Prostate Cancer

Medical experts have warned that non-communicable diseases (NCDs) such as hypertension, diabetes, cancer, cardiovascular diseases are responsible for the majority of Coronavirus disease (COVID-19) deaths in the country.

President, NCD Alliance Nigeria, Olorogun Dr. Sonny F. Kuku, in his opening remarks during a webinar on, “Non-communicable Diseases and COVID-19 in Nigeria – The response”, held Tuesday, July 21, 2020, said: “… We are only seeing the tip of the iceberg and unfortunately, people with NCDs are at greater risk. It is impacting the poorest people and most vulnerable. People with hypertension, diabetes and heart disease are the most vulnerable. We are now seeing stroke as symptom. This means COVID-19, which is an infectious disease is manifesting as an NCD in the form of stroke…”

Vice President, Scientific Affairs, NCDs Alliance Nigeria, Dr. Kingsley Akinroye, has said blamed the situation on the nation’s years of lack of commitment to the course of NCDs. The cardiologist said NCDs account for 29 per cent of deaths in Nigeria.

Akinroye, at the launch of the New Civil Society Solidarity Fund on NCDs in response to COVID-19, harped on the need to strengthen the healthcare system, intensify awareness, increase access to care and treatment, and vote more money for NCDs care and management.

However, the NCD Alliance Nigeria and 19 other global and national NCD Alliances have been awarded $300,000.

Akinroye added that regional and national NCD Alliance including NCD Alliance Nigeria would get $15,000 to address the critical needs of people living with NCDs during the pandemic through advocacy and communication activities that would support stronger organisational stability and resilience

According to the cardiologist, COVID-19 shows many connections between it and NCDs stating that people living with NCDs are more vulnerable to COVID-19 with a substantially higher risk o becoming severely ill or dying from the virus.

The expert said that actions taken to control NCDs in Nigeria include the launch o the First Multi-Sectoral Action Plan or Prevention and Control o NCDs by the Federal Ministry of Health (FMoH) and the NCD Alliance Nigeria Publication of the Handbook on Civil Society Organisation in NCDs.

“Activities in Nigeria will include the development of a database of people living with NCDs in Lagos, Osun, and Federal Capital Territory and by NCD area of focus. Also, establishment and support for people living with NCDs with skills and knowledge, and connect them to NCD Alliance Nigeria, federal Ministry o Health, World Health Organisation and State Ministry of Health in the four states,” he added.

Akinroye further stated that they would build capacity for people living with NCDs on advocacy for their rights to health, prevention, access to treatment and care; provision of support and empowerment

He explained that NCD Alliance Nigeria would develop a directory and a database in the states by area of focus cardiovascular disease, diabetes, cancer, sickle cell disease, respiratory diseases and mental health and also develop advocacy communication materials targeting Lawmakers, Policymakers and opinion leaders that are persuasive and effective to improve prevention, care and access to treatment for people living with NCDs.

The expert, however, tasked the Presidential Taskforce on COVID-19 to mobilise for more testing and awareness amongst the grassroots and also provide free hypertensive and diabetic drugs or the vulnerable population.

Executive Director, NCD Alliance Nigeria, Prof. Akin Osibogun, also presented a paper on “NCDs in Nigeria and COVID-19: The Nigerian experience.”

Osibogun is a consultant public health physician/epidemiologist, a member of Lagos State COVID-19 Response Team and former Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH) Idi Araba.

Member, Nutrition Committee, Nigerian Heart Foundation (NHF) and Food Scientist, Prof. Isaac Adebayo Adeyemi, spoke on “COVID-19 and Nutrition: Gathering evidence.”

Akinroye delivered a paper on “People Living with NCDs in Nigeria and COVID-19.”

Adeyemi, who is Vice chancellor of Bells University of Technology Ota, Ogun State, and the pioneer Deputy Vice-Chancellor, Ladoke Akintola University of Technology (LAUTECH), Ogbomoso, Oyo State, said functional foods are important to boost the immune system.

Adeyemi said that a well functioning immune system is key to providing robust defence against pathogenic organisms. Adeyemi noted that mortality in people living with NCDs is likely the result of immune decline or impaired immune response.

The expert said that energy is required to fight the virus likewise, protein to produce essential antibodies.

He encouraged intake of Phytochemicals like quercetin from onions, phloretin and also Epigallocatechin gallate (EGCG) as well as conventional foods containing bioactive food compounds like vegetables, fruits, grains, dairy, fish and meat.

“Eat fresh and unprocessed food every day like fruits and vegetables, legumes and whole grains and animal products. Eat a moderate amount o fats and oils. Eat at home to reduce your rate of contact with other people,” he added.

Adeyemi urged the consumption of plant food such as grains, legumes and oilseeds, fruits and vegetables containing vitamins, minerals, fibre and phytochemicals.

He, however, stressed on the need to avoid the intake of caffeine, trans fat while also limiting the intake of salt because they are predisposing factors that contribute to morbidity o patients with COVID-19.

According to a study published in Scholars Journal of Applied Medical Sciences and titled “COVID-19 and Nutrition: Review of Available Evidence”, nutritional support is indicated for depleted patients with respiratory diseases because it provides not only supportive care, but direct intervention through improvement in respiratory and peripheral skeletal muscle function and in exercise performance.

The researchers noted: “A combination of oral nutritional supplements and exercise or anabolic stimulus appears to be the best approach to obtaining significant functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. Furthermore, weight loss and malnutrition opens the door of infection reoccurrence. Poor response was related to the effects of systemic inflammation on dietary intake and catabolism.

“Dietary management of pre-existing diseases has been suggested as a strategy to minimise the potential risk of COVID-19 infection in conditions such as irritable bowel syndrome, Crohn’s and Colitis. WHO, dietetic associations and dietitians have been calling for patients with pre-existing conditions to continue abiding by their dietary advice and nutritional therapy steps received from their dietician if tested positive for COVID-19.”

Meanwhile, according to a World Health Organisation (WHO) survey, prevention and treatment services for NCDs have been severely disrupted since the COVID-19 pandemic began. The survey, which was completed by 155 countries during a three-week period in May, confirmed that the impact is global, but that low-income countries are most affected.

This situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.

Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, said: “The results of this survey confirm what we have been hearing from countries for a number of weeks now.

“Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

The main finding is that health services have been partially or completely disrupted in many countries. More than half (53 per cent) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 per cent for treatment for diabetes and diabetes-related complications; 42 per cent for cancer treatment, and 31 per cent for cardiovascular emergencies.

Rehabilitation services have been disrupted in almost two-thirds (63 per cent) of countries, even though rehabilitation is key to a healthy recovery following a severe illness from COVID-19.

In the majority (94 per cent) of countries responding, ministries of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.

The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50 per cent of countries. This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.

But the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services. In one in five countries (20 per cent) reporting disruptions, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.

Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country. Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.

Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72 per cent of high-income countries reported inclusion compared to 42 per cent of low-income countries. Services to address cardiovascular disease, cancer, diabetes and chronic respiratory disease were the most frequently included. Dental services, rehabilitation and tobacco cessation activities were not as widely included in response plans according to country reports.

Seventeen percent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.

Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at the highest risk to continue receiving treatment for NCDs. Among the countries reporting service disruptions, globally 58 per cent of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries, this figure is 42 per cent. Triaging to determine priorities has also been widely used, in two-thirds of countries reporting.

Also encouraging is that more than 70 per cent of countries reported collecting data on the number of COVID-19 patients who also have an NCD.

Director of the Department of NCDs at WHO, Dr. Bente Mikkelsen, said: “It will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with NCDs.

“What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses. It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 – but that innovative ways are found to implement those plans. We must be ready to ‘build back better’- strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances.”

According to the WHO, NCDs kill 41 million people each year, equivalent to 71 per cent of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85 per cent of these “premature” deaths occur in low- and middle-income countries.

Prostate cancer has been convincingly linked to the sexually transmitted human papillomavirus (HPV) for the first time.

Experts have found evidence that a significant number of prostate cancer cases are ‘highly likely’ to have been caused by the same virus that causes cervical cancer in women. And they say it may be transmitted to the gland through sex.

The researchers say their findings suggest the HPV vaccine might help lower the risk of prostate cancer.

The vaccine, which has been given to teenage girls since 2008, was last year made available to schoolboys at the age of 12 and 13 for the first time. HPV was already known to cause certain rare cancers in men, including tumours of the mouth, throat and genitals, accounting for around 2,500 cases a year.

But its implication in prostate cancer – which affects more than 57,000 men a year in the United Kingdom (UK) – significantly increases the consequences of contracting the virus.

It also highlights the importance of the vaccination programme.

The research team, from the University of New South Wales in Australia, compiled the results from 26 previous studies to create the biggest evidence base yet linking HPV to prostate cancer.

Writing in the Infectious Agents and Cancer journal, they concluded: “A causal role for HPVs in prostate cancer is highly likely.”

Prostate cancer, which kills 12,000 men in Britain each year, has previously been linked to genetics, environmental pollutants and lifestyle factors. But the researchers said: “Although HPVs are only one of many pathogens identified in prostate cancer, they are the only infectious pathogen which can be prevented by vaccination.”

This suggests HPV as a common factor, they said.

HPV is a common infection spread through skin-to-skin contact, usually during sex. Around eight in 10 people will be infected with HPV at some point in their lives and there are hundreds of different types of the virus.

Around 13 HPV types are known to cause cancer, including cervical cancer, penile cancer and some types of mouth and throat cancer.

But the researchers found HPV types 16 and 18, which cause most cases of cervical cancer, were also linked to prostate cases.

One of the researchers, Prof. James Lawson, said: “Many people assume HPV infections mainly lead to cancers in women. This is not the case.

“The data may indicate that HPV infection may be transmitted during sexual activity and play a causal role in prostate cancer as well as cervical cancer.”

The scientists said more studies needed to look at how HPV infection may lead to prostate cancer.

Two recent but separate studies have demonstrated how bitter melon and turmeric could be used to prevent, treat and reduce the progression of cancers.

Commonly called bitter melon, bitter gourd, African cucumber or balsam pear, Momordica charantia belongs to the plant family Cucurbitaceae. In Nigeria, bitter melon is called ndakdi in Dera; dagdaggi in Fula-Fulfulde; hashinashiap in Goemai; daddagu in Hausa; iliahia in Igala; akban ndene in Igbo (Ibuzo in Delta State); dagdagoo in Kanuri; akara aj, ejinrin nla, ejinrin weeri, ejirin-weewe or igbole aja in Yoruba.

Turmeric is a spice that comes from the root of Curcuma longa, a member of the ginger family, Zingaberaceae. In traditional medicine, turmeric has been used for its medicinal properties for various indications and through different routes of administration, including topically, orally, and by inhalation.

In Nigeria, it is called atale pupa in Yoruba; gangamau in Hausa; nwandumo in Ebonyi; ohu boboch in Enugu (Nkanu East); gigir in Tiv; magina in Kaduna; turi in Niger State; onjonigho in Cross River (Meo tribe).

Turmeric, also known as curcuma, produces a root that is used to produce the vibrant yellow spice used as a culinary spice so often used in curry dishes. Though native to India and parts of Asia, and is a relative of cardamom and ginger, turmeric has been domesticated in Nigeria. In Asia, turmeric is used to treat many health conditions and it has anti-inflammatory, antioxidant, and perhaps even anticancer properties.

Meanwhile, Prof. Ratna Ray from Saint Louis University in Missouri, United States (U.S.), and her colleagues, in a recent study on bitter melon, made an intriguing find. In experiments using mouse models, bitter melon extract appeared to be effective in preventing cancer tumours from growing and spreading.

The researchers report their findings in a study paper that now appears in the journal Cell Communication and Signaling. Ray grew up in India, so she was familiar not just with the culinary qualities of bitter melon, but also with its alleged medicinal properties.

This made her curious as to whether or not the plant also harbored properties that would make it an effective aid to anticancer treatments. She and her colleagues decided to put this to the test in a preliminary study by using bitter melon extract on various types of cancer cells — including breast, prostate, and head and neck cancer cells.

Laboratory tests showed that the extract stopped those cells from replicating, suggesting that it might be effective in preventing the spread of cancer. In further experiments using mouse models, the researchers found that the plant extract was able to reduce the incidence of tongue cancer.

So, in their new study, Prof. Ray and team tried to find out what might give bitter melon compounds an edge against cancer cells. This time, they used mouse models to study the mechanism through which bitter melon extract interacted with tumors of cancer of the mouth and tongue.

They saw that the extract interacted with molecules that allow glucose (simple sugar) and fat to travel around the body, in some cases “feeding” cancer cells and allowing them to thrive.

By interfering with those pathways, the bitter melon extract essentially stopped cancer tumors from growing, and it even led to the death of some of the cancer cells. Ray said: “All animal model studies that we’ve conducted are giving us similar results, an approximately 50 per cent reduction in tumor growth.”

Ray and colleagues explained that it remains unclear whether or not bitter melon would have the same effect in humans, but Prof., going forward, this is what they are aiming to find out.

“Our next step is to conduct a pilot study in [people with cancer] to see if bitter melon has clinical benefits and is a promising additional therapy to current treatments,” she noted.

Ray seemed convinced that the plant is, if nothing else, at least a positive contributor to personal health.“Some people take an apple a day, and I’d eat a bitter melon a day. I enjoy the taste,” she said.“Natural products play a critical role in the discovery and development of numerous drugs for the treatment of various types of deadly diseases, including cancer. Therefore, the use of natural products as preventive medicine is becoming increasingly important.”

Meanwhile, a recent literature review investigated whether turmeric may be useful for treating cancer. The authors concluded that it might be but noted that there are many challenges to overcome before it makes it to the clinic. The chemical in turmeric that most interests medical researchers is a polyphenol called diferuloylmethane, which is more commonly called curcumin. Most of the research into turmeric’s potential powers has focused on this chemical.

Over the years, researchers have pitted curcumin against a number of symptoms and conditions, including inflammation, metabolic syndrome, arthritis, liver disease, obesity, and neurodegenerative diseases, with varying levels of success.
Above all, though, scientists have focused on cancer. According to the authors of the recent review, of the 12,595 papers that researchers published on curcumin between 1924 and 2018, 37 per cent focus on cancer.

In the current review, which features in the journal Nutrients, the authors mainly focused on cell signaling pathways that play a role in cancer’s growth and development and how turmeric might influence them. Treatment for cancer has improved vastly over recent decades, but there is still a long path to tread before we can beat cancer. As the authors note, “the search for innovative and more effective drugs” is still vital work.

In their review, the scientists paid particular attention to research involving breast cancer, lung cancer, cancers of the blood, and cancers of the digestive system. The authors concluded: “Curcumin represents a promising candidate as an effective anticancer drug to be used alone or in combination with other drugs.”

According to the review, curcumin can influence a wide range of molecules that play a role in cancer, including transcription factors, which are vital for Deoxy ribonucleic Acid (DNA)/genetic material replication; growth factors; cytokines, which are important for cell signaling; and apoptotic proteins, which help control cell death.

Alongside the discussions surrounding curcumin’s molecular influence over cancer pathways, the authors also addressed the possible issues with using curcumin as a drug. For instance, they explain that if a person takes curcumin orally — in a turmeric latte, for example — the body rapidly breaks it down into metabolites. As a result, any active ingredients are unlikely to reach the site of a tumour.

With this in mind, some researchers are trying to design ways of delivering curcumin into the body and protecting it from undergoing metabolisation. For instance, researchers who encapsulated the chemical within a protein nanoparticle noted promising results in the laboratory and in rats.

Although scientists have published a great many papers on curcumin and cancer, there is a need for more work. Many of the studies in the current review are in vitro studies, which means that the researchers conducted them in laboratories using cells or tissues. Although this type of research is vital for understanding which interventions may or may not influence cancer, not all in vitro studies translate to humans.

Relatively few studies have tested turmeric’s or curcumin’s anticancer properties in humans, and the human studies that have taken place have been small-scale. However, aside from the difficulties and limited data, curcumin still has potential as an anticancer treatment.

Scientists are continuing to work on the problem. For instance, the authors mention two clinical trials that are underway, both of which aim to “evaluate the therapeutic effect of curcumin on the development of primary and metastatic breast cancer, as well as to estimate the risk of adverse events.”

They also refer to other ongoing studies in humans that are evaluating curcumin as a treatment for prostate cancer, cervical cancer, and lung nodules, among other diseases. The authors believe that curcumin belongs to “the most promising group of bioactive natural compounds, especially in the treatment of several cancer types.”

However, their praise for curcumin as an anticancer hero is tempered by the realities that their review has unearthed, and they end their paper on a low note: “Curcumin is not immune from side effects, such as nausea, diarrhea, headache, and yellow stool. Moreover, it showed poor bioavailability due to the fact of low absorption, rapid metabolism, and systemic elimination that limit its efficacy in diseases treatment. Further studies and clinical trials in humans are needed to validate curcumin as an effective anticancer agent.”

Meanwhile, an earlier study published in journal Current Pharmacology Reports established that besides diabetes, bitter melon is effective in treating other chronic diseases such as cancer and Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS).

The study is titled “Bitter Melon as a Therapy for Diabetes, Inflammation, and Cancer: a Panacea?” The researchers noted: “Over the last few decades, multiple well-structured scientific studies have been performed to study the effects of bitter melon in various diseases. Some of the properties for which bitter melon has been studied include: antioxidant, anti-diabetic, anticancer, anti-inflammatory, antibacterial, antifungal, antiviral, anti-HIV, anthelmintic, hypotensive, anti-obesity, immuno-modulatory, anti-hyperlipidemic, hepato-protective, and neuro-protective activities. This review attempts to summarize the various literature findings regarding medicinal properties of bitter melon. With such strong scientific support on so many medicinal claims, bitter melon comes close to being considered a panacea.”

According to Food as Medicine: Functional Food Plants of Africa published 2017 by CRC Press, “…Dietary use of bitter melon or its juice decreases blood glucose levels, increases High Density Lipo-protein (HDL)/good cholesterol, and decreases triglyceride levels, thus exhibiting antiatherogenic qualities. Extract of bitter melon in supplement form has been widely used as a traditional medicine for diabetic patients.

When administered alone, it has a modest hypoglycemic effect at doses of at least 2000 mg/day. This botanical supplement enhances the cellular uptake of glucose and promotes insulin release, potentiating its effect, and in animal studies has been shown to increase the number of insulin-producing beta cells in diabetic animals. Bitter melon has also been found to reduce adiposity and oxidative stress in addition to reducing blood triglycerides and Low Density Lipo-proteins (LDL)/bad cholesterol.”

Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological.

An adnexal mass could be:

  • an ovarian cyst
  • an ectopic pregnancy
  • a benign tumor
  • a malignant tumor

A family doctor can usually manage benign masses. However, prepubescent and postmenopausal individuals will need to see a gynecologist or oncologist.

Malignant adnexal masses require treatment from a specialist.

In this article, we discuss the characteristics of adnexal masses. We also review how doctors diagnose and treat adnexal them.

Symptoms

People report different symptoms, depending on the cause of the adnexal mass.

People with an adnexal mass may report:

  • severe lower abdominal or pelvic pain that is usually on one side
  • abnormal bleeding from the uterus
  • pain during sexual intercourse
  • worsening pain during a period
  • painful periods
  • abnormally heavy bleeding during periods
  • abdominal symptoms, including a feeling of fullness, bloating, constipation, difficulty eating, increased abdominal size, indigestion, nausea, and vomiting
  • urinary urgency, frequency, or incontinence
  • weight loss
  • lack of energy
  • fatigue
  • fever
  • vaginal discharge

Different causes of adnexal masses may have similar symptoms, so doctors usually conduct further investigations to determine the exact cause.

Once the doctor has worked out the cause of the adnexal mass, they can recommend treatment and management.

Causes

Adnexal masses include a variety of different conditions that range in severity from benign growths to malignant tumors.

The cause of adnexal masses could be gynecological or nongynecological.

Some of the causes of adnexal masses include:

  • Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus.
  • Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown.
  • Leiomyoma: A benign gynecological tumor, also known as a fibroid.
  • Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs.
  • Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection.
  • Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease.
  • Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

Diagnosis

A doctor may diagnose an adnexal mass by:

  • taking a complete medical history
  • asking questions about symptoms
  • conducting a physical examination
  • obtaining blood samples

Most of the time, people will need a transvaginal ultrasound to allow doctors to evaluate the characteristics of an adnexal mass.

Females who have had a positive pregnancy test result and report abdominal or pelvic pain and vaginal bleeding might have an ectopic pregnancy. An ovarian torsion causes sudden, severe pain with nausea and vomiting. Immediate medical attention is necessary to treat both an ectopic pregnancy and ovarian torsion.

People with pelvic inflammatory disease or a tubo-ovarian abscess may experience gradual pelvic pain with nausea and vaginal bleeding.

Early ovarian cancer may sometimes present with nonspecific symptoms. Sometimes, doctors may only detect cancer when the tumor has become malignant.

Malignant tumors may have one or several of the following characteristics:

  • a solid component of the tumor
  • parts of the tumor have thick divisions larger than 2–3 centimeters separating them
  • they are present on both sides of the reproductive tract
  • the presence of fluid filled lumps

Treatment

A doctor will choose the most appropriate treatment depending on the cause of the adnexal mass. Women with an ectopic pregnancy will have to end their pregnancy. A doctor may choose one of the following procedures:

  • the administration of a single or two-dose intramuscular methotrexate
  • laparoscopic surgery
  • a salpingostomy or salpingectomy, which are surgical procedures involving the fallopian tubes

Doctors have not yet determined the optimal management of an endometrioma, according to a study that featured in Obstetrical & Gynecological Survey.

Currently, the possible treatments for an endometrioma include:

  • watchful waiting
  • medical therapy
  • surgical intervention
  • inducing ovulation and using assisted reproductive technology in females with infertility

People with pelvic inflammatory disease will require courses of intravenous antibiotics, which may include:

  • cefotetan (Cefotan)
  • cefoxitin (Mefoxin)
  • clindamycin (Cleocin)

Some people can receive treatment outside of the hospital setting with oral doxycycline (Vibramycin) and intramuscular ceftriaxone (Rocephin) or another third generation cephalosporin antibiotic. In some cases, doctors will need to add oral metronidazole (Flagyl).

In the past, tubo-ovarian abscesses required surgical removal of the uterus, ovaries, and fallopian tubes. However, doctors can now prescribe broad-spectrum antibiotics. A person with a ruptured tubo-ovarian abscess may still require surgery.

Ovarian torsion is a gynecological emergency. The only treatment is surgery to prevent severe damage to the ovaries and fallopian tubes.

People with leiomyomas or fibroids may receive hormonal treatments or nonsteroidal anti-inflammatory drugs to control the symptoms. Once a person stops taking medication, the symptoms may return, and the fibroids may continue to grow. Surgery is the most successful treatment for fibroids.

The treatment options for ovarian cancer include surgery, chemotherapy, and targeted therapy. Oncologists will consider the following factors before recommending a treatment plan:

  • the type of ovarian cancer and how much cancer is present
  • the stage and grade of the cancer
  • whether the person has a buildup of fluid in the abdomen causing swelling
  • whether surgery can remove the whole tumor
  • genetic changes
  • the person’s age and general health status
  • whether it is a new diagnosis, or if cancer has come back

Risk factors

Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger.

Doctors diagnose fibroids in about 70% of white females and more than 80% of black females by the age of 50 years. Other factors may increase a person’s risk of developing fibroids, such as:

  • starting periods early in life
  • using oral contraceptives before 16 years of age
  • an increase in body mass index (BMI)

Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include:

  • inherited genetic changes
  • hereditary nonpolyposis colorectal cancer
  • endometriosis
  • postmenopausal hormonal therapy
  • obesity
  • tall height

The likelihood of developing cancer also tends to increase with age.

Summary

Adnexal masses are lumps that doctors may find in the adnexal of the uterus, which is the part of the body that houses the uterus, ovaries, and fallopian tubes. Not all masses are cancerous, and they do not all require treatment.

Different types of adnexal mass can share many of the same symptoms. As a result, doctors need to collect a full medical history and data from physical examinations, blood tests, and medical imaging, including transvaginal ultrasounds.

Doctors need to pinpoint the location and cause of an adnexal mass to determine the appropriate management and treatment.

In last week’s Thursday’s edition of the Guardian Newspaper, I wrote generally on the fruit berries. Having done that I have also seen the richness of individual berries in the group of fruits in what is called berries. For this reason I have decided to write about four of the commonest fruits in this group.

It is important for us to know that there are berries in such shops as Shoprite, SPAR etc. In other words, these fruits can easily be found and bought here in Nigeria.

Strawberries are juicy and delicious nutrient-rich fruits, which are full of antioxidants. Minerals and vitamins commonly found in strawberries are potassium, calcium, magnesium, iron and vitamin CC.

Health benefits of strawberries

Boosts the immune system
Strawberries are a powerful source of vitamin C, which is an established immune booster. Vitamin C is also a well-known antioxidant. It is a fast working antioxidant, which effectively neutralises free radicals and contributes to the effectiveness of the Vitamin Antioxidant Defense System. Consumption of one serving of strawberries is sure to provide one half of our body’s daily requirement of vitamin C

Helps to prevent cancer
Vitamin C, the antioxidant neutralizes free radicals that would have destroyed cells and DNA and possibly cause cancer (vitamin C boosts the immune system). Ellagic acid is a phytonutrient that is also found in strawberry. Ellagic acid has been found to exhibit anti-cancer properties by suppressing cancer growth. Lutein and zeaxanthin (zeathanins) are free fatty acids also found in strawberry. They are antioxidants, which mop up free radicals and prevent oxidative stress damage of cells.

Ensures healthy vision
Strawberry, by its antioxidant function can help to prevent cataract formation. Cataract can lead to blindness in old age. The UV rays from the sun causes the release of free radicals from the protein in the lens. Sufficient vitamin C in the system neutralizes these free radicals and prevents damage to the lens of the eyes. Also, vitamin C functions in strengthening of the cornea and retina of the eye.

Cholesterol Lowering Effect
Strawberries are included in the list of heart-healthy foods. Ellagic acid and flavonoids in strawberries are antioxidants, which prevent the build up of plaques on the walls of arteries by the LDL (bad) cholesterol in the blood circulation. The anti-inflammatory effect of ellagic acid and flavonoids also prevent heart disease.

Reduction of inflammation
Arthritis, which is inflammation of the joints have also been found to respond positive to the antioxidants and phytochemicals in strawberries. An elevated C-reactive protein is an indication of inflammation. This CRP has been shown to decrease in those who consume strawberries regularly.

Effect on blood pressure
Potassium is richly found in strawberries – about 134mg per serving. Potassium is a buffer against the negative effect of sodium in the cell, which leads to a reduction of the blood pressure.

Increase intake of fibre
Fibre helps in the healthy digestion of food in the intestine and prevents conditions such as constipation and diverticulitis. Fibre also helps to reduce the absorption of glucose in the blood. Strawberries are a good source of fibre.

Lung cancer is the second most common type of cancer in adults in the United States. It is also the leading cause of death from cancer.

Lung cancer treatment is much more effective when the disease is in its earlier stages. However, most people with lung cancer do not experience symptoms until the disease has spread.

Some people experience subtle symptoms of early stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.

Below, we describe early symptoms of lung cancer, as well as risk factors and when to see a doctor.

Possible signs and symptoms of early stage lung cancer

According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they have spread to other areas.

However, some people experience subtle symptoms during the earlier stages of the disease.

The early lung cancer symptoms that we describe below usually result from some other cause. However, people who experience these symptoms should consider visiting their doctors as a precautionary measure.

Sudden weight loss

The American Society of Clinical Oncology report that weight loss is often the first noticeable sign of cancer.

They estimate that 40% of people who receive a cancer diagnosis experience unexplained weight loss during that time.

Cancer can cause weight loss for many reasons, including:

  • changes to immune function
  • changes to metabolism
  • changes to hormones
  • a sudden loss of appetite
  • difficulty swallowing

Shortness of breath

Shortness of breath and wheezing can also be early symptoms of lung cancer.

Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but have no cough.

Cough

A slight cough that does not go away can indicate early stage lung cancer. Some people assume that this cough is only a result of smoking.

A person who regularly coughs because of another lung condition may notice changes in their cough, and these can likewise indicate lung cancer.

Also, a cough that produces blood may result from lung cancer or another issue with the lungs. Anyone who experiences this symptom should see a doctor.

General fatigue

Lung cancer can cause the number of red blood cells in the body to drop. The medical term for this issue is anemia.

Because red blood cells carry oxygen, a person with anemia may not take in enough oxygen to support their body’s needs. This can result in tiredness and fatigue. Severe fatigue can make it difficult to function on a day-to-day level.

Shoulder, chest, or back pain

Most people with lung cancer do not feel pain or other symptoms during the early stages. This is because there are very few nerve endings in the lungs.

However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.

As a tumor develops, a person may begin to feel pain in their:

  • arms
  • chest
  • back

Hoarse voice

A person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.

This can happen if a tumor presses on the laryngeal nerve, which is located within the chest. When the nerve is compressed, it can paralyze a vocal cord, causing the voice to change.

Risks

According to the Centers for Disease Control and Prevention (CDC)cigarette smoking is still the biggest risk factor for lung cancer, accounting for 80–90% of lung cancer-related deaths.

Other risk factors for lung cancer include:

  • using other tobacco products, such as cigars or pipe tobacco
  • inhaling secondhand smoke
  • being exposed to radon gas, possibly from materials within the home
  • working with dangerous chemicals, such as asbestos, arsenic, or diesel
  • living in a highly polluted area
  • having other lung conditions, such as chronic obstructive pulmonary disease
  • having a family history of lung cancer

When describing risk, organizations and experts sometimes use the term “pack-year.” A pack-year refers to the number of cigarettes smoked per day each year. So a person with a 30 pack-year smoking history may have:

  • smoked one pack per day for 30 years
  • smoked two packs per day for 15 years

The ACS recommend yearly lung cancer screenings for people aged 55–74 who:

  • currently smoke or have quit smoking in the past 15 years
  • have at least a 30 pack-year smoking history
  • currently smoke and are receiving counseling to help them quit
  • are aware of the potential benefits and harms of screening
  • have access to a facility that has experience with lung cancer screening and treatment

Screening cannot detect every instance of lung cancer, but it does lower a person’s chance of dying from the disease.

Smokers vs. nonsmokers

According to the CDC, people who smoke are 15–30 times more likely to die from lung cancer than people who do not.

Meanwhile, according to statistics from 2013–2014, about 1 in 4 people who do not smoke, including children, are exposed to secondhand smoke. This increases their risk of developing the disease.

Quitting smoking at any age can lower the risk of lung cancer.

When to see a doctor

The symptoms above usually result from issues other than lung cancer. However, anyone who experiences any of the following issues should visit a doctor:

  • a cough that lasts longer than 2–3 weeks
  • a persistent cough that worsens
  • a cough that produces blood
  • aches or pains when breathing or coughing
  • persistent shortness of breath
  • persistent tiredness or fatigue
  • recurrent chest infections
  • unexplained weight loss

Summary

Lung cancer is the second most common form of cancer. It can affect anyone but is particularly prevalent among people who smoke.

Usually, lung cancer does not cause symptoms until it has spread. As a result, it is not always possible to detect lung cancer in its earliest stages.

Nonetheless, some people experience subtle symptoms during the initial stages. It is important to recognize these because treatment is typically more effective when a person receives it early.

Anyone who experiences early symptoms of lung cancer should see a doctor. In many cases, something other than cancer is the cause. Still, it is best to seek medical advice as a precaution.

A new study spanning nearly 2 decades has found a link between an unhealthful diet and vision loss in older age. Should we be keeping more of an eye on what we eat?

A robust body of research has shown that a diet rich in red meat, fried foods, high fat dairy, processed meats, and refined grains is bad for the heart and linked to the development of cancer.

However, not many people consider the impact of diet on their eyesight.

A new study, now appearing in the British Journal of Ophthalmology, has found a link between a diet rich in unhealthful foods and age-related macular degeneration (AMD).

AMD is a condition that impacts the retina with age, blurring central vision. Central vision helps people see objects clearly and perform everyday activities such as reading and driving.

According to the Centers for Disease Control and Prevention (CDC), in the United States, around 1.8 million people aged 40 and above are living with AMD, and another 7.3 million have a condition called drusen, which usually precedes AMD.

The CDC also explain that “AMD is the leading cause of permanent impairment of reading and fine or close-up vision among people aged 65 years and older.”

Now, the new study — which was the first to look at dietary patterns and the development of AMD over time — has found an association between an unhealthful diet and AMD.

Senior study author Dr. Amy Millen, of the University at Buffalo in New York, told Medical News Today, “Most people understand that diet influences cardiovascular disease risk and risk [of] obesity; however I’m not sure the public thinks about whether or not diet influences one’s risk [of] vision loss later in life.”

Although research has shown links between certain foods and nutrients and AMD — for example, some studies have suggested that high dose antioxidants may slow progression — there has been less research into dietary patterns as a whole.

Furthermore, studies that have looked at dietary patterns have focused on late stage risk — that is, the point at which the condition becomes vision threatening — rather than early and late stage disease.

“We wanted to examine how the overall pattern of one’s diet may predict later development of AMD, both early onset and late stage disease,” said Dr. Millen.

Unhealthful diet raises AMD risk by threefold

The study looked at the development of early and late AMD in participants of the Atherosclerosis Risk in Communities study, which looked at arterial health over 18 years (1987–1995).

Using data on 66 different food types, the researchers identified two diet patterns: one they dubbed “Prudent,” or healthful, and one they dubbed “Western,” which included a high intake of “processed and red meat, fried food, dessert, eggs, refined grains, high fat dairy, and sugar sweetened beverages.”

Although the researchers found no link between early AMD and dietary patterns, they found that the incidence of late AMD was three times higher among those with a Western eating pattern.

“What we observed in this study was that people who had no AMD or early AMD at the start of our study, and reported frequently consuming [unhealthful] foods, were more likely to develop vision threatening, late stage disease approximately 18 years later,” says Dr. Millen.

Prevention is better than cure

Early stage AMD has no symptoms, so a person may not know that have it. Also, although not everyone develops late stage AMD, for those who do, it can be costly and invasive to treat.

There are two forms of late stage AMD. One is called wet AMD, or neovascular AMD, which healthcare professionals tend to treat by injecting antivascular growth factors.

The other is called dry AMD, or geographic atrophy, which occurs when the photoreceptor cells die without neovascularization. There is no effective treatment for this form of AMD.

“We would like the public to realize that diet is important to their vision,” said Millen.

“The clinical take-home message is that dietary intake likely makes a difference in determining central vision loss later in life. If a person has early onset AMD, it is in their best interest to eat foods we identified as part of the Western diet pattern in moderation.”

Dr. Amy Millen

The kidneys are small organs in the lower abdomen that play a significant role in the overall health of the body. Some foods may boost the performance of the kidneys, while others may place stress on them and cause damage.

The kidneys filter waste products from the blood and send them out of the body in the urine. They are also responsible for balancing fluid and electrolyte levels.

The kidneys perform these tasks with no outside help. Several conditions, such as diabetes and high blood pressure, may affect their ability to function.

Ultimately, damage to the kidneys may lead to chronic kidney disease (CKD). As the authors of a 2016 article noteTrusted Source, diet is the most significant risk factor for CKD-related death and disability, making dietary changes a key part of treatment.

Following a kidney-healthy diet plan may help the kidneys function properly and prevent damage to these organs. However, although some foods generally help support a healthy kidney, not all of them are suitable for people who have kidney disease.

Water

Water is the most important drink for the body. The cells use water to transport toxins into the bloodstream.

The kidneys then use water to filter these toxins out and to create the urine that transports them out of the body.

A person can support these functions by drinking whenever they feel thirsty.

Fatty fish

Salmon, tuna, and other cold-water, fatty fish that are high in omega-3 fatty acids can make a beneficial addition to any diet.

The body cannot make omega-3 fatty acids, which means that they have to come from the diet. Fatty fish are a great natural source of these healthful fats.

As the National Kidney Foundation note, omega-3 fats may reduce fat levels in the blood and also slightly lower blood pressure. As high blood pressure is a risk factor for kidney disease, finding natural ways to lower it may help protect the kidneys.

Sweet potatoes

Sweet potatoes are similar to white potatoes, but their excess fiber may cause them to break down more slowly, resulting in less of a spike in insulin levels. Sweet potatoes also contain vitamins and minerals, such as potassium, that may help balance the levels of sodium in the body and reduce its effect on the kidneys.

However, as sweet potato is a high-potassium food, anyone who has CKD or is on dialysis may wish to limit their intake of this vegetable.

Dark leafy greens

Dark leafy greens, such as spinach, kale, and chard, are dietary staples that contain a wide variety of vitamins, fibers, and minerals. Many also contain protective compounds, such as antioxidants.

However, these foods also tend to be high in potassium, so they may not be suitable for people on a restricted diet or those on dialysis.

Berries

Dark berries, which include strawberries, blueberries, and raspberries, are a great source of many helpful nutrients and antioxidant compounds. These may help protect the cells in the body from damage.

Berries are likely to be a better option than other sugary foods for satisfying a sweet craving.

Apples

An apple is a healthful snack that contains an important fiber called pectin. Pectin may help reduce some risk factors for kidney damage, such as high blood sugar and cholesterol levels.

Apples can also often satisfy a sweet tooth.

Foods to avoid

There are several foods that people should avoid if they want to improve their kidney health or prevent damage to these organs.

These include the following:

Phosphorous-rich foods

Too much phosphorus can put stress on the kidneys. ResearchTrusted Source has shown that there is a correlation between high phosphorous intake and an increased risk of long-term damage to the kidneys.

However, there is not enough evidence to prove that phosphorous causes this damage, so more research into this topic is necessary.

For people looking to reduce their phosphorous intake, foods high in phosphorous include:

  • meat
  • dairy products
  • most grains
  • legumes
  • nuts
  • fish

Red meat

Some types of protein may be harder for the kidneys, or the body in general, to process. These include red meat.

Initial research has shown that people who eat a lot of red meat have a higher risk of end-stage kidney disease than those who eat less red meat. However, there is a need for more studies to investigate this risk.

Foods for people with CKD

Sliced cabbage on a board
Cabbage may be beneficial for people with CKD.

While the above foods may support a healthy kidney in general, they are not usually the best choices for people with CKD.

Doctors will put most people with CKD on a specific diet to avoid minerals that the kidneys process, such as sodium, potassium, and phosphorous.

The National Institute of Diabetes and Digestive and Kidney Diseases recommend that people with CKD eat less than 2,300 milligrams of sodium each day.

As CKD progresses, people may also need to limit their phosphorous intake, as this mineral can build up in the blood of people with this disease.

Choosing the right amount of potassium is also important for people with CKD, as problems may occur when potassium levels get too high or low.

People with CKD should aim to eat healthful foods that are low in these minerals but still provide the body with other nutrients.

It may also be important for people with CKD to reduce their protein intake and only include small amounts of protein in their meals. When the body uses protein, it turns into waste, which the kidneys must then filter out.

As a 2017 studyTrusted Source notes, eating a diet lower in protein may protect against complications of CKD, such as metabolic acidosis, which occurs as kidney function deteriorates. The researchers indicated that eating a diet rich in fruits and vegetables and low in protein might help reduce these risks.

People with CKD can work directly with a dietitian to create a suitable diet plan that meets their needs.

Cabbage

Cabbage is a leafy vegetable that may be beneficial for people with CKD. It is relatively low in potassium and very low in sodium, yet it also contains many helpful compounds and vitamins.

Red bell peppers

In addition to being very low in minerals such as sodium and potassium, red bell peppers contain helpful antioxidant compounds, which may protect the cells from damage.

Garlic

Garlic is an excellent seasoning choice for people with CKD. It can give other foods a more satisfying, full flavor, which may reduce the need for extra salt. Garlic also offers a range of health benefits.

Cauliflower

Cauliflower is a versatile vegetable for people with CKD. With the right preparation, it makes a good replacement for foods such as rice, mashed potatoes, and even pizza crust.

Cauliflower also contains a range of nutrients without providing too much sodium, potassium, or phosphorous.

Arugula

People with CKD may have to avoid many greens, but arugula can be a great replacement. Arugula is generally lower in potassium than other greens, but it still contains fiber and other beneficial nutrients.

Berries

bowl of blueberries
Blueberries are a healthful snack for people with CKD.

The fruits below can be a healthful sweet snack for people with CKD:

  • cranberries
  • strawberries
  • blueberries
  • raspberries
  • red grapes
  • cherries

Olive oil

Olive oil may be the best cooking oil because of the type of fat that it contains. Olive oil is high in oleic acid, which is a polyunsaturated fatty acid that may help reduce inflammation in the body.

Egg whites

Eggs are a simple protein, but the yolks are very high in phosphorous. People with CKD can make omelets or scrambled eggs using just the egg whites.

Foods for people with CKD to avoid

For people with CKD, some foods may be difficult for the body to process and might place more stress on the kidney. These include:

  • white potatoes
  • red meat
  • dairy products
  • sugary beverages
  • avocado
  • bananas
  • canned foods
  • pickled foods
  • alcohol
  • egg yolks

People looking to protect their kidneys from future damage may also want to consider eating these foods in moderation.

Summary

The kidneys play an important role in filtering the blood and eliminating waste products in the urine. Many foods may help support an already healthy kidney and prevent damage to this organ.

However, people with chronic kidney disease will need to follow a different set of dietary rules to protect their kidneys from further damage.

It is always best to talk to a licensed dietitian before moving forward with any dietary changes.

A recent study has investigated links between hair products and breast cancer. The findings have caused a stir, so in this article, we put the results into perspective.

Overall, breast cancer affects around 1 in 8 women during their lifetime.

Although breast cancer incidenceTrusted Source rates among non-Hispanic white women have historically been higher than among non-Hispanic black women, in recent decades, the rate of breast cancer among black women has increased.

Today, the breast cancer rates among black and white women are similar. However, according to the authors of a new study:

“[B]lack women [are] more likely to be diagnosed with aggressive tumor subtypes and to die after a breast cancer diagnosis.”

Scientists are working to pin down all the risk factors associated with breast cancer, and they are eager to understand why race-related disparities occur.

The study, which now appears in the International Journal of Cancer, focuses on hair products. Specifically, the researchers investigated hair dye and chemical hair straighteners, which permanently or semipermanently “relax” the hair.

Hair dye and breast cancer

Over the years, a number of studies have hinted at hair products’ potential role in cancer. As the study authors explain, “Hair products contain more than 5,000 chemicals, including some with mutagenic and endocrine‐disrupting properties.”

Older studiesTrusted Source have shown that certain chemicals in hair dye can induce tumors in the mammary glands of rats.

However, studies that have searched for an association between hair products and breast cancer in human populations have produced inconsistent results.

The authors of the recent research, based at the National Institute of Environmental Health Sciences, set out to take a fresh look. They decided to include hair straighteners in their analysis because earlier studies have largely ignored them. Importantly, according to the authors, these straightening chemicals “are used predominately by women of African descent.”

Because hair product ingredients tend to vary depending on whether the manufacturers market them to white or black women, the authors wondered if this might play a part in the disparity in breast cancer.

To investigate, the researchers took data from the Sister Study. This dataset includes information from 50,884 women aged 35–74. The scientists followed the women for an average of 8.3 years. The participants had no personal history of breast cancer but at least one sister who had received a breast cancer diagnosis.

Headline statistics

As part of their analysis, the researchers accounted for a wide range of variables, including age, menopausal status, socioeconomic status, and reproductive history. Importantly, they also had access to information about participants’ use of hair care products.

They found that women who used hair dye regularly in the 12 months before enrolling in the study were 9% more likely to develop breast cancer.

Specifically, when the scientists assessed the use of permanent dyes, they found that women who used these products every 5–8 weeks or more had an increased risk of breast cancer. Among white women, the risk increased by 8%. Among black women, the risk increased by 60%.

The study authors found no significant links between breast cancer and the use of semipermanent or temporary dyes.

When they looked at chemical hair straighteners, they concluded that women who used them every 5–8 weeks or more had a 30% increased risk of breast cancer. In this case, there were no significant differences between white and black women, though it is worth noting that black women seemed to use these products more often.

Not all percentages are equal

It is important to put these figures into perspective. The percentages above describe relative risk, which publishers tend to focus on because the numbers appear more dramatic.

For instance, studies have shown that women who drink two or more alcoholic beverages per day have a 50% higher risk of developing breast cancer. In other words, over the course of a lifetime and compared with women who do not drink, these women are 50% more likely to develop breast cancer.

However, this does not mean that they have a 50% chance of developing breast cancer.

In the general population, women have a 12% risk of developing breast cancer in their lifetime. So, if we increase this risk by 50%, that brings the risk up to 18%. In this example, the absolute risk increase is 6%, which is the difference between 12% and 18%. Although this is a significant increase, it does not have the same psychological impact as 50%.

Returning to the hair product study, although the reported relative risk of a 60% increase in breast cancer risk among black women is a significant result, the absolute risk of a new cancer diagnosis in this study population was less than 1% per year.

This does not mean that the topic is not worth pursuing. Any increase in cancer risk is important, but understanding the statistics helps put the matter into perspective.

Study limitations

As with any observational study, it is impossible to determine whether or not a factor is causal. The observed relationship might be dependent on other factors that the analysis could not account for.

Another potential issue is that every participant in the study had at least one first-degree relative who has experienced breast cancer. As the authors explain, this “may limit the generalizability of these findings.”

However, taking everything into account, this is a large study, and the findings are worth following up.

“We are exposed to many things that could potentially contribute to breast cancer, and it is unlikely that any single factor explains a woman’s risk,” explains study co-author Dale Sandler, Ph.D. “While it is too early to make a firm recommendation, avoiding these chemicals might be one more thing women can do to reduce their risk of breast cancer.”

As the use of marijuana is increasing in the United States, researchers are asking whether the use of this substance — particularly smoking joints — is associated with an increased risk of any form of cancer, and, if so, which.

Marijuana is one of the most widely used drugs in the United States, with more than one in seven adults reporting that they used marijuana in 2017.

Statistical reports project that sales of cannabis for recreational purposes in the U.S. will amount to $11,670 million between 2014 and 2020.

According to recent researchTrusted Source, smoking a joint remains one of the main ways in which individuals use marijuana recreationally.

While specialists already know that smoking tobacco cigarettes is a top risk factor for many forms of cancer, it remains unclear whether smoking marijuana can increase cancer risk in a similar way.

To try to find out whether there is a link between recreational marijuana use and cancer, researchers from the Northern California Institute of Research and Education in San Francisco and other collaborating institutions recently conducted a systematic review and meta-analysis of studies assessing this potential association.

In their paper — which appears in JAMA Network OpenTrusted Source — the team notes that marijuana joints and tobacco cigarettes share many of the same potentially carcinogenic substances.

“Marijuana smoke and tobacco smoke share carcinogens, including toxic gases, reactive oxygen species, and polycyclic aromatic hydrocarbons, such as benzo[alpha]pyrene and phenols, which are 20 times higher in unfiltered marijuana than in cigarette smoke,” write first author Dr. Mehrnaz Ghasemiesfe and colleagues.

“Given that cancer is the second leading cause of death in the United States and smoking remains the largest preventable cause of cancer death (responsible for 28.6% of all cancer deaths in 2014), similar toxic effects of marijuana smoke and tobacco smoke may have important health implications,” they go on to emphasize.

‘Misinformation — a threat to public health’

Dr. Ghasemiesfe and team identified 25 studies assessing the link between marijuana use and the risk of developing different forms of cancer. More specifically, eight of these studies focused on lung cancer, nine looked at head and neck cancers, seven examined urogenital cancers, and four covered various other forms of cancer.

The studies found associations of different strengths between long-term marijuana use and various forms of cancer.

The researchers note that the study results regarding the link between marijuana lung cancer risk were mixed — so much so that they were unable to pool the data.

For head and neck cancer, the researchers concluded that “ever use,” which they define as exposure equivalent to smoking one joint a day for 1 year, did not appear to increase the risk, although the strength of the evidence was low. However, the studies produced mixed findings for heavier users.

There was insufficient evidence to link this drug to a heightened risk of nasopharyngeal carcinoma, oral cancer, or laryngeal, pharyngeal, and esophageal cancers.

Among urogenital cancers, the investigators found that individuals who had used marijuana for more than 10 years appeared to have a higher risk of testicular cancer — more specifically, testicular germ cell tumors. Once again, however, the strength of the existing evidence was low.

There was insufficient evidence that marijuana use was associated with an increased risk of other forms of cancer, including prostate, cervical, penile, and colorectal cancers.

Dr. Ghasemiesfe and colleagues note that the studies that they had access to had many limitations, including numerous methodological problems and an insufficient number of participants who reported high levels of marijuana use.

Going forward, the team suggests that there is an urgent need for better quality studies assessing the potential relationship between marijuana and cancer. The researchers conclude:

“Misinformation [on this topic] may constitute an additional threat to public health; cannabis is being increasingly marketed as a potential cure for cancer in the absence of evidence, with enormous engagement in this misinformation on social media, particularly in states that have legalized recreational use.”

“As marijuana smoking and other forms of marijuana use increase and evolve, it will be critical to develop a better understanding of the association of these different use behaviors with the development of cancers and other chronic conditions and to ensure accurate messaging to the public,” they add.