usually starts in glandular cells on the outer part of the lung. This type of cancer is called adenocarcinoma. Non–small cell lung cancer can also start in flat, thin cells called squamous cells. These cells line the bronchi, which are the large airways that branch off from the windpipe (trachea) into the lungs. This type of cancer is called squamous cell carcinoma of the lung. Large cell carcinoma is another type of non–small cell lung cancer, but it is less common. There are also several rare types of non–small cell lung cancer. These include sarcoma and sarcomatoid carcinoma.  SCLC usually starts in cells that line the bronchi in the centre of the lungs. The main types of small cell lung cancer are small cell carcinoma and combined small cell carcinoma (mixed tumour with squamous or glandular cells).

Anatomy & Facts About Our Lungs

 

 

Did you know?

  • In proper anatomy our right lung is shorter and wider than our left.  Our left lung is narrower and more oblong
  • The anterior border of the left lung is marked by a deep cardiac notch while the right lung is straight
  • Our left lung is smaller than our right lung because our heart occupies space on the left side
  • Our right lung consists of 3 lobes.  Our left lung has 2
  • Our right lung connects to the trachea by two bronchi while the left lung connects to the trachea by a single bronchus

Possible causes of lung cancer

🔹Cigarette smoking causes most lung cancers.  Of note however many patients who are diagnosed with lung cancer have either never smoked or are former smokers.

🔹Exposure to high levels of pollution⁠

🔹Exposure to radiation and asbestos may increase risk of lung cancer⁠

🔹Genetics

Common symptoms of lung cancer

✔️A cough that doesn’t go away and gets worse over time⁠

✔️Constant chest pain⁠

✔️Coughing up blood⁠

✔️Shortness of breath⁠

✔️Fatigue⁠

Help lower your risk of lung cancer by incorporating the following tips

☑️Stop Smoking:⁠

Smoking is responsible for the majority of lung cancers. If you are a smoker it’s never too late to quit. For those who have been diagnosed with lung cancer, by stopping your smoking habit you can make cancer treatment more effective

☑️Limit Your Chemical Exposure:⁠

Chemicals in the workplace and at home can contribute to lung cancer

☑️Reduce Your Exposure to Second-Hand Smoke:⁠

Exposure to second-hand smoke increases your chance of developing lung cancer

☑️Consume Green Tea and Black Tea:⁠

Studies have shown that consuming Green & Black tea are associated with a reduced lung cancer risk⁠

As well as the above, proper sleep, exercising regularly and eating a diet rich in fruits and veggies are very important habits for cancer prevention as a whole.⁠


References

 

Talk to Your Son About Testicular Cancer

Movember moustaches, campaigns and initiatives in support of raising the awareness of men’s health issues is a great opportunity to talk with your son about the warning signs of testicular cancer. It may not be a topic that you are comfortable with but it is a necessary one.

Testicular cancer is the leading cancer in men ages 15 to 44 with an estimated 1,150 Canadian men being diagnosed with it in 2019.

Who is at Risk?

Factors that can increase a man’s risk for testicular cancer include:

  • An undescended testicle (cryptorchidism). A man who has a testicle that hasn’t descended is at a greater risk of testicular cancer than are men whose testicles have descended normally. The risk remains elevated even if the testicle has been surgically relocated to the scrotum
  • If a family member has had testicular cancer, then there is an increased risk for related males
  • Abnormal testicle development. Conditions that cause testicles to develop abnormally may increase risk of testicular cancer
  • Although it can occur at any age, testicular cancer affects teens and younger men, particularly those between ages 15 and 44.
  • Testicular cancer is more common in white men than in black men

Important Things to Say

It is important to stress to your son that this cancer is not common and if found early is curable.

Let him know that he can come to you if he notices any changes or has any concerns or questions.

As your son reaches puberty and his body begins to change, encourage him to become familiar with his testicles.  Often testicles are not symmetrical.  He can only know if there is change if he knows what is his normal.

It is also important to teach your son how to perform a monthly self-exam so that he can monitor any changes that may have occurred in a testicle.

How to Perform a Monthly Testicle Self-Examinations

Have your son:

  • Stand in a hot shower, allowing his testicles to descend
  • Hold his penis out of the way and examine the skin of the scrotum
  • Examine each testicle. Using both hands, have him place his index and middle fingers under the testicle and his thumbs on top
  • Gently roll the testicle between your thumbs and fingers

What to Look for

A healthy testicle will have a soft, squishy consistency throughout.

Signs of irregularity can include hard lumps, changes in the size, shape or consistency of the testicle, tenderness or pain.

The anatomy of the testicle includes a structure called the Epididymis that your son will also need to become familiar with.  It is a cordlike structure running along back of the testis.  It provides for the storage, transport and maturation of sperm.

Self-care is a key piece for your son’s health.  By talking to your son about testicular cancer you equip him with tools for self management and help him to understand that ultimately he is responsible for his own health.

 

References:

https://www.mayoclinic.org/tests-procedures/testicular-exam/about/pac-20385252

https://www.mayoclinic.org/diseases-conditions/testicular-cancer-care/symptoms-causes/syc-20352986

https://www.testicularcancerawarenessfoundation.org/statistics-risk-factors/

https://www.cancer.ca/en/cancer-information/cancer-type/testicular/statistics/?region=on

https://www.mayoclinic.org/tests-procedures/testicular-exam/about/pac-20385252

https://medical-dictionary.thefreedictionary.com/epididymis

 

 

 

The Complete Lymphedema Management and Nutrition Guide by Jean Lamantia, RD and Ann DiMenna, PT, CDT

Lymphedema is abnormal swelling that is caused by a build-up of lymph fluid.  It occurs most frequently in the arms and in the legs and is commonly caused by the removal of or damage to lymph nodes as a part of cancer treatment.  In this scenario, the onset of lymphedema can occur during treatments, days, months or even years after the treatment protocol is completed.

According to the World Health Organization there are over 170 million people world-wide who suffer from secondary lymphedema.  It affects approximately 15% of all cancer survivors and an estimated 30% of those treated for breast cancer after surgery to remove lymph nodes.

Lymphedema is a chronic condition that, if not cared for, can lead to infection, thickening of the skin, pain and loss of proper function.  But with the help of professionals in the field and by learning techniques for self-care it can be managed.

Unfortunately lymphedema is poorly understood and researched.  For this reason the new book entitled:

The Complete Lymphedema Management and Nutrition Guide

Empowering Strategies, Supporting Recipes & Therapeutic Exercises

by Jean Lamantia, RD and Ann DiMenna, PT, CDT

is a great resource for both those suffering from lymphedema and for practitioners.

A Great Resource for those Suffering from Lymphedema and for Practitioners

Scientifically researched and thoughtfully put together, the book is divided in to four sections.

Parts 1 & 2 are authored by Ann DiMenna, PT, CDT.  Parts 3 & 4 by Jean Lamantia, RD.

Part 1: Understanding Lymphedema

This section beautifully lays out the physiology and biology of the lymphatic system as well as addressing Lymphedema Risk Reduction by using an easy to understand narrative coupled with informative visuals.

Part 2: Self-Care for Lymphedema

Self-care management is vital for those with lymphedema.  This section covers the key areas of skincare, self-taping, self-massage and exercise.  It also covers the topic of compression garments very well.

The next 2 sections cover the importance of nutrition for lymphedema management.

Part 3: Nutrition for Lymphedema

This is a very informative section of the book that covers these important topics for lymphedema management:

  • Bodyweight
  • The role of the lymphatics in digestion
  • Reducing Chronic Inflammation
  • Fluids, protein and sodium
  • Supplements
  • Meal Planning

Of note here as well, most of you know that I am a proponent of intermittent fasting.  Included within this section is an interesting notation from Jean about her thoughts on intermittent fasting and possible benefits for managing lymphedema.  She is very clear that her thoughts are speculative, not researched based, but I find the notion thought provoking at the very least.

 Part 4: Recipes for Lymphedema

And to wrap it up, the book contains some wonderful recipes to help the reader implement the nutritional advise that Jean Lamantia  has provided.

As a practitioner who works with patients suffering from lymphedema, I find this book to be a valuable reference.  As a sufferer of lymphedema myself, I know that this book will be of great benefit for those trying to manage this condition.

 

 

 

 

 

Tips for Reading Nutrition Labels

Sticking to the perimeter of the grocery store is the ideal way to shop. But when the ideal meets the real and we find ourselves nose to label with packaging we need to be armed and ready.

Let’s face it, reading labels can be confusing.  But it is a necessary evil when you want to eat healthy.

With a few tips however you will be able extrapolate the important information that you need to make good decisions in the grocery aisles.

First off avoid the propaganda on the front of the product and go right to the good stuff on the back.  Companies can free wheel with what they say on the front of the packaging but there are real guidelines for what’s on the back.  For example a label may say that a food product is reduced in fat or reduced sodium. What this means is that the amount of fat or sodium has been reduced from the original product amount. It doesn’t mean, however, that the food is low in fat or sodium.

Here are My 3 Top Things to Look For on a Product Label

1. Check out the Ingredients

Check out the ingredient list.  Product ingredients are listed by quantity, from highest to lowest amount

2. Understand the serving size

It is really important that you understand that all of the nutrition information shown is based on serving size.

And don’t be deceived by this.  A single serving may not be what you think.  For instance, a serving size may be half a cup where as you might logically think it would be whole cup.

3. Know the Different Names for Sugar

We know by now the dangers of over consuming added sugars.  With this in mind, it is very important that you become aware of the fact that there are many, many different names for sugar on a food label.  Some of them end in –ose such as Sucrose, Maltose and Dextrose.  Others like Barley Malt, Turinado and Molasses do not.

Click here for my list of Different Names For Sugar

On the right side of a food label, you’ll see a column that lists the percent daily values (%DV). Percent daily values tell you how much of a the particular nutrient one serving will give you compared to how much you need for the entire day. It helps you gauge the percentage of a nutrient requirement met by one serving of the product.

Nutrition Facts Tables

Do you ever look at the Nutrition Facts tables? Do they help you decide which foods to buy or not? Do the numbers even make sense?

To be honest, I don’t think it’s that the most user-friendly or helpful tool. But it’s good to understand it since it’s here to stay.

Let me give you a super-quick crash course on reading the Nutrition Facts tables.

Then, try my delicious and super-easy snack recipe that’ll blow your pre-packaged granola bars out of the water.

How to Read the New Nutrition Facts Tables

The Nutrition Facts table is on the side of most packaged foods. It’s often found close to the ingredient listing.

The purpose of it is to help consumers make better nutrition decisions. When people can see the number of calories, carbs, sodium, etc. in food, they should be able to eat better, right?

Whether you like the Nutrition Facts table or not, let’s make sure you get the most out of it, since it’s here to stay!

Here’s my four-step crash course on reading the Nutrition Facts table.

Step 1: Serving Size

The absolute most important part of the Nutrition Facts table is to note the serving size. Manufacturers often strategically choose the serving size to make the rest of the table look good. Small serving = small calories/fat/carbs. So, it’s tricky.

All the information in the table rests on the amount chosen as the serving size. And, since every manufacturer chooses their own, it’s often difficult to compare two products.

In Canada, in the next few years (between 2017-2022), serving sizes will be more consistent between similar foods. This will make it easier to compare foods. The new labels will also have more realistic serving sizes to reflect the amount that people eat in one sitting, and not be artificially small.

Let’s use an example – plain, unsalted walnuts from Costco.

Right under the Nutrition Facts header is the serving size. That is a ¼ cup or 30 g. This means that all the numbers underneath it are based on this amount.

FUN EXPERIMENT: Try using a measuring cup to see exactly how much of a certain food equals one serving. You may be surprised at how small it is (imagine a ¼ cup of walnuts).

Step 2: % Daily Value

The % Daily Value (%DV) is based on the recommended daily amount of each nutrient the average adult needs. Ideally, you will get 100% DV for each nutrient every day. This is added up based on all of the foods and drinks you have throughout the day.

NOTE: Since children are smaller and have different nutritional needs if a type of food is intended solely for children under the age of 4, then those foods use a child’s average nutrition needs for the %DV.

The %DV is a guideline, not a rigid rule.

You don’t need to add all of your %DV up for everything you eat all day. Instead, think of anything 5% or less to be a little; and, anything 15% or more to be a lot.

NOTE: Not every nutrient has a %DV. You can see it’s missing for things like cholesterol, sugar, and protein. This is because there isn’t an agreed “official” %DV for that nutrient. The good news is that the new Nutrition Facts tables will include a %DV for sugar. Keep your eyes out for that.

Step 3: Middle of the table (e.g. Calories, fat, cholesterol, sodium, potassium, carbohydrates, and protein)

Calories are pretty straight forward. Here, a ¼ cup (30 g) of walnuts has 200 calories.

Fat is bolded for a reason. That 19 g of fat (29% DV) is total fat. That includes the non-bolded items underneath it. Here, 19 g of total fat includes 1.5 g saturated fat, (19 g – 1.5 g = 17.5 g) unsaturated fat, and 0 g trans fat. (Yes, unsaturated fats including mono- and poly-unsaturated are not on the label, so you need to do a quick subtraction).

Cholesterol, sodium, and potassium are all measured in mg. Ideally, aim for around 100% of potassium and sodium each day. It’s easy to overdo sodium, especially if you grab pre-made, restaurant foods, or snacks. Keep an eye on this number if sodium can be a problem for you (e.g. if your doctor mentioned it, if you have high blood pressure or kidney problems, etc.).

Carbohydrate, like fat, is bolded because it is total carbohydrates. It includes the non-bolded items underneath it like fiber, sugar, and starch (not shown). Here, 30 g of walnuts contain 3 g of carbohydrates; that 3 g are all fiber. There is no sugar or starch. And as you can see, 3 g of fiber is 12% of your daily value for fiber.

Proteins, like calories, are pretty straight forward as well. Here, a ¼ cup (30 g) of walnuts contains 5 g of protein.

Step 4: Bottom of the table (e.g. vitamins & minerals)

The vitamins and minerals listed at the bottom of the table are also straightforward. The new labels will list potassium, calcium, and iron. Yes, potassium will drop from the middle of the table to the bottom, and both vitamins A & C will become optional.

Manufacturers can add other vitamins and minerals to the bottom of their Nutrition Facts table (this is optional). And you’ll notice that some foods contain a lot more vitamins and minerals than others do.

Conclusion

I hope this crash course in the Nutrition Facts table was helpful because it is important to be informed about what you are eating.

Proper nutrition is a key piece of cancer prevention so understanding what you choose to put in to your shopping cart is key.

Do you have questions about it?  If so, leave me a comment below.

 

Delicious and Super-Easy Walnut Snack Recipe

Serves 1

Ingredients:

8 walnut halves

4 dates, pitted

Instructions:

Make a “date sandwich” by squeezing each date between two walnut halves.

Serve & enjoy!

Tip: Try with pecans instead.

References:

http://www.healthycanadians.gc.ca/eating-nutrition/label-etiquetage/changes-modifications-eng.php

https://www.canada.ca/en/health-canada/services/understanding-food-labels/percent-daily-value.html

http://www.healthycanadians.gc.ca/eating-nutrition/label-etiquetage/regulatory-guidance-directives-reglementaires/daily-values-valeurs-quotidiennes/guide-eng.php#p1

 

 

 

 

 

 

 

 

 

 

 

 

 

Coping with Post-Mastectomy Pain Syndrome

It is certainly well within the level of expectation to have some pain and/or discomfort after a mastectomy or lumpectomy. But when pain continues for more than a few months post surgery and begins to impact quality of life, this is very likely Post-Mastectomy Pain Syndrome (PMPS).

Studies have shown that between 20 and 30 percent of women who have breast surgery develop PMPS.

What is Post-Mastectomy Pain Syndrome?

Post-mastectomy pain syndrome (PMPS) is chronic nerve (neuropathic) pain after lumpectomy or mastectomy…The classic signs of PMPS are chest wall pain and tingling down the arm. Pain can also be felt in the shoulder, scar, arm, or armpit. Other common complaints include numbness, shooting or pricking pain, or unbearable itching

The exact cause of PMPS is unknown.  A strong theory however is that during surgery damage is caused to the intercostobrachial nerve.  This nerve extends from the outer edge of the breast and runs along the underside of the arm.

Treatments for Post-Mastectomy Pain Syndrome

There are treatments to help relieve PMPS.  This often starts with the use of ibupofen and/or other nonsteroidal anti-inflammatory drugs.

The application of topical anesthetics can be effective for treatment in many cases.

Steroid injections or local anesthetic can be helpful for those who suffer from pain around the scar area.

As well as medical interventions, Integrative therapies can also be of help for those suffering with PMPS.  These include massage therapy, reflexology and acupuncture.

Why Seek Help?

In light of the toll that cancer therapies can have on the body, it may seem somewhat trivial to question your doctor about aches and pains. But it is not.

Pain not only has a physical impact, it can also have a mental one.

Research has demonstrated that the pain women experience suffering from PMPS has been linked to fear of recurrence.  This can be a paralyzing feeling.

Depression, as well, is strongly associated with pain.

Conclusion

Post-Mastectomy Pain Syndrome is real.

Do not dismiss symptoms or concerns that you are experiencing.  Consult your doctor and get relief.

We must be advocates of our own health.


References

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain/post-mastectomy-pain-syndrome.html

https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/pain/post-mastectomy-pain-syndrome.html

https://well.blogs.nytimes.com/2015/06/08/pain-after-breast-cancer-surgery-pmps/

https://www.painresource.com/cancer/post-mastectomy-pain-syndrome-pmps/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031190/