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October is National Breast Cancer Awareness Month. Due in great part to improved awareness and advances in treatment and early diagnosis, the survival rate continues to improve. The American Cancer Society relies on information from the Surveillance, Epidemiology and End Results (SEER) database to provide survival statistics for different forms of cancer.

While the overall 5-year survival rate for breast cancer is 90% and the 10-year survival rate is 84%, the survival rate for those fortunate to have early detection and treatment is even more encouraging. For example, when breast cancer is determined to be “localized” (no sign that the cancer has spread outside of the breast), the 5-year survival rate improves to 99%! AWARENESS AND EARLY DETECTION ARE CRITICAL!

BREAST CANCER PREVENTION TIPS

Maintain Healthy Body Mass Index (BMI) – studies repeatedly show that obesity increases the risk of breast cancer. A healthy BMI for women falls between 18.5 and 24.9. To find out your BMI visit: www.calculator.net

Maintain a Healthy Diet – the Mediterranean Diet emphasizes plant-based foods such as vegetables, beans, whole grain, fruits, nuts and seeds, and plant-based oils, especially olive oil. Avoid sugared drinks, refined carbs and fatty foods and eat fish or chicken instead of red meat. 

Limit Alcohol Consumption – While no alcohol consumption may be optimal, up to one drink a day for women is acceptable.

Avoid or Limit Hormone Replacement Therapy – Studies show that menopausal hormone therapy increases the risk of breast cancer. For those who must take hormones to manage menopausal symptoms, limit the time period to less than three years and avoid progesterone.

Consider Estrogen-Blocking Drugs – For women with a family history of breast cancer or those over 60, consulting your physician about the pros and cons of these drugs.

Do Not Smoke – Studies show that smoking increases the risk of breast cancer.  Visit: smokefree.gov for help with smoking cessation.

Breast Feed – According to the scientific literature, women who breast feed for at least a year in total have less risk of developing breast cancer. So, breast feed as long as possible.

Participate in Research – What can you do to help? Participate in clinical trials studying new and more effective ways to detect and treat breast cancer. Visit the National Cancer Institute

Limit - Manage Stress - According to a recent long-term study, both men and women have a higher incidence of cancer in those who did not manage chronic stress well. Life is full of potential stress and it cannot be avoided. But, you can learn to handle stress better. Exercise, meditation, and counseling are some options to explore. Try Progressive Muscle Relaxation (PMR) videos.

Exercise – A recent study in the Journal of the American Medical Association from Harvard has found that regular exercise can improve the survival of patients with breast cancer.

Benefits of exercise in women with breast cancer:

Current research supports the fact that exercise may not only prevent, but also improve breast cancer survival.  The following guidelines are proposed:

Source: Hutchinson Cancer Research Center

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles visit our Health and Wellness Page!

PREVENTION OF RUNNING INJURIES

It is two months away from the 25th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.

Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.

Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.

HOW TO PREVENT RUNNING INJURIES

Avoid the “terrible too’s”

Only run miles needed to meet your goals

Avoid inconsistent training

Avoid repeating hard workouts without any easy workouts in between

Consider cross training to avoid overtraining without compromising fitness level

Treat your feet right

Visit your doctor regularly and listen to your body. 

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”  

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Part 2 of 2

I have a vested interest in this column…I just had a big birthday! It is a BIG birthday because it is the one before I get health care insurance from Uncle Sam! Consequently, the “aging process” is very much on my mind!

In the book, “Being Mortal,” Atul Gawande discusses the role of medical care placing emphasis on “well-being” rather than survival, especially as it relates to end-of-life care. It is a “must read” for health care providers as well as the general public. The book also describes, in great detail, the process of aging; the physiology of bone and muscle mass loss, factors affecting balance and coordination, changes in mental acuity, memory, and mood. As depressing as it sounds (many of the changes begin as early as mid to late thirties), it is also a “call to arms!”

To prepare for the inevitable aging process one must be proactive, not reactive. From an early age, challenge yourself mentally by taking classes and learning things for which you may not have an interest. Try new physical activities and sports even if you feel unable to excel. Find balance in your diet by trying to eat fruits and vegetables that you don’t find appealing. Engage in daily exercise and physical activities even if you would rather be indoors playing video games. Lastly, get professional advice on matters beyond your scope. See your physician regularly for routine care and diagnostic tests, find a mental health professional if you are not at peace, consult with a physical therapist to help you design an exercise routine appropriate for your individual needs.

While it is never too late, remember, slowing down the aging process should not begin at 60, it begins at 30!

Memory Loss

Minor word or memory loss is a normal part of aging as the brain changes and affects how you remember things. Don’t hesitate to use technology or other tricks to assist you. For example, consider using alerts, reminders and lists on your smart phone. Also, you may want to organize certain items in a set location, use post it notes or a white board. However, these reminders are not a substitute for keeping your mind sharp. Studies show that being social, exercising regularly, eating well and learning a new skill can go a long way to maintain a healthy brain.

Weight Gain

According to several studies on aging, unfortunately, most people gain 1-2 pounds per year (10 to 20 pounds over 10 years). The aging body does not burn calories like you used to. But there are some simple steps you can implement to offset this pattern of weight gain. Obviously, eat less (less calories) and exercise more (stimulate your metabolism). Consider fruits, vegetables, and leaner protein instead of foods high in sugar/carbs and saturated fats and don’t forget portion control. Be active and take the stairs instead of the elevator.

Sexual Performance Challenges

Aging can also affect sexual performance. According to the Mayo Clinic, lower testosterone levels in men can lead to erectile dysfunction and hormonal changes in women can cause vaginal dryness. Stiff and painful joints add to the challenge. However, with a little effort, most healthy people can continue to be sexually active well into their 70’s and 80’s. Communication with your partner is important. Try new positions. Discuss hormone supplements and ED medications with your doctor. Try over-the-counter lubricants. Remember, exercise improves blood flow and stimulates sex hormones!

Urinary Frequency

Like the other muscles in your body, pelvic and bladder muscles also weaken with age. This problem can be worsened for men by an enlarged prostate and for women following multiple births. However, the muscles can be strengthened by performing specific exercises that target the area called Kegel exercises. These exercises involve squeezing the muscles that control urine flow. For example, while urinating try to stop midstream and hold your urine flow for a few seconds. Repeat 10 times and do this 3-5 times a day.  Other recommendations include eating foods high in fiber, avoiding carbonated drinks and limiting caffeine.

Boredom

People often fall into a rigid routine with age. While this predictable pattern often provides comfort, it can also lead to boredom. Try changing your routine or schedule. Learn a new skill (baking, painting, golf) or visit a new place (museums, libraries, community centers). Getting a part-time job or volunteering can be rewarding and stimulating.

Loneliness and Isolation

There are a number of reasons for one to feel lonely with age…children relocate, loss of a spouse, divorce. Experts say that it is important to take control by initiating contact with others. Call upon neighbors, friends, relatives, and former coworkers to chat or get together. Volunteer for a charity; join a book club or fitness group. Take classes at a local college and consider getting a pet.

Take Care of Your Health

Most health problems associated with aging can be treated. Regular checkups and routine diagnostic tests (blood work, colonoscopy, cardiac tests) will assure that health issues do not get out of control. Be sure to organize your medications and take them as directed. Keep a health journal or use and app on your phone to list meds, allergies and record tests and doctor visits.

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.

For further inquires related to this topic email: drpmackarey@msn.com

For all of Dr. Mackarey's articles visit: www.mackareyphysicaltherapy.com/forum

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

Exercise is Important in Prevention

In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month. The purpose of this designation is to increase public awareness of the facts about colon cancer – a cancer that is preventable, treatable and has a high survival rate. Regular screening tests, expert medical care and a healthy lifestyle, which includes a proper diet and exercise, are essential for prevention. Several studies have demonstrated that exercise can also help prevent colon cancer. 

The American Cancer Society estimates that there will be approximately 150,000 new cases of colorectal cancer in 2021. Of these, 52,980 men and women will succumb to the disease. It is the second-leading cause of U.S. cancer deaths for both men and women combined. The good news is incidence and mortality rates are dropping both nationally as well as in northeast Pennsylvania. The bad news is northeast Pennsylvania still has increased incidence and mortality rates when compared to the national average.

Studies show that prevention of this disease is multifaceted and includes: engaging in daily exercise, eating a low-fat diet with little red meat, avoiding smoking, drinking in moderation and having regular colonoscopy screenings.

Early detection is the key to survival. Death from colorectal cancer can be eliminated if caught at the earliest signs of disease. Colorectal cancer progresses very slowly, usually over years. It often begins as non-cancerous polyps in the lining of the colon. In some cases, these polyps can grow and become cancerous, often without any symptoms. Some symptoms that may develop are: blood in stool, changes in bowel movement, feeling bloated, unexplained weight loss, feeling tired easily, abdominal pain or cramps, and vomiting. Contact your physician if you have any of these symptoms.

The risk of colon cancer increases with age, as 90 percent of those diagnosed are older than age 50. A family history of colon cancer increases risk. Also, those with benign polyps, inflammatory bowel disease, ulcerative colitis or Crohn’s disease are at greater risk and should be screened more frequently.

Prevention of Colon Cancer:

How Exercise Prevents Colon Cancer:

The intestine works like a sewage plant, recycling the food and liquid needed by your body. However, it also stores waste prior to disposal. The longer the wastes remain idle in your colon or rectum, the more time toxins have to be absorbed from you waste into the surrounding tissues. One method in which exercise may help prevent colon cancer is to get your body moving, including your intestines. Exercise stimulates muscular contraction called peristalsis to promote movement of waste through your colon.

Exercise to prevent colon cancer does not have to be extreme. A simple increase in daily activity for 15 minutes, two times per day or 30 minutes, once per day is adequate to improve the movement of waste through your colon. This can be simply accomplished by walking, swimming, biking or playing golf, tennis or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes four to five days per week, with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for five to 10 minutes, two to three times per day. Then, add one to two minutes each week until you attain a 30-45 minute goal. 

Medical Contributor: Christopher A. Peters, M.D

Dr. Christopher Peters is a partner of Radiation Medicine Associates of Scranton (RAMAS) and serves as medical director of Northeast Radiation Oncology Centers (NROC). He is an associate professor of clinical medicine at GCSOM.

Sources: American Cancer Society/Northeast Regional Cancer Institute, and CA Cancer J Clin.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

More than 65 million people, almost 30% of the population in the United States, are actively involved in providing 20 or more hours of care for a chronically ill, disabled, or aged family member or friend each week. As our population continues to age, this number is expected to grow rapidly.

The role of a caregiver is multifaceted and often involves tasks and skills beyond the education or comfort level of most providers. Some examples include; managing money, paying bills, shopping, cleaning, maintaining and repairing a home, dispensing and injecting medications, cleaning wounds, changing dressings, catheter management, bed baths, assisting in position changes, transferring from the bed to the chair, ambulation, stair climbing, bathroom assistance for toileting and showering and many other responsibilities. Consequently, a caregiver is often at risk for mental, spiritual and physical fatigue or breakdown. It is no surprise that depression, illness and injury often plague a caregiver and eventually, the caregiver is in need of a caregiver. One of the most common injuries suffered by a caregiver is back pain.    

Lower back pain (LBP) is one of the most common problems in our society. Over 90% of all Americans will suffer from it at least once in their lives. It is generally agreed that prevention is the best treatment for LBP.

TIPS FOR THE PREVENTION OF BACK PAIN FOR THE CAREGIVER

Maintain Health & Fitness Level

As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well and exercise regularly.

Aerobic Exercise

Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. It will also help with the stress and depression associated with providing care for a loved one. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. You can also use an elliptical or bike at home while your loved one is resting. Get outdoors and take multiple short walks …go around the block a few times per day.

Core Exercises

Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are:

Pelvic Tilt - lying on your back and performing a pelvic tilt as you flatten you lower back into the floor.

Pelvic Tilt and Heel Slide - lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel.

Core on Ball - Perform arm exercises such as biceps and triceps with light weight while sitting on a therapeutic ball while simultaneously trying to hold an isometric contraction of your abdominal and lower back muscles.

Do Not Smoke

Smoking effects natural healing because it constricts the small blood vessels. Smokers have a much higher incidence of LBP and failure from lower back surgery.

Practice Good Posture & Body Mechanics

Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.

Caregivers spend much of the day with their spine bent over a bed or chair feeding, bathing, and lifting a loved one. Postural exercises are designed to stretch your back in the opposite direction of this forward flexed position. Examples include:

Ergonomics

From Lying to Sitting in Bed (Photo 1)

Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Bend the knees of your loved one; roll their trunk toward you to get their legs over the edge of the bed as you pivot their weight on their butt to get them sitting upright.

Photo 1

From Sitting in Bed to Sitting in Chair (Photo 2)

Bend your knees, maintain an arch in the back with head up, and bend over as little as possible. Place your hands around the waist or on a transfer belt. Use your legs, turn with feet, and do not twist spine. Block the feet and knees of your loved-one with your feet and knees and use them to pivot and transfer from the bed to the chair. Be sure the chair is along side of the bed and arm of chair removed if possible before the lift.

Photo 2

Transfer Belt - Use a transfer belt around the waist of the patient. Grip the transfer belt, instead of the patient or clothing, during the lift or when ambulating. Lower Back Lifting Belt - Also, if you have a back problem, consider using a lifting belt or back brace to protect your back when lifting the patient. Immediately following the lift, stand up straight and stretch lower back into extension.

Transfer belts and lower back lifting belts can be found online or at your local pharmacy.

Lift Chair – For patients that require maximum or moderate assistance and only one caregiver is available to lift or transfer, an electric lift chair should be considered.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at GCSOM. 

Visit your doctor regularly and listen to your body.     

For all of Dr. Mackarey's articles visit: https://mackareyphysicaltherapy.com/forum/