Study examines use of yoga therapy to address lymphedema

Vanderbilt University School of Nursing

Cancer is bad enough. But cancer patients who receive surgery, radiation and chemotherapy may suffer from side effects that run from irritating to crippling — problems that are postural, musculoskeletal and respiratory, along with lowered self-esteem. Many suffer from lymphedema, swelling caused by retained fluid in a compromised lymphatic system.

One answer may be the ancient practice of yoga. Researcher Sheila Ridner, Ph.D., MSN, R.N., Martha Rivers Ingram Professor of Nursing, is conducting a pilot study, in which head and neck cancer patients are receiving yoga therapy. It's designed to increase the mobility of affected parts in order to address lymphedema symptoms, postural problems, and breathing issues, in addition to improving mood.

"Breathing, particularly diaphragmatic breathing, helps move the fluid and standing upright clearly takes away restrictive bends in the body that might keep fluid from moving," Ridner said.

For the last year, study participants have been coming to the Vanderbilt University School of Nursing for 90-minute, one-on-one sessions with Sujatha Yarlagadda, yoga therapist and assistant in Nursing. Each session includes awareness practice, postures that focus on improving mobility in the neck, jaw and shoulders, breathing exercises, relaxation and meditation.

They come three times a week for a month, while Yarlagadda helps determine which of 16 yoga poses are effective "to loosen the entire body and facilitate free flow of energy," she said. The sessions are filmed, and participants can leave with a DVD of the session that they can use to practice yoga at home.

Ridner compares the participants' physical measurements taken after the four weeks of treatment to before. Then, the patients come two times a week for another four weeks, a similar regimen to what they would receive if they received traditional physical therapy, Ridner said.

So far, more than 20 people have participated, out of a pool of 40 that Ridner hopes to recruit. Though the study is not scheduled to end until July 31, Ridner is encouraged by the changes she's seeing in patients.

"They walk better," she said. "They're standing up straighter. They say hi when they see people and they have a smile on their face that they literally didn't have when they first came in the door."

Michael Walsh, a neck cancer survivor who is finished with his part in the study but continues to practice yoga, said he's much improved. He's resumed playing ice hockey on weekends, something he had to give up after the cancer treatments rendered him unable.

"It feels a lot better, and I know that because I'm not getting my headaches that I used to get," he said.

Ridner is closely measuring the effectiveness of each yoga position, and combinations of positions. Her hope is that this is one step toward a more comprehensive study that will lead to targeted yoga therapies that patients can do at home.

She emphasized that the postures are carefully chosen and are safe, and haven't resulted in injury. This isn't group yoga or hot yoga, which is practiced in a room heated to about 105 degrees.

Ridner has been passionate about head and neck patients since she treated them as a bedside nurse in the late 1970s. She said that often, lymphedema sufferers are either not diagnosed or asked to live with their conditions until they get much worse.

"These may be things that we can fix," she said. "It's not like you just have to accept that people have to be impaired after having head and neck cancer. We don't have to accept that for them. We do not have to accept that's just what happens."

11 Foods That Are Making Your Hair Fall Flat

By Emily Alford

If your hair has been looking a little flat and lifeless lately, it could be more than just winter hat head. The culprit behind your dull locks might just lie in your refrigerator.

Most of us are pretty superficial when it comes to hair — meaning we try to make our manes more presentable with superficial solutions, like conditioners and hair products. But really, when it comes to a great head of hair, the answer lies within. A poor diet is often the cause of all manner of hair calamities, from greasy scalps to brittle ends.

“Healthy hair is more than just the shampoo you're using,” says Carlene Thomas, registered dietitian and author of Healthfully Ever After.  “Healthy hair starts with a healthy diet. Eating sugary or nutritionally empty foods edges out the foods that can help you have that healthy hair: quality protein, B vitamins, and healthy fats.”

Some of the best foods you can eat for glossy, healthy hair, according to Thomas, are foods high in Omega 3 fatty acids, which the body needs for energy and cell production. “For glossy locks, don't skip the fat,” says Thomas. “Pick healthy fats like olive oil, fish, nuts, and avocado.”

Skipping meals is actually one of the worst things you can do for your hair. If you’re cutting calories in preparation for swimsuit season, don’t be surprised if you’re rewarded by a dry scalp and a thinning hairline. According to certified hair restoration surgeon Alan J. Bauman, hair loss is common this time of year in what he calls “February Follicle Fallout,” when New Year’s crash dieting leads to mass hair loss in many well-intentioned dieters.

But before you run out and stock up on super hair power foods, be sure to check our list of the foods that damage hair and seriously increase your risk of ponytail days.

Bacon
Greasy meats like fatty bacon can actually lead to more oil production in the body, especially on the scalp, says Carla Rivera, hairstylist and co-founder of Hair La Vie. It’s best to blot your bacon or, better yet, skip it for leaner protein.

Candy
Too much sugar could be leading to more than just trouble with your waistline. According to registered dietitian and recipe columnist Michelle Dudash, “Foods with a high glycemic load may be associated with increased sebum production, which can lead to oily skin, and, therefore, oily hair.” Since most candy has a super high glycemic index, your intake could be taking its toll on your hair.

Carrots
If you’re cutting down on calories by gorging on carrots, you might not be doing your hair any favors, says Michelle Dudash. Carrots are one of the best sources around for Vitamin A, but some studies have shown that too much Vitamin A can actually lead to thinning hair.

Cereal
Cereal is often considered a meal in the United States.  Unfortunately, replacing protein with a starchy substitute might leave you feeling full, but it won’t do your hair any favors. Foods, like cereal, that are quickly broken down into sugar can increase the body’s androgen levels, which often leads to hair loss, especially in women.

French Fries
Not only can fatty foods lead to increased oil production, they often end up all over your face and hair, damaging your strands, according to Carla Rivera. “Anything that irritates your skin will bother your scalp, which can damage your hair follicle,” says Rivera.

Frozen Dinners
Frozen dinners are often preserved with salt, and too much salt means dried out, lifeless hair. “Consuming a lot of salty meals and snacks will dry your hair out and leave it weak, lifeless, and broken,” Rivera says.

Jasmine Rice
If you’re eating a ton of white jasmine rice, you may be taking in more sugar than you realize, according to Dudash. Jasmine rice has a higher glycemic index than most other starches, and consuming it in bulk could lead to more oil on the face and scalp, resulting in limp, oily hair.

Negative Calorie Foods
Sure, celery, cantaloupe, and other foods that require more calories to chew and digest than they contain might help your waistline, but heavy dieting isn’t doing your hair any favors. “By eating a diet that leaves you sickly, your body won't put the calories towards maintaining your glossy and healthy hair,” says registered dietitian Carlene Thomas.

Pasta
Pasta and other starchy foods may be an easy way to get full fast but eating too much starch at the expense of protein could keep your body from producing the proteins it needs for shiny, healthy locks. “Your hair is actually made of a protein called keratin,” Rivera says. “Diets low in protein will leave hair limp and unhealthy. That bounce and shine most ladies want is not possible without a healthy dose of protein.”

Potato Chips
Chips are really more salt than potato, and an excess of salt can lead to dehydration. But dehydration means more than just feeling thirsty; it can dry out skin and leave hair brittle.

Swordfish
While mercury poisoning is actually pretty rare, even the trace amounts found in fish like swordfish could lead to thinning hair. To avoid mercury, the FDA recommends canned tuna and salmon instead.

Heart healthy lobster for Valentine's Day!

Keep your Valentine's heart healthy with this recipe that takes minutes to make but will make you look like a pro!

Whole Foods has sustainably-caught lobster tails on sale right now @ 2 for $16!

How to season a lobster tail

1. Dress the lobster with olive oil (more heart healthy than butter)

2. Squeeze one half lemon on each lobster tail

3. Sprinkle a little salt on each tail

4. Sprinkle a little paprika on each lobster tail

5. Sprinkle a tiny bit of garlic salt on each lobster tail

You really don't have to measure the above just take the spices and sprinkle them with your fingers lightly dusting and evenly distributing the spices. You can also just go with olive oil and lemon and your lobster will taste wonderful

For your side...

Roasted Asparagus

Preheat your oven to 350 degrees

Wash asparagus and pat dry with a towel (you don't want your asparagus to steam so you want to make sure they aren't wet) Cut the end of the asparagus off and discard (this part is too chewy).

Dress your asparagus with grape seed oil, or other high heat oil that you enjoy .

Sprinkle the asparagus with sea salt and black pepper

Place your asparagus on a cookie sheet for about 15 minutes until it's a little browned and still crunchy. You don't want your asparagus to cook to long because it will get soggy.

You can line your cookie sheet with parchment paper and place the asparagus on the cookie sheet for easier clean up.

You can sprinkle a little fresh parmesan cheese to add a little flavor, but it's really not needed because roasting asparagus really brings out the sweet flavor of the vegetable.

Top Designers, Models and Celebrities Demonstrate Their Support for Women’s Heart Health

The American Heart Association’s Go Red For Women® Red Dress Collection™ 2015 presented by Macy’s is an exclusive event where top designers, models and celebrities demonstrate their support for women’s heart health during Mercedes Benz Fashion Week. Founded by The Heart Truth®, the event reminds women of the need to protect their heart health and inspires them to make a change because heart disease and stroke is not just a man’s disease. In fact, more women than men die every year from cardiovascular disease. The good news is that 80 percent of cardiac events can be prevented with education and lifestyle changes. Join us for this virtual event right here on Thursday, February 12 at 8 P.M. Eastern!


See the list of this year’s models:

• Alexa Ray Joel
• Barbara Eden
• Bethany Mota
• Carla Hall
• Catt Sadler
• Ciara
• Cynthia Bailey
• Dascha Polanco
• Donna Mills
• Hoda Kotb
• Irina Pantaeva
• Jenette McCurdy
• Kristin Cavallari
• Laverne Cox
• Star Jones
• Thalia
• Tracy Anderson
• Zendaya Coleman
• Fifth Harmony 

Red Dress Collection™ 2015 is happening tonight! Follow @GoRedForWomen on Twitter for behind-the-scenes glamour and watch it live starting at 8PM ET: http://spr.ly/6185LSFx

Laila Ali fights to raise awareness about heart disease

By Cassandra Spratling, Detroit Free Press
(Photo: Marcus Ingram/Getty Images)

Champion boxer Laila Ali is fighting a new fight: one to raise awareness among women about the importance of taking care of their health.

Her latest bout was in the public service ring speaking before hundreds of women at the Detroit Marriott at the Go Red for Women event sponsored by the American Heart Association's Southeast Michigan chapter.

"We can take control ... no matter what stage you are in your life right now," Ali told an audience of 600 women, most of them dressed in red. Ali, who has retired from boxing, is the daughter of the iconic boxer, Muhammad Ali. She challenged women to step up and start taking care of themselves.
"This is a fight and I feel like we're losing, and as you've heard, I don't like to lose," said Ali. "When I heard one in three women will die of heart disease I was stunned.

The good news is it can be prevented." Ali outlined a multistep plan to help women on the journey to optimal health, acknowledging that she remains on that journey herself and knows it's not easy. "First, you have to be aware that you can and must take care of yourself," she said.

Every day offers a new opportunity to make a choice about what to eat and when and whether to exercise, she said. "It has to be a priority," she said.

Other steps she outlined, included:
■ Be honest with yourself about the changes you need to make.
■ Map out a plan with a wellness plan. For many women that plan should include losing weight, exercising and reducing stress.
■ Eat a diet heavy on whole foods, fruits and vegetables, whole grains, healthy fats and lean meat. 

She called eating right a fight for your health. She cited a nutritionist who likened eating right to fueling a luxury vehicle. "Your body is like a sports car; put in the best quality gasoline. What is it going to take to get the best performance?" Acknowledging her own weakness for sugar, she said, "Decrease your sugar. Trust me I tried to find a way around that one."

She echoed earlier speakers in encouraging women to drink more water and exercise. "Nothing tastes as good as being fit feels," Ali said.

Prior to Ali's talk, Go Red for Women chairperson Janice Cosby, offered her definition of what GO RED Means:

G is for Get your numbers. (Cholesterol, high blood pressure and other indicators of heart health).

O is for Own your lifestyle.

R, Realize your risks.

E, Educate yourself and your family.

D, Don't be silent.  Donate time and resources to raising awareness and money for heart health, especially among women.

For more on the Go Red For Women program, go to https://www.goredforwomen.org/

Medicare Will Cover Limited Lung Cancer Screening

By Rebecca Adams

The Centers for Medicare and Medicaid Services will cover screening for lung cancer for the first time for certain beneficiaries, the agency said last week. The coverage for lose dose imaging takes effect immediately.

“This is an important new Medicare preventive benefit since lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States,” said Patrick Conway, chief medical officer and deputy administrator for innovation and quality for CMS.

Under the final decision, Medicare will cover the screening once a year for Medicare beneficiaries who are between 55 years old and 77 years old, and are either current smokers or quit smoking within the last 15 years. To qualify, the beneficiaries also must have smoked an average of one pack a day for 30 years and must get a specific type of written order from a physician or qualified non-physician practitioner.

A trial of about 54,000 people showed that CT scans may allow some cancers to be caught earlier and thus allow people to live longer with the deadly disease. A National Cancer Institute summary of  trial results found about 18 people in 1,000 who were given CT tests died of lung cancer after about 6.5 years, compared with 21 in 1,000 whose lungs were scanned with older X-rays. But 25 in 1,000 people in the CT group had a false alarm leading to an invasive procedure, such as biopsy, or surgery, while the rate was seven in 1,000 in the x-ray group.

Medicare coverage includes a visit for counseling on the benefits and risks of lung cancer screening.

“We believe this final decision strikes an appropriate balance between providing access to this important preventive service and ensuring, to the best extent possible, that Medicare beneficiaries receive maximum benefit from a lung cancer screening program,” Conway said.

“This decision is a triumph for Medicare beneficiaries who are at high-risk for lung cancer and will now have access to life-saving scans,” said Gail Rodriguez, executive director of the Medical Imaging & Technology. “Given the high bar CMS holds in making national coverage determinations, it is clear that the benefits of LDCT [low-dose computed tomography] scans for those at high risk of lung cancer are indisputable.”

Mastectomy vs. Lumpectomy for Early Breast Cancer: How to Choose

Weighing the pros and cons of two different surgical options.
By Deborah Kotz

Each year more than 200,000 women diagnosed with early-stage breast cancer, the most common kind, must make myriad treatment decisions. Among them: whether to have a mastectomy or breast-conserving surgery known as a lumpectomy.

If you’ve been diagnosed with a stage 1 or 2 breast tumor that’s not highly aggressive, you may have been offered both surgical options and left to decide which is best for you.

“Once we determine that we can remove the tumor with clear cancer-free margins, we generally leave the choice up to the woman whether to have a lumpectomy or mastectomy without recommending one over the other,” says Bonnie Sun, a breast surgeon at Sibley Memorial Hospital in the District of Columbia. “It becomes a personal decision, and the patient will have to decide, ‘what do I really want?’”

A large body of evidence indicates that breast cancer patients who have mastectomies face the same survival odds as those who have lumpectomies along with breast radiation, and for the past few decades oncologists have been encouraging women with early-stage breast cancer to opt for the less radical surgery.

In fact, an expert panel convened by the National Cancer Institute declared in 1990 that lumpectomy with radiation was “preferable” to mastectomy for women with stage 1 or 2 breast cancer – which helped drive down mastectomy rates for these patients from 100 percent in the 1980s to less than 40 percent today.

But the pendulum is starting to swing back a bit toward mastectomies. A 2014 study published in the journal JAMA Surgery – which examined anonymous records from 70 to 80 percent of American women who had breast cancer surgery – found that the percentage of those with early-stage breast cancer increased from 34 percent in 1998 to 38 percent in 2011.

While the study authors could not explain the reasons for the increase, several developments over the past decade may have contributed.

Improvements in breast reconstruction following mastectomy provide patients with more natural looking results than in decades past, says Mehra Golshan, director of breast surgical services at Dana-Farber Cancer Institute in Boston. More breast cancer patients are also getting insurance coverage for the procedure, thanks to a 1998 federal law mandating coverage.

In recent years, oncologists have moved away from strongly recommending lumpectomies toward involving women in a shared decision-making process, which entails a more in-depth discussion of the pros and cons of both surgeries.

Ask yourself the following questions to help determine which surgical option is best for you.

1. How much do you fear annual breast screenings and a potential new breast tumor? Many breast cancer patients opt to have a mastectomy – and even a prophylactic mastectomy on the other healthy breast – because they know they’ll feel extreme anxiety during future annual mammograms and over any abnormal finding, follow-up biopsy and possible diagnosis of another breast tumor down the road. About 5 percent of patients who opt for a lumpectomy will have a recurrence in the affected breast or opposite breast, Golshan says, but it’s rarely life threatening.

2. How much do you want to avoid a painful recuperation? Mastectomy with breast reconstruction typically involves multiple surgical procedures and a painful healing process that can last for weeks or even months. Lumpectomy, on the other hand, is usually a shorter procedure with a shorter recovery time but sometimes also requires a second surgery if a pathologist later finds cancer cells in the tissue surrounding the removed tumor.

 “I give patients the option of speaking with women who have had lumpectomies and mastectomies, so they can get first-hand experiences of what others went through,” Golshan says.

3. Do you have concerns about radiation treatments? After lumpectomy surgery, patients typically need five to seven weeks of radiation therapy, five days per week, to destroy any stray cancer cells. Side effects from the treatments can include breast swelling, fatigue and skin redness and blistering (like a sunburn). Scatter from the radiation can, in rare cases, damage the heart, lungs or surrounding bones.

Some women are now being offered a new option called intraoperative radiation therapy, IORT for short, in which a single dose of radiation is delivered directly into the tumor site during lumpectomy surgery. Those who have IORT do not need subsequent radiation treatments, but only certain patients are candidates. “These are women over age 45 with early-stage invasive tumors less than 2.5 centimeters in size,” says Andrea McKee, chairman of the radiation oncology department at Lahey Hospital and Medical Center in Burlington, Massachusetts. Candidates also must have only ductal breast cancer, which occurs in the milk-producing ducts, with no signs of tumor cells in healthy tissue surrounding the excised lump and no spread to local lymph nodes.

Some caveats: Since the procedure is fairly new, many cancer treatment centers do not yet offer it, and some insurance companies do not cover it. What’s more, about 15 percent of patients who have IORT wind up needing traditional radiation treatments because their final pathology report shows that they weren’t appropriate candidates, McKee says.

4. How much importance do you place on breast appearance? On sexual pleasure? Reconstructed breasts may look great, but they don’t respond to cold, heat, touch or stimulation, which can reduce sexual pleasure, Golshan says. Lumpectomy will retain the sensation of the breast, but may result in a lopsided appearance if a large amount of tissue is removed or if a woman has a small breast. For this reason, breast reconstruction may be offered along with lumpectomy to even out breast size.

5. What’s your life expectancy? Women diagnosed with breast cancer at a younger age may be more likely to opt for mastectomy because their longer expected lifespan means they have a higher lifetime risk of recurrence. “We typically tell patients that their risk of developing another primary breast cancer is about ½ percent per year,” Sun says. A 30-year-old breast cancer patient who expects to live another 50 years will face a 25 percent risk of developing another breast cancer compared to a 5 percent risk for a woman diagnosed at age 70.

Young breast cancer patients are also more likely to carry gene mutations that put them at even greater risk of recurrence, Sun said, which could tip the balance toward having a single or double mastectomy.