Doctor’s blog

There are many ways to lose weight, for obese and overweight people. Overweight are the people whose BMI (Body Mass Index) is in between 25 and 30, if BMI is more than 30 it is called obesity. For females it is little less, and obesity is considered as BMI more than 28 in females. If BMI is more than 40 it is extreme obesity. The fat present in body of obese people is like toxin, because it does more harm than benefit (the benefit is suppose to be provision of energy during time of lean period when the availability of food is less, during the time of evolution of human species).

If you are obese or overweight have to lose weight, you can chose from many different strategies available to you. You can chose diet planning and regular physical exercise or you can select a strategy of using many weight loss products like acai burn, purity12, total cleanse etc. to name a few. There are many more weight loss products available in the market which are claimed to be very good in reducing extra weight and you can get it with a click of mouse in your computer online.

Products like total cleanse and purity12 works by cleansing the body, burning the extra fat and helping your body to lose weight and by reducing the side effects that are present with weight loss programs. These products are natural ingredients that are made to burn your fat without increasing the craving for food. If you follow the diet and exercise programs for weight loss, one of the major problem is hunger and craving for food, which is a genuinely major problem faced by the obese person. In general overweight and obese persons tend to eat more and there is a craving for food already present in them.

There are many diet reviews that are helpful and informative for all people, especially for the obese/overweight persons who are trying to lose weight.    

Annual mammography is the technique used for screening of breast cancer. There is controversy regarding effectiveness of annual screening mammography in terms of survival and quality of life in women. Different studies shows different results, but it is generally taken to be beneficial for the survival of the patients.

Analysis of the studies which has been conducted shows that there is a reduction of about 25–30% in the chance of dying from breast cancer with annual screening after age of 50. The data for women between 40 and 50 years of age also shows the same result. The data of older studies which were used for screening of breast cancer shows that the screening may not be beneficial. But these may not be correct due to some defects in the design of studies which were conducted previously. That is why, though it is controversial many experts including panels of the American Society of Clinical Oncology and the American Cancer Society still believe that screening of breast cancer is beneficial. Another strong point in favor of screening is that, there is huge drop in the mortality due to breast cancer. This cannot be solely due to improvement in therapy.

For all the above reasons it is advisable to recommend annual mammography for women above 40 years of age, although no randomized trial has shown there is improved survival. The main benefit of annual mammography is identification of tumors appropriate for conservative local therapy.

Better mammography technology, including digitized mammography, routine use of magnified views, and greater skill in mammography interpretation can make it possible to identify breast tumor much earlier when it is locally respectable. Latest diagnostic techniques like MRI, magnetic resonance spectroscopy and PET (positron emission tomography) are making it possible to identify even earlier.

Screening by any technique other than mammography is not recommended, except for younger women who are BRCA-1 or BRCA-2 carriers may benefit from MRI screening. This is because MRI may be non specific but it is highly sensitive. That means MRI will detect all the tumors in breast including non malignant (benign) tumors but not leave a tumor undetected.

There are no effective ways to prevent primary breast cancer like lung cancer (stop smoking). For effective preventive strategy, the cause or causes should be identified first. Among the preventable causes of breast cancer are, high fat and high calorie diet (though controversial), alcohol consumption (even in moderation), breast feeding (protects from breast cancer) and radiation exposure before the age of 30 years.

So the preventive strategy should target the potentially preventable causes of breast cancer. These include reduced intake of fatty and refined foods, abstinence from alcohol consumption, promotion of breast feeding and avoiding of radiation exposure before age of 30 years. After the age of 30 years the risk of developing breast cancer after radiation exposure is negligible, though the cause is not clear. Large prevalence of breast feeding in developing countries may be the cause of less incidence of breast cancer in developing countries.

Another important aspect of breast cancer prevention is prevention of development of breast cancer in cotralateral (other breast) breast, in women who already had breast cancer. This is important because, women who have one breast cancer are at risk of developing a contralateral breast cancer at a rate of approximately 0.5% per year. Which means if, 200 women have breast cancer in one breast, one of them will develop breast cancer in other breast every year. This is very high in compare to normal and need to be prevented.

If adjuvant tamoxifen is administered to these patients of breast cancer, the rate of development of contralateral breast cancers is reduced to large extent. Tamoxifen also has estrogen-like effects like, preservation of bone mineral density and long-term lowering of cholesterol that are beneficial. The Breast Cancer Prevention Trial (BCPT) in USA revealed more than 49% reduction in breast cancer among women taking the drug for 5 years.

 But due to tamoxifen’s estrogen-like effects on the uterus there is an increased risk of uterine cancer (0.75% incidence after 5 years on tamoxifen). In addition to the above tamoxifen also increases the risk of cataract formation.

Raloxifene also has similar breast cancer reduction property as that of tamoxifen, with lesser thromboembolic episodes than tamoxifen. But raloxifene can not reduce noninvasive cancers as effectively as tamoxifen.