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Health Information An Expert Opinion: Hot Topics in Health

When it comes to your health, you want the best and most accurate information you can get. But with so much information out there from so many different sources — including the Internet, TV, radio, newspapers and magazines — it's sometimes difficult to separate fact from fiction. Discover Rush Online sought out four specialists from Rush University Medical Center to discuss four of today's hottest topics in health and help you get a better grasp on these important issues.

Q: How close are we to finding a cure for cancer?
Howard Kaufman, MD , director, Rush University Cancer Center: While we've made great strides in cancer treatments, another concept in cancer care may be more appropriate than "cure," and that’s "control." Many cancers can now be controlled like chronic conditions, such as certain leukemias and lymphomas. 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. Similar drugs are in the works for lung cancer, liver cancer and others. So we're not curing these cancers, but we can help patients have a good quality of life for a very long time.

Q: Why is vitamin D so important?
Kathryn Keim, PhD, registered dietitian at Rush: It has become clear that many people don't get enough of this vitamin — and 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.

But really, that's just the beginning. Vitamin D is involved in a lot more body processes than was originally thought. 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 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. So the best solution is to take a vitamin D supplement.

 
Q: Alcohol is good for the heart, but bad for cancer. What do you do?
Olivia Forys, MD, internist at Rush: When a medical question seems to have more than one answer and you're confused about what to do, 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. Alcohol consumption is a good example, because moderate consumption of alcohol — the type doesn't matter — can confer health benefits, such as lowering your heart disease risks by improving your cholesterol levels. 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. On the down side, however, excessive alcohol consumption is associated with liver disease and cancers of the mouth, esophagus and breast.

My advice is that if you're a nondrinker, you shouldn't start drinking just for the health benefits. And if you already drink, moderation is key. That means one drink per day for women and two for men. 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. But if you have any questions about how alcohol will affect you personally, have a conversation with your doctor and get the answers you need to make an informed decision.

 
Q: Why are women's heart attack symptoms different from men’s?
Annabelle Volgman, MD , medical director, Rush Heart Center for Women: There are some sensations in the chest, such as pain, pressure, squeezing and discomfort, that can signal a heart attack in both men and women. But there are other, less obvious signs 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, and that's because women can have a different kind of coronary artery disease.

The blockages in women can be in the smaller blood vessels. 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, and doctors may not recognize what's happening.

That's why I'm always telling women that the best time to talk with a 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.
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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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