Friday, September 15, 2017

Women with Alopecia Share Powerful Photos and Stories

When Brittany Myers was just a little girl, her mother noticed that her hair was falling out while she was brushing it. After several test screenings and by the process of elimination, doctors diagnosed her with alopecia at just 7 years old. Alopecia is a type of hair loss that occurs when your immune system mistakenly attacks hair follicles.

Now at 33, Myers is raising awareness during Alopecia Awareness Month, when many people with the condition take to social media to share their stories. “[Alopecia is] not a sickness. It’s not caused by stress. It’s simply a function of the body that we have no control over,” Myers tells Yahoo Beauty. “Throughout my childhood and into early adulthood, I would only have a missing patch of hair here or there — sometimes more and sometimes less,” she says. “When things were good, I didn’t think about it much. When things were bad, I worried a lot about one day losing all my hair.”

Myers overcame her fear of becoming bald when she was 26. One missing patch of hair grew bigger, so with the help of a stylist friend, she saw this as a sign that it was time to reinvent herself and her look. “Back then, I never imagined it wouldn’t grow back,” she says, “but I’ve been bald ever since.”

Myers says meeting other women with alopecia has been “hugely beneficial.” She explains, “It helped me begin to see the complex beauty in the baldness, in the challenge of it all, and finding that comfort over time helped me to shift focus away from alopecia and baldness.” Other women like Myers are sharing their inspiring journey with alopecia on Instagram, including powerful photos that illustrate how they’ve handled hair loss.

When discussing her resilience, Myers says, “Part of being strong is coming to terms with the fact that these are the cards I’ve been dealt. We’ve all been dealt something. I realized not too long ago that once you stop caring so much, once you stop focusing on it all the time, the rest of the world does too.” She continues, “So much freedom comes from acceptance and letting it go.”

Thursday, September 14, 2017

Apple-shaped women are at risk of a deadlier form of breast cancer (and those who store fat on their thighs, hips and buttocks are prone to a more treatable form of the disease)

Apple-shaped women are at risk of developing a deadlier form of breast cancer, a new study suggests. But those who have a pear-shaped figure, with fat stored on their thighs, hips and buttocks, are prone to a more treatable form of the disease.

For years, scientists have warned of the dangers of obesity due to evidence of its role in triggering breast cancer among other health risks. But the Chinese study shows the link between obesity and this form of the disease to be more complex than previously thought.

They discovered women with a higher BMI, which measured subcutaneous fat, were more likely to have ER+ (oestrogen-receptor positive) breast cancer. This form of the disease can be influenced by oestrogen, as the hormone can attach to proteins in cancerous cells to stimulate growth. Patients are often given Tamoxifen, a drug that costs 6p a day and which work by blocking oestrogen, which is known to stimulate the formation of tumour cells.

In contrast, those with a high waist-to-hip ratio, showing belly fat, were more likely to have ER- (oestrogen-receptor negative) breast cancer. This form of the disease can't be tackled with hormone blocking drugs, and have to go down traditional chemotherapy routes. The greater risk of developing ER- breast cancer for women with a high waist-to-hip ratio existed even if they weren't obese, Shandong University scientists noted.

Lead researcher Dr Zhigang Yu said: 'A possible reason is that subcutaneous fat is involved in estrogen production, which may promote ER+ breast cancer. 'Visceral fat is more closely related to insulin resistance and may be more likely to promote ER- breast cancer.' The researchers said that clinicians should assess ER- risk by assessing a woman's body shape before prescribing Tamoxifen, which is often given to those at high risk.

Experts stressed the findings, published in The Oncologist, were important as breast cancer is becoming a 'pandemic'. Around one in eight women will develop breast cancer in their lifetime and the illness is becoming increasingly prevalent as the population ages. There were 55,222 new cases recorded in the UK in 2014 and 11,433 deaths. In the US, 252,710 are expected to receive a diagnosis this year. Around 40,000 will die.

Researchers recruited 1,316 women who were newly diagnosed with breast cancer for the study. They were compared to a control group. Body measurements were taken, alongside details of their form of cancer - whether it was ER+ or ER- breast cancer.

Friday, September 8, 2017

Why does chemotherapy cause hair loss?

Because many chemotherapy drugs are designed to effectively kill all rapidly dividing cells, hair is the unfortunate bystander that takes the fall along with the cancer cells. While some find the thought of losing their hair so distressing that they refuse chemotherapy, most people will see their locks grow back after the treatment has finished.

The level of hair loss, or chemotherapy-induced alopecia (CIA), depends on the type of cancer, the specific drug, and the dose and pattern of the treatment. Many patients experience the first wave of CIA within 1 to 2 weeks of starting their treatment. Areas that experience high friction during sleep, such as the top of the head and the sides above the ears, are often the first to see hair loss. Yet the precise pattern depends on the individual's hair. Those hairs that are actively growing will be most affected, but because growing hair follicles can be arranged in patches or evenly distributed all over the scalp, it is unfortunately impossible to predict the pattern of hair loss for any given individual.

Hair regrowth after chemotherapy usually starts within 1 to 3 months after the therapy has finished. Up to 60 percent of patients report a change in hair color or structure during the first wave of hair regrowth, with many experiencing curlier hair. However, these changes are mostly temporary, and hair returns to normal eventually.

Hair has important functions in culture and communication, and so CIA is consistently ranked top of the list of traumatic events for many patients that undergo chemotherapy. Some patients even consider refusing chemotherapy as a result of the impending threat of CIA. Treatments for CIA are, at best, experimental. Cooling the scalp with ice packs or special caps was first introduced in the 1970s. The theory underlying this treatment is that cooling will narrow the blood vessels leading to the hair follicles. Some studies have reported success rates of up to 50 percent with this technique, but there is clearly a need for more effective therapies.

Very little is known about how chemotherapy drugs cause CIA. Most information stems from studies using mouse models. Here, research has shown that programmed cell suicide, or apoptosis, is the most likely cause of cell death in the hair follicle, causing the hair to fall out. Researchers in the Department of Medicine at the University of Chicago, IL, used genome-wide association studies to compare the genetic signature of breast cancer patients who had experienced CIA with that of those who had not. They found several candidate genes that might be implicated in the loss of functional hair follicles. One of these, CACNB4, is part of a calcium channel that plays an important role in cell growth and apoptosis. Another gene, BCL9, was active in a subset of CIA patients and is known to play a role in hair follicle development. Armed with this knowledge, scientists are continuing their quest to develop effective inhibitors of chemotherapy-induced hair loss, hoping to reduce the burden that this unwanted side effect has on cancer patients.

Wednesday, September 6, 2017

How one app is helping to tighten the link between cancer patients and their doctors

When chemotherapy patient Allison Hailey meets with Dr. Angela Kueck at Texas Oncology in Austin, she comes prepared. That is because Hailey's phone displays graphs, charts and logs of her medications, mood changes and physical health — courtesy of an app called ChemoWave. Since its launch on June 29, ChemoWave is giving chemotherapy patients and their doctors more insight on treatment plans, side effects and mental health. The app arrives on the scene at a time when health care is becoming a major focus for tech giants like Amazon and Apple, and joins an increasingly crowded field of biometric tech that helps people track vital health information.

ChemoWave is designed to help track a wide variety of vital data like symptoms, exercise, water intake and medications. It then compiles those figures into a health compliance database, then graphs the information so patients — and their doctors — can connect what symptoms are related to what medication or activity. Patients can also send daily updates to their doctors, which can be critical when treating cancer. A recent study by the Journal of the American Medicine Association found a 21 percent increase in survival time for patients who tracked and reported their symptoms. Thirty-one percent were more likely to report better quality of life and physical functions, the study said. "I have a better understanding as opposed to when I see [Hailey] every couple weeks in the office with her trying to remember what side effects she had on what day," Kueck told CNBC. "You can see trends over time, so we can plan for her next cycle" of chemo, she added. "It improved communication and we're connected more."

Matt Lashey, the developer of the app and co-founder of Treatment Technologies & Insights, came up with ChemoWave when his partner Richard Grenell was diagnosed with cancer in 2013. Each morning, Lashey would administer Grenell a survey about how he was feeling emotionally and physically, along with any side effects. Lashey's background in data analysis propelled him to do some correlation analysis from the surveys to track Grenell's symptoms. "I started doing some simple correlation analysis to see what things were related to his highs and lows, and our doctor loved (the charts)," the former research consultant for Discovery Communications and Nationwide Insurance told CNBC. "We could point to very specific days when something had occurred, and having those graphs and data really led to a lot more efficient collaboration with him." ChemoWave features an added benefit, according to Kueck: helping to improve communication between patient and doctor. "I might see a patient every three weeks, and when trying to recount what happened on day two or four, it's hard for them to remember so it does take a lot of time of the visit," Kueck said. Using the app, she now gets daily updates.

Kueck said there haven't been any widely used apps among her patients, and ChemoWave is fulfilling a large need among those involved in chemotherapy. "I'm already in the loop. We can just talk about today and the future. It's definitely streamlined the visits in the office," she said. ChemoWave is free to download, in order to get it as widely disseminated as possible, according to Lashey. He's also meeting with care organizations, doctors and pharmaceutical companies to explore future partnerships and possible financing. "There could be a lot of money to be made if we were to charge money for this app, but we decided that the real value is in the data," Lashey said. "The hope is that getting it into the hands of patients will start to add value to their life on an immediate basis, and that if we can stick with this and we can get the app with funding that we need, there's going to be money to be made in the future," he added. Grenell is now healthy and sees his doctor regularly, while Hailey said she plans on using the app throughout her treatment. "It does exactly what it's supposed to do, and it provides even more information for a patient to have some control over what what's going on with us," she said.

Tuesday, September 5, 2017

Large diet study suggests it's carbs, not fats, that are bad for your health

A large, 18-country study may turn current nutritional thinking on its head. The new research suggests that it's not the fat in your diet that's raising your risk of premature death, it's too many carbohydrates -- especially the refined, processed kinds of carbs -- that may be the real killer. The research also found that eating fruits, vegetables and legumes can lower your risk of dying prematurely. But three or four servings a day seemed to be plenty. Any additional servings didn't appear to provide more benefit. What does all this mean to you? Well, a cheeseburger may be OK to eat, and adding lettuce and tomato to the burger is still good for you, but an excess of white flour burger buns may boost your risk of dying early. People with a high fat intake -- about 35 percent of their daily diet -- had a 23 percent lower risk of early death and 18 percent lower risk of stroke compared to people who ate less fat, said lead author Mahshid Dehghan. She's an investigator with the Population Health Research Institute at McMaster University in Ontario. The researchers also noted that a very low intake of saturated fats (below 3 percent of daily diet) was associated with a higher risk of death in the study, compared to diets containing up to 13 percent daily.

At the same time, high-carb diets -- containing an average 77 percent carbohydrates -- were associated with a 28 percent increased risk of death versus low-carb diets, Dehghan said. "The study showed that contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death," Dehghan said. "We found no evidence that below 10 percent of energy by saturated fat is beneficial, and going below 7 percent may even be harmful. Moderate amounts, particularly when accompanied with lower carbohydrate intake, are probably optimal," she said. These results suggest that leading health organizations might need to reconsider their dietary guidelines, Dehghan noted. But not everyone is ready to throw out current dietary guidelines. Dr. Christopher Ramsden is a clinical investigator with the U.S. National Institute on Aging. "There's a lot more information that's needed. They did a great job and they're going to have a lot more coming out of it for years to come, but it's hard to get it down to recommendations regarding food at this point," he said. "It really highlights the need for well-designed randomized controlled trials to answer some of these questions," Ramsden added.

The researchers noted that their study did not look at the specific types of food from which nutrients were derived. And, that, said Bethany O'Dea, constitutes a "major flaw from a nutrition standpoint." O'Dea is a cardiothoracic dietitian with Lenox Hill Hospital in New York City. "For example, eating a healthy carb like an apple is more nutrient dense and better for you than eating a bag of processed potato chips," O'Dea said. "Furthermore, the study did not take trans fats into account, which hold heavy evidence of being unhealthy and contributing to cardiovascular disease," she pointed out. Current global guidelines recommend that 50 percent to 65 percent of a person's daily calories come from carbohydrates, and less than 10 percent from saturated fats, the researchers said. Dehghan suggested that "the best diets will include a balance of carbohydrates and fats, approximately 50 to 55 percent carbohydrates and around 35 percent total fat, including both saturated and unsaturated fats." All foods contain three major macronutrients essential for life -- fat, carbohydrate and protein. The optimum amounts a person should eat has been the focus of debate for decades, with the pendulum swinging from low-fat to low-carb diets over time.

For this study, Dehghan and her colleagues tracked the diet and health of more than 135,000 people, aged 35 to 70, from 18 countries around the world, to gain a global perspective on the health effects of diet. Participants provided detailed information on their social and economic status, lifestyle, medical history and current health. They also completed a questionnaire on their regular diet, which researchers used to calculate their average daily calories from fats, carbohydrates and proteins. The research team then tracked the participants' health for about seven years on average, with follow-up visits at least every three years. The investigators found that high-carbohydrate diets are common, with more than half of the people deriving 70 percent of their daily calories from carbs. High-carbohydrate diets have been linked with increases in both blood cholesterol and in the chemical building blocks of cholesterol, Dehghan said. While the experts continue debating what's the best diet, what should you be eating? O'Dea said, "Your diet should consist of healthy carbs, lean protein, and plenty of fruits and vegetables. Remember to avoid processed snacks that contain trans and saturated fats, and opt for a healthy carb source." The study was scheduled to be presented Tuesday at the European Society of Cardiology annual meeting in Barcelona, Spain. The research was being published online as two studies on Aug. 29 in The Lancet.

Thursday, August 24, 2017

Is our love of protein hurting our health? Make sure you're eating the right amount

The protein powder aisle is beginning to look like the cereal aisle. Dozens of options, an abundance of ingredients and colorful packaging, with promises of better health. The market for more protein in the American diet has arrived — and it’s not going away. The attraction to protein as a weight-loss and muscle-building nutrient has exploded so exponentially that many of us may be getting more than medical experts think we need.

Recently, a story came out about a woman who died after consuming an extremely high-protein diet. She was a body builder and suffered from a rare genetic condition called urea cycle disorder. This condition is an inborn error of metabolism and can be diagnosed in both children and adults. Those who have it may have a diminished ability to break down protein in the correct manner. As a consequence, the byproducts of protein don't leave the body like they should. Instead, they build up in the blood, and can cause coma or death.

According to the National Urea Cycles Disorder Foundation, the condition may be mild, and undiagnosed for years if the individual carrying it produces enough enzymes to remove these protein byproducts from the blood. It’s when the body is pushed to the limit that problems may occur. An excessively high intake of protein can be one of these stressors.

Death from too much protein intake is not something you hear of every day, but there are certainly people who should focus on getting less (not more) protein in their diets. For example, individuals who have chronic kidney disease, certain diseases of the liver as well as phenylketonuria (PKU) and other inherited disorders all require a low-protein diet. On the opposite end of this are populations that need more protein: endurance or weight-training athletes, pregnant and breastfeeding women, individuals recovering from surgery or injury and elderly. Then, there's the rest of us. What’s the protein sweet spot for everyone inside the extreme ranges and can we keep including all the bars, powders and liquids safety and effectively?

Unlike other macro and micronutrients, there remains no official standard defining an upper limit for protein consumption, and most government standards recommend a bare bone minimum to be assessed by a universal calculation that takes your weight in kilograms multiplied by 0.8. For example, if you are a healthy, 150-pound woman, your low end of protein would start at 54.5 grams per day, and as for your high end, there’s really no agreement on what that is.

Bottom line: Should we take a chill on this very hot macronutrient? Will death by protein be the next fear derived from food? My advice to my patients is this: Embrace protein and the many benefits it can provide to health, but resist the urge to triple or quadruple your recommended amounts on a regular basis by downing protein drinks the way you would water. Going to this extreme may mean you're skimping out on other important macronutrients, like healthy fats and complex carbohydrates. While it may not lead to death in relatively healthy individuals, too much for too long may put too much stress on your kidneys, which can lead to other serious problems.

Some liquid forms of protein and protein powders and drinks can be loaded with additional supplements and herbs, added sugar or excess amounts of sugar alcohols (which can lead to diarrhea) or artificial sweeteners. Just like any other dietary choice, you’ll want to find the options that best fit your goals. If you’re a vegetarian or dairy intolerant, your best bet is a plant-based option made with pea, soy, hemp or rice. If you're not interested in a plant-based form, then whey, or bone broth products may work best for you. Do your research, and try a few single packet options before you settle on buying an entire vat of it.

A powder or drink can never mimic whole foods, so use them as a way to boost your protein for one meal, or after a workout, for example, but not exclusively. You can get plenty of protein in the day by adding in small amounts at each meal, like sprinkling hemp seed in your yogurt in the morning, enjoying canned wild salmon over a salad for lunch, munching on roasted chick peas as a snack and ending the day with a grilled tempeh sandwich. In the world of food, you can have too much of ANY good thing. Protein included.

Wednesday, August 23, 2017

Women open up about hair loss: 'It's not spoken about'

Lauren Engle was just 28 when she noticed her hair falling out. As her strands got thinner, her part line widened and her ponytail shrunk to the thickness of a pencil. When she saw more scalp showing, she knew she had a problem. Engle, who lives in Dallas, Texas, is far from alone. Millions of women in the U.S. suffer from hair loss, caused by genes, age or alopecia areata. In Engle’s case, the culprit was unexplained female pattern baldness.

“There’s tons of us out there, but it’s not spoken about,” Engle, 35, who writes about her experience in the Corner of Hope & Mane blog, told TODAY. “It’s really sad for women. Their hair is oftentimes their crowning glory. That’s what we do to make ourselves look different, feel beautiful … Everything in the media is always women with long, flowing hair and we don’t have that, so there’s a lot of shame.”

August is National Hair Loss Awareness Month — an effort to bring attention to a condition that can cause "dramatic and devastating" emotions in patients, dealing a blow to their self-esteem, body image and self-confidence, the American Academy of Dermatology notes. A thinning mane can be challenging for anyone since hair is associated with identity, sexuality, age and mortality, but it’s definitely harder for women, said Dr. Marc Glashofer, a hair loss expert with The Dermatology Group in West Orange, New Jersey. “For a man to have a bald head or even a shaved head, it’s so common. For women, there’s still a lot of social stigma to it and it’s tougher to accomplish that confidently,” Glashofer said.

When it comes to hair loss, a big culprit is alopecia areata, an auto-immune condition in which the body’s immune system attacks its own cells instead of bacteria and viruses. In the case of alopecia areata, it targets hair follicles, Glashofer said. Almost 7 million people in the U.S. have or will develop the condition, according to the National Alopecia Areata Foundation. Both genders can get it, though it’s a bit more common in women, Glashofer noted. The trigger is a mystery. Margaret Staib, 49, still remembers the questions swirling in her head when she was diagnosed. “Why me? What did I eat? Will it grow back? Will my husband still love me and find me attractive?” the Long Island, New York, businesswoman recalls thinking. "Our disease does not 'hurt' physically; it's an emotional and mental disease once you get it."

Treatment: Right now, there’s no treatment for alopecia areata that’s sustainable or consistently works for everyone, Glashofer said. That might change in the next couple of years as researchers develop new pills and creams based on a class of compounds called JAK inhibitors that might be the first official medications specifically for alopecia areata. “It’s very exciting that that’s on the horizon,” he said. “We feel like we’re on the precipice of some real success.” These drugs were originally used for rheumatoid arthritis and, by coincidence, it was discovered that some patients who took it for that condition and who also had alopecia aerata grew their hair back. Clinical trials are underway to see how safe and effective this option is, the National Alopecia Areata Foundation says. For now, therapies include cortisone injections directly into the bald patches; topical cortisone; Minoxidil — known to many people under the brand name Rogaine; and anthralin cream. A less-widely available option is topical immunotherapy: certain chemicals applied to the scalp can trigger an allergic rash, which alters the immune response, NAAF notes.

About half of women over the age of 50 start to have some thinning of the hair to the point where the scalp begins to show through, Glashofer said. This is also called androgenetic alopecia or female pattern baldness. “It’s not discussed frequently because it’s a sensitive subject, so everybody thinks they’re in their own personal vacuum, their own agony, that they’re the only ones dealing with it,” he noted. “The reality of it is that a large number of women are dealing with this issue after a certain age.” It’s all about hormones: As women start to reach perimenopause and menopause, the balance of estrogen and testosterone starts to change. Extra testosterone around the hair follicle can lead to decreased thickness of the hair and increased shedding, Glashofer noted. A British journalist recently described how upsetting she found it to lose a third of her hair with age.

Treatment: Minoxidil. This over-the counter topical treatment can help maintain some of the hair you have and decrease the amount of shedding, Glashofer said. There’s inconclusive data about whether Propecia, a drug used to treat male pattern hair loss, can help women, he added. Female patients can try it, but it’s not a first-line therapy. A more recent option is PRP, or platelet-rich plasma. Doctors draw a small amount of blood and separate the platelets from other blood cells. “It’s been shown that the platelets, when injected back into the areas of thinning hair, can help maintain the amount of hair you have, so it can slow down the hair loss,” Glashofer noted.

Thinning hair can run in families. When women in their 20s and 30s see their hair thinning, genes could be to blame. Chances are their mothers and grandmothers experienced a similar problem. Kayla Itsines, a 26-year-old Australian fitness star, recently revealed she has genetically thin hair and wears a clip-in pony tail to add length and volume. Engle wears a topper — “faux hair” extensions that clip to the top of her head — which helps her take back control of the situation, she said. Treatment: Minoxidil may also help with hereditary-pattern baldness. Many women choose to wear clip-in hair. If you are a woman experiencing hair loss for any reason, don’t suffer in silence and don’t become a hermit, Glashofer advised. Talking to a therapist can help. “Life can be challenging in general, but especially when you’re dealing with a chronic condition that’s evident to the whole public,” he said. “Try to gain perspective and then try to share that perspective with other women.”