Throughout 2016, KDVA will feature monthly messages from Kathleen Robbins, a women’s health nurse practitioner with the Women’s Veterans Program at the Robley Rex VA Medical Center in Louisville.
February: Healthy Hearts Month
Every February the American Heart Association designates a day entitled, GO RED FOR WOMEN. This year that day is Friday February 5th when everyone is encouraged to wear red to raise awareness of heart disease in women. This month’s health topic is heart disease in women. Currently heart disease is the leading cause of death for women in the United States. It accounts for 1 of every 4 female deaths. Despite educational efforts in past few years, only 54 % of women verbalize heart disease as the number one cause of female deaths, which it is for African American and Caucasian women. Heart disease and cancer are equally responsible for deaths of Hispanic women and it is second only to cancer for American Indian, Alaska Natives or Pacific Island women.
Two-thirds (64%) of women who die suddenly have no prior symptoms of heart disease. Even with no symptoms, a woman can be at risk heart disease. A woman may be asymptomatic or experience angina (dull to sharp chest pain). Forty per cent of women experience non chest pain symptoms such as, pain in the jaw, throat, abdomen or back, feeling short of breath, sweating, a racing heart rate (palpitations), light headedness or nausea and vomiting. Symptoms may occur at rest, begin with physical activity or even occur with stress. Many women ignore these symptoms due to being the main caretaker for their family, but they shouldn’t.
The top three risk factors for heart disease are increased blood pressure, increased LDL cholesterol and smoking. Forty-nine per cent of women have at least one of these risk factors. Other significant risk factors include: diabetes, overweight or obesity, poor diet, physical activity and excessive alcohol intake. Most of these risk factors can be modified by a woman to decrease some of the risk.
So what can you do to decrease stress factors:
1. Eat a healthy well balanced diet: Try to eat 5 servings of fresh fruit and vegetables daily and whole grains. Reduce salt intake. Read food labels and compare the sugar, fat, and sodium of different brans to choose products with lower amounts of these. Drink 6-8 glasses of water daily. Limit alcohol to no more than 2 drinks/day.
2. Quit smoking: As soon as one quits smoking the body starts to repair itself. Circulation improves by reducing the heart rate and blood pressure almost immediately. Food tastes better. A year after quitting the risk for a heart attack is reduced by 50 per cent. Every woman should know what her blood pressure is and monitor it.
3. Be Active: Engage in moderate activity that makes you sweat or exercise at least 20-30 minutes every day to cut your heart disease risk in half. Exercise also lowers your blood pressure and blood sugar, burns calories which helps lose weight, lowers blood cholesterol and reduces stress levels by lowering cortisol. Exercise can also have antidepressant effects and it can strengthen bones decreasing the risk for osteoporosis. Activity can be as simple as walking in the neighborhood. Try one of the activity applications available for most smart phones or buy a pedometer to track your steps.
4. Followup with you health care provider several times per year: Keep up with your numbers – blood pressure, cholesterol levels, triglycerides and glucose and of course weight.
The following resources are available if you wish more information heart disease.
American Heart Assoc iation: Go Red for Women
Women Heart: the National Coalition of Women and Heart Disease.
January: Cervical Cancer Awareness
This month’s health topic is cervical cancer. Cervical cancer, like all cancers develops due to out of control growth of abnormal cells leading to invasion of other tissues. Cells become cancer cells due to damage to DNA in the cells caused by mistakes that happen when a cell is reproducing or by something in the environment. People can also inherit damaged DNA, such as BRACA gene in breast and ovarian cancer. Cervical cancer was once the most common cause of cancer death for American women. In 2015, newly diagnosed cases of cervical cancer totaled 12,900 and about 4100 women died. The rate of cervical cancer deaths has declined by more that 50 per cent in past 30 years due to pap smear screening. Now more precancers than cancers are diagnosed. Cervical cancer tends to occur in midlife. It is rare younger than age twenty or in older women that have had routine screening. By ethnicity, cervical cancer in the US is most common in Hispanic women, followed by African Americans, Asians, Pacific Islanders and whites. American Indians and Alaskan natives have the lowest risk of cervical cancer.
Factors that increase a woman’s risk for developing cervical cancer include the following:
1. Exposure to the Human Papilloma Virus (HPV) is the most important factor. The virus can infect cells on the surface of the skin and cells lining the genitals, anus,mouth and throat. It is spread by skin to skin contact and through sex, including vaginal,anal, and oral sex. Low risk strains of the virus are responsible for the so called venereal warts on genitals of both men and women (strains 6 and 11 are most common). High risk strains of the virus which are most often not visible, are responsible for changes that lead to abnormal pap smears and development of cervical cancer. Gardisil is an HPV vaccine that helps protect against the 2 types of HPV responsible for 90% of genital warts and the 2 types (strains 16 and 18) responsible for 70% of cervical cancers. Gardisil is recommended for young girls and boys ages 9 to 26. Like other vaccines it is most effective if given before exposure to the virus.
2. Women who smoke are twice as likely to develop cervical cancer as nonsmokers.
3. Anything that decreases a person’s immune response such as HIV or medications used to treat autoimmune disorders or for immune suppression in organ transplantation, can increase risk of cancer including cervical cancer.
4. Some studies say that exposure to chlamydia infection can increase risk for cervical cancer since often chlamydia infections may be asymptomatic.
5. Overweight women are more likely to develop adenocarcinoma of the cervix.
6. Taking oral contraceptives for a long period has been shown to increase risk. In one study the risk of cervical cancer doubled in women who took OCPS longer than 5 years but returned to normal 10 years after they stopped. As with any medication a discussion of risk versus benefit with a woman’s health care provider is always needed.
7. Diethylstilbesteral (DES) was a medication given to prevent miscarriage from 1940-1971. Women whose mothers took DES while carrying them in utero developed cervical cancer at a higher rate. Even though the daughters of women who took DES are now past age of highest risk, the risk is still present as there is no age cutoff .
8. Other factors that increase risk for cervical cancer include; greater than 3 term pregnancies, term pregnancy under the age of 17, poverty , and family history of cervical cancer.
9. A recent study found that women who had ever used an IUD for birth control actually had a lower risk of cervical cancer. Use of an IUD might also lower risk of endometrial cancer.
New ways to prevent and treat cervical cancer are being studied. These include sentinel lymph node biopsy at the time of surgery for cervical cancer, HPV vaccines such as gardisil discussed above. In addition experimental vaccines are being studied for women with a history of HPV infections, to help their immune system destroy the virus. Other vaccines are being studied to help women with cervical cancer that has recurred or metastasized. The vaccines attempt to help produce an immune reaction that will help cancer cells slow their growth or stop them from growing. Drug therapy targeted at abnormal genes is being researched as well. Drug treatment of precancers has shown promise. A commonly used one is a cream named aldara that is used to treat genital warts.
To learn more about cervical cancer and other cancers go to www.cancer.org.