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Health Information Hot Topics in Health: Answers from Experts

When it comes to your health, you want the best information you can get. But it can sometimes be tough to tell fact from fiction — unless you have a source you can rely on. Here, four experts from Rush University Medical Center discuss hot topics in health.



A cure for cancer: How close are we?
Vitamin D: Why is it important?
Alcohol: What's the right approach?
Heart attack symptoms: Why are women's different than men's?

How close are we to finding a cure for cancer?

Howard Kaufman, MD, director of the Rush University Cancer Center, says another concept in cancer care may be more appropriate than "cure": control.

"Many cancers can now be controlled like chronic conditions," he says. "The idea of living with cancer while preventing it from growing is gaining momentum."
For example, with melanoma, an immunotherapy agent called ipilimumab activates the immune system, prompting it to attack cancer cells. Patients live much longer as a result of this therapy.

Control can also mean stabilizing a tumor. That's what happens with a targeted medicine for renal cell carcinoma, a form of kidney cancer.

"The tumor doesn't necessarily go away completely, but it doesn't grow either," Kaufman says. Similar drugs are in the works for lung cancer, liver cancer and others.

"We don't cure these cancers, but we can help patients have a good quality of life for a very long time," Kaufman says.

Vitamin D: Why is it important?

Vitamin D has recently taken center stage in health news as it has become clear that many people don't get enough of this vitamin. That's a problem because vitamin D is essential for bone health, helping the body absorb and use calcium in bones and teeth. It also helps build your immune system and regulate cell growth.

According to Kathryn Keim, PhD, a registered dietitian at Rush, that's just the beginning.

"Vitamin D is involved in a lot more body processes than was originally thought," Keim says.

For example, most people know that vitamin D deficiency can cause weakened bones. But research now suggests that low levels of this vitamin also may be linked to diabetes and heart disease. In fact, in one study, people with low levels of vitamin D and high blood pressure had nearly twice the rate of heart attack as those with adequate levels, although the reason was not clear.

Vitamin D also may be important to thinking and memory. And although more research needs to be done, some studies show that vitamin D may protect against multiple sclerosis.

Getting enough vitamin D from food can be difficult, since food sources are limited. Milk and some cereals are fortified with vitamin D, and it's also in fatty fish such as salmon and tuna. Sunlight converts vitamin D to its activated form in the skin, but during the short days of winter, it's hard to get enough sun — especially in northern-latitude locations such as Chicago.

According to Keim, the solution is to take a vitamin D supplement. Infants and children need at least 200 inter-national units (IUs) per day. (Ask your pediatrician about how to give vitamin D to your baby.) Adults up to age 50 need at least 200 IUs each day. As we age, we become less efficient at converting sunlight to vitamin D, so people age 51 to 70 need 400 IUs, and people age 71 and older should get 600 IUs each day.

Extremely high doses of vitamin D are toxic. But taking up to several thousand IUs a day is safe. In fact, the daily recommendation may soon be raised in light of vitamin D's recently uncovered roles in health.

Alcohol: Good for the heart, bad for cancer. What do you do?

News headlines pull you one way today and another tomorrow. A certain diet or food is great, and then it isn't. A medication or therapy works, but maybe not for you. How do you decide what to do when a medical question seems to have more than one answer?

Your first move should be to talk with your doctor. He or she can help you evaluate the risks and benefits of tests, treatments or lifestyle choices. A good example is drinking alcohol. According to Olivia Forys, MD, an internist at Rush, moderate consumption of alcohol — the type doesn't matter — can confer health benefits.

"Alcohol can lower your heart disease risks by improving your cholesterol levels," Forys says. Specifically, it raises your high-density lipoprotein, or HDL, the good cholesterol that protects your heart. Studies suggest other benefits such as reduced risk for gallstones and diabetes.

But drinking alcohol also has a downside. Excessive drinking is associated with liver disease and cancers of the mouth, esophagus and breast.

Forys emphasizes that nondrinkers shouldn't start drinking for the health benefits. And if you already drink, moderation is key. "That's one drink per day for women and two for men," she says. Because older people may be more vulnerable to alcohol-related health problems, men over age 65 should also limit their intake to one drink per day.

Why are women's heart attack symptoms different from men's?

Pain, pressure, squeezing, discomfort — these are some of the sensations in the chest that can signal a heart attack in both men and women.

Other symptoms are less obvious signals of a heart attack, and that's where an important distinction shows up.

Women experience symptoms such as nausea, fatigue or jaw pain more often than men do. According to Annabelle Volgman, MD, medical director of the Rush Heart Center for Women, that's because women can have a different kind of coronary artery disease, which can lead to heart attacks.

"The blockages in women can be in the smaller blood vessels," Volgman says. "The end result is the same — the heart doesn't get enough blood. But it's harder to diagnose."

This condition is known as endothelial dysfunction or microvascular disease, and even if it causes a heart attack, women may not realize their symptoms are serious. In fact, initial tests at an emergency department can miss it.

"Women have real symptoms, but doctors may not recognize what's happening," Volgman says.

The best time to talk with your doctor about heart attack symptoms is before you have them. Ask about your risk for heart disease and about advanced tests that can diagnose difficult heart attack cases in women.

"Women can also have heart disease that is easily diagnosed. But it's important to have a doctor who understands that that's not always the case," Volgman says.

About the Doctors

Howard Kaufman, MD, is director of the Rush University Cancer Center. He has conducted numerous clinical trials on cancer vaccines and immunotherapy for cancer patients. He is the author of The Melanoma Book and many other publications.

Kathryn Keim, PhD, is a registered dietitian at Rush. Her research focuses on developing assessment tools for nutrition education, especially among minorities and people with low income who have diabetes.

Olivia Forys, MD, is an internist who practices at Rush University Family Physicians at Lincoln Park. She is especially interested in preventive medicine, women's health and health issues related to hypertension.

Annabelle Volgman, MD, is a cardiologist at Rush specializing in the electrophysiology of the heart. She has written extensively about heart disease in women and was selected as a top doctor for women in the field of cardiology by Women's Health magazine.

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