Are there lifestyle changes that can help my cancer recovery?

Posted July 03, 2013, 2:00 am

I’m a cancer survivor. Should I be following special guidelines for diet and exercise?

Advances in cancer treatment and earlier detection are allowing more people to live longer after a cancer diagnosis. Today, more than 12 million Americans are cancer survivors. And many of them look to diet and exercise to help prevent cancer recurrence, live longer or just feel better.

Recently, the American Cancer Society (ACS) reviewed and summarized the scientific evidence about the role of diet and exercise for cancer survivors. They found that the same things that prevent cancer from developing in the first place also help keep it from coming back. The ACS published its findings in a report called “Nutrition and Physical Activity Guidelines for Cancer Survivors.”

The ACS found that to reduce the chance of cancer returning and increase the chance of surviving, cancer-free, after a cancer diagnosis, survivors should:

Achieve and maintain a healthy weight;Get enough physical activity (at least 150 minutes per week);Eat a healthy diet that emphasizes vegetables, fruits and whole grains;

The ACS also provided specific advice for survivors of a variety of major cancers. I’ve put a summary of the guidelines below.

The ACS also advised:

Cancer survivors should work with a registered dietitian who has special certification in cancer care. He or she can provide specific, evidence-based advice.Many cancer survivors have trouble taking in enough calories each day. Eating smaller and more frequent meals can help. Or try special fortified or nutrient-dense foods.Use dietary supplements cautiously. Taking more than the recommended daily amounts (RDA) of vitamins and minerals does not improve treatment outcomes or long-term survival. In fact, it can interfere with some cancer treatments. For example, taking a beta-carotene supplement may encourage the growth of lung cancer.Exercise can help fight fatigue, keep you functioning and improve your quality of life. Discuss when to start exercising, and how much, with your doctor.Obesity appears to increase the risk of breast (and possibly other) cancer recurrence. Losing weight and keeping it off can help improve survival.

When some of my patients hear advice like the ACS has given, they are skeptical. To them, cancer is a powerful force, and it seems unlikely that a healthy lifestyle could do much to tame it. I tell them that the advice is supported by large and well-done scientific studies. There is little doubt from those studies, for example, that survivors of breast cancer who are overweight have a worse prognosis than those of normal weight. Or that those who exercise regularly have a better prognosis than those who don’t.

We even are beginning to understand why. A research study was published recently which showed regular exercise leads to hormonal changes that discourage the growth of breast cancer cells. It’s not anecdotal: It’s science.

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just wondering if any girls are up for a challenge and have bigger calves than mine there 14.5 inches

just wondering if any girls  are up for a challenge does any girls have bigger calves than mine there 14.5 inches

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Are there exercises I can do to strengthen my weak ankles and prevent sprains?

Posted June 15, 2013, 2:00 am

I tend to sprain my ankle fairly often. Are there any exercises that could help me strengthen my ankles and prevent future sprains?

Your ankles are remarkable joints. They must bear the full weight of your body, yet stay nimble and flexible. Every step, every jump, every move puts your ankles through a surprising range of motion. Even when you stand quietly, your ankles are constantly making minute adjustments to help you stay balanced.

Your central ankle bone is called the talus. Your shin bone, the large bone in your lower leg, connects to the talus. A second, smaller bone in the lower leg ends alongside the talus. Bracketed by two bony bumps (each called a malleolus) on either side of the ankle, the talus acts as a hinge that allows you to point and flex your foot.

Two other joints on the talus permit sideways movements. Two ligaments (the strong, usually inelastic, tissue that bind joints) link the inner malleolus to the ankle bones. Three more ligaments bind the outer malleolus to the talus and heel bone. Ligaments play an important role in ankle anatomy — and ankle sprains.

Ankle sprains occur when you roll your foot inward or outward, or turn or twist an ankle. Probably the most common cause of an ankle sprain is when your foot comes down on the floor or ground, and instead of landing on the sole of the foot you land on the outer edge of the foot. The force of your weight on the outer edge puts a great strain on the ligaments of the outer part of your ankle.

That stretches, or even tears, the ligaments that keep the bones and joints properly positioned. Depending on the force applied as you land, the sprain can be mild, moderate or severe.

The same injuries that cause ankle sprains can also cause ankle fractures. It can be hard even for your doctor to determine if you’ve broken a bone just by examining your ankle; an X-ray often is needed. Weak ankles not only have a tendency toward repeated sprains; they also are more easily fractured.

Weak ankles often can be traced to repeated sprains that loosen the ligaments — and loose ligaments increase the risk of future ankle sprains. It’s a vicious cycle.

However, loose ligaments are not the only reason ankles have a tendency to suffer from sprains. Weakness of muscles that support the ankle also make sprains more likely. That’s where exercises come in.

You’re likely to benefit from an ankle workout that incorporates strength exercises and stretches. These exercises will help you increase flexibility in your ankles and build up ankle-supporting muscles.

If possible, work with a physical therapist. He or she can design an individualized program to meet your needs. In the meantime, I’ve put a few ankle-strengthening exercises below.

Reps: 1 per leg

Sets: 1–3

Intensity: Moderate to hard

Hold: 60 seconds

Rest: 30–90 seconds between sets

Starting position: Stand up straight with your feet hip-width apart.

Movement: Lift your right foot a few inches off the floor, bending your knee slightly, and balancing on your left leg. Hold for 60 seconds, then lower your foot to the starting position. Repeat with your left leg. This completes one set

Tips and techniques:

Maintain neutral posture with your shoulders down and back.Tighten the muscles around your hips and buttocks for stability.Keep your abdominal muscles contracted.Too hard? Hold on to a chair or counter for support, or perform for less than 60 seconds.

Too easy? Stand on a soft mat to make it more difficult to balance.

Reps: 10

Sets: 1–3

Intensity: Light to moderate

Tempo: 3-1-3

Rest: 30–90 seconds between sets

Starting position: Stand up straight with your feet hip-width apart and your hands at your sides.

Movement: Slowly lift up on your toes so that your heels rise off the floor as high as possible. Pause, then slowly return to the starting position.

Tips and techniques:

Maintain neutral posture with your shoulders down and back.Stand evenly on your toes and heels before lifting and when returning to the starting position.Exhale as you lift.Too hard? Hold on to a chair or counter for support.

Too easy? Hold weights (3 to 5 pounds) in your hands while doing the exercise.

Reps: 10 front, 10 side-to-side

Sets: 1–3

Intensity: Light to moderate

Tempo: 1-1

Rest: 30–90 seconds between sets

Starting position: Stand up straight with your hands on your hips and your feet hip-width apart. Move your right foot forward so the right heel is in line with the toes of your left foot.

Movement: This is a two-step exercise.

Step 1: While keeping your heel grounded on the floor, lift the toes of your right foot as high as you can and tap them on the floor 10 times.

Step 2: Still keeping your heel grounded, lift up the toes of your right foot, then tap in and out (to the left and right) 10 times. Repeat both steps with your left foot. This completes one set.

Tips and techniques:

Maintain neutral posture with your shoulders down and back.Keep toe taps smooth and controlled.Too hard? Perform the exercise while seated in a chair with both feet on the floor.

Too easy? Secure a 1- to 3-pound ankle weight around your foot behind the toes.

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Are there exercises I can do to relieve my knee pain?

Posted June 01, 2013, 2:00 am

I have pain in my kneecap, right in front of my knee. It hurts to walk down the stairs or even sit for too long. What can I do?

It sounds like you have what is called patellofemoral pain. That’s pain where your kneecap (patella) meets your thighbone (femur). It usually results from overdoing exercise. Fortunately, there’s a lot you can do to prevent and relieve this pain.

To understand this condition, here’s a brief anatomy lesson. Sit in a chair, and then lift up your foot (on either leg) and hold your leg straight out. How were you able to do this? A big muscle in the front of your thigh (your quadriceps, or “quads”) is attached to a tough tendon. The tendon is like a cord; it runs over the top of your knee and attaches to the biggest bone in your lower leg, the tibia. When your quadriceps muscle shortens and tugs on the tendon, it lifts up your lower leg and foot.

In the middle of the tendon, right over the knee, is a small bone: the patella, or kneecap. It protects the bones of the knee joint by putting a hard bone in front of them to take the hit if you fall on your knee.

Your patella glides within a groove in the thighbone. Anything that stresses that connection can cause patellofemoral pain.

Patellofemoral pain can occur with one-time overuse (such as several sets of tennis when you haven’t played regularly) or from chronic stress. It’s common in people who run a lot, especially on hills. It’s also common in people who play sports involving jumping, or frequent stops or direction changes. Doctors often see it in people who suddenly start to work out much harder and more often. Certain physical characteristics, such as flat feet, can also contribute.

Pain-free exercise is the cornerstone of treatment. A workout plan to relieve or prevent patellofemoral pain should focus on improving strength and flexibility in the tissues around the knee. (I’ve put a selection of appropriate exercises below.) Work with a physical therapist, who can design an individualized exercise program for you.

Isometric quadriceps exercise (not pictured): Sit on the floor and lean back on your elbows with one knee bent and the affected leg extended. Tighten the quadriceps muscles of the extended leg; hold for five seconds, and relax. Repeat 10 to 20 times, three times a day.Leg raises to strengthen the quadriceps (above): Sit on the floor and lean back on your elbows with the affected leg extended on the floor and the other knee bent. Tighten the quadriceps muscles of the extended leg, and lift the leg a foot off the floor; hold for five seconds, and slowly lower the leg. Do 10 to 20 repetitions, three times a day.Leg raises to strengthen the outer thigh muscle (above): Lie on your side with the affected leg on top, tighten the thigh muscles, and lift the leg straight up to a 45-degree angle; hold it for five seconds, and slowly lower it. Repeat 10 to 20 times, three times a day. As the muscles become stronger, gradually add up to 5 pounds of ankle weights.Leg raises to strengthen the inner thigh muscle (above): Lie on your side with the affected leg on the bottom and the top leg as shown. Tighten the thigh muscles of the bottom leg, lift it straight up, hold for five seconds, and slowly lower it. Repeat 10 to 20 times, three times a day. Gradually add up to 5 pounds of ankle weights.To stretch the iliotibial band and buttock muscles (above): Bend the knee of the leg you want to stretch and cross it over the other leg, as shown. Twist your trunk toward the bent knee, and press the opposite elbow against the outside of the bent knee. Hold for 10 to 20 seconds. Repeat five to 10 times.Hamstring curls to strengthen the hamstrings (above): Stand with your hands on something for balance; bend the affected knee, and slowly lift the foot behind you until the heel is about level with the standing knee; hold for a second and slowly lower the foot. Repeat 10 to 15 times, three times a day. Increase the intensity by adding ankle weights. You can also strengthen the hamstrings by slowly walking backward on a treadmill or by using the lying-down hamstring curl machine at the gym.

While you’re recovering, don’t do anything that causes pain. If you run, avoid hills, go for shorter distances or substitute other activities. Avoid high-impact exercises and squatting or kneeling. Don’t wear high heels or sit with your legs bent for too long.

Ice and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, others) or naproxen sodium (Aleve, others) can help ease immediate pain. If you have flat feet, you may need additional arch support.

If you’re still in pain after more than one year, you may have to consider surgery. Even then, surgery is recommended only if there is an obvious anatomical problem.

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Recreational Marijuana: Are There Health Effects?

Dec. 11, 2012 -- On Monday, Colorado Gov. John Hickenlooper signed an order legalizing recreational marijuana use for adults.

Last week, Washington was the first state to OK adult recreational use of the drug. Several other states are considering similar laws.

While much research has focused on the value of medical marijuana to help chronic pain and other problems, what about the health effects of purely recreational marijuana?

WebMD turned to two experts, recently published studies, and the National Institute on Drug Abuse to draw up a scorecard of possible major health effects.

"Putting smoke in your lungs is not good for the lungs," says Roland Lamarine, HSD, professor of public health at California State University, Chico. He reviewed published studies on the health effects of marijuana earlier this year for the Journal of Drug Education.

Smoking marijuana produces a nearly threefold increase of inhaled tar compared with tobacco, according to some studies. Other research suggests that marijuana smokers, compared to cigarette smokers, inhale more deeply and hold their breath longer.

"There are still questions that aren't answered about lung damage," Lamarine says. For cigarette smokers who also smoke marijuana, there may be an additive effect, he says.

Combining the two appears to be a trend, he says. "Some of the [college] kids tell me they buy cigars and put in some marijuana, so there is both marijuana and tobacco," Lamarine says.

Marijuana smoke contains cancer-causing substances, according to the National Institute on Drug Abuse. Some research shows that marijuana smoke has up to 70% more cancer-causing substances than tobacco smoke, it says.

"Nobody is advocating that routinely inhaling carcinogenic smoke is healthy," says Paul Armentano, the deputy director of NORML (National Organization for the Reform of Marijuana Laws).

However, he says, many marijuana users these days have turned to alternate delivery methods, such as oral, tinctures, and vapor forms. In research, he says, the vaporized forms have fewer adverse chemicals than the inhaled form.

Those who keep marijuana use light do not appear to lose lung function, according to a 2012 study in the Journal of the American Medical Association.

Researchers compared tobacco and marijuana users. Tobacco use was associated with lower lung function, and the function got worse as smoking levels increased.

For the study, low levels of lifetime exposure to marijuana, defined as one joint a day for seven years, did not show evidence of adverse effects on lung function. The study does not confirm these findings with heavy users.

Long-term, heavy use of marijuana can lead to impaired thinking skills and memory problems, Lamarine says, citing published studies.

The impairments can be especially hazardous when trying to do everyday activities such as driving.

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Recreational Marijuana: Are There Health Effects?

ByKathleen Doheny
WebMD Health News Reviewed byBrunilda Nazario, MD

Dec. 11, 2012 -- On Monday, Colorado Gov. John Hickenlooper signed an order legalizing recreational marijuana use for adults.

Last week, Washington was the first state to OK adult recreational use of the drug. Several other states are considering similar laws.

While much research has focused on the value of medical marijuana to help chronic pain and other problems, what about the health effects of purely recreational marijuana?

WebMD turned to two experts, recently published studies, and the National Institute on Drug Abuse to draw up a scorecard of possible major health effects.

Health Effects of Marijuana: Lungs

"Putting smoke in your lungs is not good for the lungs," says Roland Lamarine, HSD, professor of public health at California State University, Chico. He reviewed published studies on the health effects of marijuana earlier this year for the Journal of Drug Education.

Smoking marijuana produces a nearly threefold increase of inhaled tar compared with tobacco, according to some studies. Other research suggests that marijuana smokers, compared to cigarette smokers, inhale more deeply and hold their breath longer.

"There are still questions that aren't answered about lung damage," Lamarine says. For cigarette smokers who also smoke marijuana, there may be an additive effect, he says.

Combining the two appears to be a trend, he says. "Some of the [college] kids tell me they buy cigars and put in some marijuana, so there is both marijuana and tobacco," Lamarine says.

Marijuana smoke contains cancer-causing substances, according to the National Institute on Drug Abuse. Some research shows that marijuana smoke has up to 70% more cancer-causing substances than tobacco smoke, it says.

"Nobody is advocating that routinely inhaling carcinogenic smoke is healthy," says Paul Armentano, the deputy director of NORML (National Organization for the Reform of Marijuana Laws).

However, he says, many marijuana users these days have turned to alternate delivery methods, such as oral, tinctures, and vapor forms. In research, he says, the vaporized forms have fewer adverse chemicals than the inhaled form.

Those who keep marijuana use light do not appear to lose lung function, according to a 2012 study in the Journal of the American Medical Association.

Researchers compared tobacco and marijuana users. Tobacco use was associated with lower lung function, and the function got worse as smoking levels increased.

For the study, low levels of lifetime exposure to marijuana, defined as one joint a day for seven years, did not show evidence of adverse effects on lung function. The study does not confirm these findings with heavy users.

Health Effects of Marijuana: Brain Impairment

Long-term, heavy use of marijuana can lead to impaired thinking skills and memory problems, Lamarine says, citing published studies.

The impairments can be especially hazardous when trying to do everyday activities such as driving.

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