Scanning the prostate before a Don’t give yourself a...

8 – MARCH 2017 HEALTH CONNECT ION

Scanning the prostate before abiopsy

In the 1985 comedy “Movers & Shak-ers,” writer Herb Derman (CharlesGrodin) gets a checkup from his doctor(Sandy Ward) that leaves the audiencewondering just what medical school theguy went to: “Your prostate is boggy,”says the physician.

Turns out that vague descriptionisn’t much more precise than what’s ac-tually touted as the best way to diagno-sis prostate cancer. When PSA (pros-tate-specific antigen) readings areabove normal and a digital rectal examindicates possible prostate changes, thecombo often leads to a multi-sample bi-opsy, a tough procedure, to check forcancerous cells.

Even now, when active surveillance(a PSA test every six months and track-ing symptoms) or watchful waiting(less-aggressive tracking) is the smartmove, 1 million prostate biopsies aredone in the U.S. annually. From thatnumber, only about 161,360 new cases ofprostate cancer are identified.

Since up to 40 percent of those biop-sies trigger complications rangingfrom soreness to infection to acute urin-ary retention, you’d think there’d be an-other way to successfully diagnoseprostate cancer. There may be, becausewe’re learning how to minimize diag-nostic difficulties.

A new British study offers greatnews: If men with suspected prostatecancer are given a multiparametricMRI (MP-MRI), doctors can determinewho should have a biopsy and who canadopt a watch-and-wait plan. (The scancorrectly ID’d 93 percent of aggressivecancers as opposed to the standard bi-opsy finding only 48 percent!) If you’rescheduled for a biopsy, ask your docabout getting the MP-MRI scan first.

Big news on lower epinephrineauto-injector prices

The band Berlin hit the charts with“Take My Breath Away” in 1986, a yearbefore the first epinephrine auto-injec-tor was approved by the Food and DrugAdministration. That device was agame-changer, protecting people atrisk for life-threatening anaphylacticreactions, which actually do take yourbreath away by causing a swollenthroat and tongue, respiratory distress,edema and low blood pressure. Theycan happen from contact with an aller-gen such as peanuts, insect bites orchemicals, like latex.

In 2007, Mylan acquired the right tosell EpiPen, the brand-name epineph-rine auto-injector. Since 2007, the pricefor a two-pack went from $93.88 to$608.61. NBC news reports that it costsMylan about $35!

Thankfully, you can lower the cost.However, to obtain a lower-priced, ge-neric EpiPen your doctor must writeyou a prescription for an “epinephrineauto-injector,” NOT “EpiPen.” Also, notall discount coupons deliver what they

imply (up to 75 percent off), so ask whatyour rate will be, and know that Mylan’sMy EpiPen Savings Card has restric-tions.

So, what discounts are available?CVS offers a generic two-pack for un-der $100; discount coupons are avail-able online from national drugstorechains and places like GoodRx.com.Just Google “EpiPen discounts.” Forthe brand version: Walgreens, RiteAidand others offer EpiPen two-packs foraround $200. Then there’s Auvi-Q. TheEpiPen alternative hits shelves thismonth -- free to folks with commercialinsurance or with no insurance inhouseholds earning less than $100,000.Will insurers and pharmacy benefitmanagers go along with the plan? We’llsee. And there’s Mylan’s discount: atwo-pack for $300.

Perpetual munchies

As Murphy (the narc) says in“Cheech and Chong’s Up in Smoke”(1978): “Ingestion of marijuana fromsmoking invariably produces not onlysevere hunger pains, but ... [a] porten-tous appetite ... manifesting itself in atotal uncontrollable frenzy of eatingquite a lot.”

Well, research now shows that thetypical high-fat, sugar-packed Ameri-can diet creates similar impulses byoverstimulating your body’s endocan-nabinoid system. This system is neededfor appetite regulation (and otherstuff), and it’s made up of lipid-signal-ing molecules called endocannabinoids

that essentially are the body’s naturalcannabis. In fact, these molecules acti-vate the same receptors in your brainand body that THC, the active compo-nent of marijuana, does.

According to the study in Physiology& Behavior, mice fed a typical Ameri-can diet, loaded with fat and sugar, atelarger meals, took in more calories anddid so more rapidly than mice fed a low-fat, low-sugar diet. But don’t take themice’s word for it.

One medication that blocked thebrain’s endocannabinoid receptors ef-fectively prevented the munchies thathigh-fat, high-sugar foods trigger. Itwas approved for use as a weight-con-trol drug in Europe, but had to be pulledoff shelves because it caused severepsychiatric side effects. The Food andDrug Administration in the U.S. neverdid approve it.

However, the researchers who didthe recent mice experiments say theycan prevent those side effects, so oneday you might be able to turn off yourendocannabinoid-triggered munchiesand watch your compulsion to overeatgo up in smoke!

Be prepared to dish up awinning meal

When it comes to creating a teamthat delivers a full menu of talents, theCleveland Cavaliers’ acquisition of 6-foot-7 Kyle Korver didn’t quite fit thebill. “We still got a couple more thingswe need to do. We got to get a pointguard,” said LeBron James. Seems

when you try to prepackage a champi-onship, you have to make sure all thepower positions (backing up LeBron,Kyrie Irving and Kevin Love) are filledwith top-grade talent.

In the same way, you want to makesure you’re dishing up meals that deliv-er the full menu of nutrients it takes tohave a winning breakfast/lunch/dinner.Unfortunately, in 2014, Americansspent nearly $14 billion on frozen pre-pared foods, many of which would bebetter off benched.

A recent study explains why manyfolks rely on high-fat, high-sodium, cal-orie-packed, sugar-laced, prepackaged,frozen meals: 57 percent say that quickprep -- meals both parents and childrencan zap -- is the attraction. Also, parentsoften are more confident in preparedfood than in their own cooking, and theythink they’re cutting costs (which is notusually true). To deliver championshipmeals, try these tricks:

» Learn a few great recipes. Go towww.doctoroz.com for quick and easyrecipes and 30-minute meals. Cook-once, serve-twice meals -- like soups,stews and casseroles -- reduce cookingtime and costs.

» Don’t ditch quick-to-fix frozenveggies. They’re nutrition-filled (but,no buttery, sauced-up versions!).

» Supplement prepared meals withfresh produce. If you do dish up a pre-pared meal, make a fresh salad and addsome walnuts or steamed veggies to gowith it.

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According to the study in Physiology & Behavior, mice fed a typical American diet, loaded with fat and sugar, ate larger meals, took in morecalories and did so more rapidly than mice fed a low-fat, low-sugar diet.

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GETTY IMAGES/ISTOCKPHOTO

One study found that having high levels of stress over an average of 10 years was linked toa 27 percent higher risk of coronary heart disease.

Don’t give yourself a heartattack

There’s a reason the song “StressedOut,” by Twenty One Pilots, struck achord with listeners last year, toppingthe charts and getting over 800 millionmusic video views. The chorus is nos-talgic: “Wish we could turn back time tothe good old days/when our mommasang us to sleep, but now we’re stressedout.” And that stress response can putyour heart in jeopardy. One study foundthat having high levels of stress over anaverage of 10 years was linked to a 27percent higher risk of coronary heartdisease. It also found that psychologicalinterventions that reduce your stressresponse are associated with a 27 per-cent decrease in coronary heart dis-ease. So, how does stress harm theheart, and what can you do about it?

It’s all between your ears. The part ofyour brain that’s responsible for proc-essing emotions is called the amygdala.Recent research has found that yourstress response can fire up amygdalaactivity, which in turn cranks up yourbone marrow. You end up with overpro-duction of white blood cells, which thencauses arterial inflammation. That’sone way stress can lead to cardiovascu-lar diseases like high blood pressure,heart attack and stroke.

The good news is that understandingthis soon may lead to more effectiveways to prevent heart disease. In themeantime, we already know a pretty ef-fective way to reduce your stress re-sponse, calm your amygdala and spareyour heart, not to mention your brainand relationships: mindful meditation.Go to www.sharecare.com for instruc-tions.

Pregnancy and opioidaddiction

Alicia Keyes craved root-beer floatswhile pregnant with her second child,Genesis; Victoria Beckham was mar-malade-crazed while carrying daugh-ter Harper; and Blake Lively had tohave pumpkin ice cream when expect-ing Ines. As cravings go, they’re notgood nutrition choices.

But it could be far worse.For an ever-increasing number of

pregnant women, cravings are foropioids such as heroin and the prescrip-tion painkillers fentanyl, oxycodoneand hydrocodone. According to a newreport from the Substance Abuse andMental Health Administration, druguse among pregnant women in the U.S.has increased dramatically. And about21,000 pregnant women ages 15 to 44have misused opioids in the past month.

Those women are putting their fetusat risk for placental abruption, pretermlabor and death. And 70 to 95 percent ofthose women’s newborns suffer with-drawal or neonatal abstinence syn-drome (NAS), low birthweight and res-piratory complications, and they riskfuture brain dysfunction. According toan Australian study, by seventh grade

more than a third of children with NASfail to meet test standards in reading,writing, math, spelling and/or gram-mar.

Pregnant woman experiencing ad-diction need quality pre- and postnatalcare! According to the American Soci-ety of Addiction Medicine, “Pregnantwomen who are physically dependenton opioids should receive treatment us-ing methadone or buprenorphine ...rather than withdrawal management orabstinence.” The National Alliance ofAdvocates for Buprenorphine Treat-ment can help you find a doc(www.naabt.org), as canwww.samhsa.gov. This as a health is-sue, not a moral failing, and we shouldsupport and help these women and theirbabies.

Looking out for earlyAlzheimer’s symptoms:S.A.G.E. advice

If you’re concerned about dementiaor Alzheimer’s disease, either for a fam-ily member or yourself, we’re here withsome sage advice. Consider the wordsof Thomas Jefferson: “I find that theharder I work, the more luck I seem tohave.”

So if you put some effort into learn-ing about early detection of Alzheim-er’s and other forms of dementia, youjust might get lucky too. Early detec-tion allows doctors to slow or evensometimes halt dementia’s progress.

Our sage advice? Try the at-homescreening test developed by research-ers at Ohio State University called theSelf-Administered Gerocognitive Ex-am, or S.A.G.E.

This simple test (Google “OSUS.A.G.E.” to download) takes only 10-15minutes to complete and was designedto detect early signs of cognitive im-pairment. Dr. Mike’s Cleveland Clinicand its Wellness Institute use S.A.G.E.to help decide if you’re a candidate forits brain wellness shared medical ap-pointment program or need neurologictreatment from its Neurologic Insti-tute. Another early sign of Alzheimer’s:your nose. The part of the brain thatcontrols smell often is affected in theearly stages of the disease. So if you no-tice that you’re having trouble pickingup fragrances or odors, talk to your doc-tor.

Whatever your age, family historyor cognitive powers, remember thatstaying engaged and curious, socializ-ing with family and friends, getting10,000 steps a day or the equivalent, do-ing “speed of processing” games likebrainHQ’s Double Decision, and stick-ing with brain-healthy nutrition, likethe DASH and Mediterranean diets,helps protect your brain.

Mehmet Oz, M.D. is host of “The Dr.Oz Show,” and Mike Roizen, M.D. isChief Wellness Officer and Chair of Well-ness Institute at Cleveland Clinic. Tolive your healthiest, tune into “The Dr.Oz Show” or visit www.sharecare.com.

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In 2014, Americans spent nearly $14 billion on frozen prepared foods, many of which wouldbe better off benched.

HEALTH CONNECT ION MARCH 2017 – 9