Intelligent Questions to Ask Your Doctor Fall 2014

Intelligent questions answered by the experts...

1. In one new study, yoga was found to help reduce stress hormones in women undergoing radiation therapy for breast cancer.

Q: Could yoga lower my stress even if I do not have cancer? And does it work for both men and women undergoing cancer treatments? 

A: The simple answer to both questions is “yes.” Yoga exercises that incorporate controlled breathing, meditation, and relaxation techniques will help lower stress and improve quality of life for everyone. And it most certainly will work equally well for men and women. 

—Lorenzo Cohen, PhD, professor and director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center

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2. A new study showed that men with prostate cancer had higher levels of bisphenol A (BPA), a chemical found in plastics, than cancer-free men. 

Q: I drink bottled water. Should I worry? 

A: Recently, a study published in the journal Endocrinology investigated how fetal exposure to BPA could increase the risk of prostate cancer later in life. This very complicated and elegantly performed study showed that BPA has an estrogen-like function, and that environmental exposure to BPA in utero can increase the risk of cellular changes that predispose such cells to becoming cancerous many decades later. It is difficult to make recommendations based on this data, but the information does increase the urgency for further study. In the meantime, families should speak with their physicians about how to best avoid exposures to high-risk chemicals, especially early in life. 

—Brian S. Morris, MD, associate director of UCLA’s Comprehensive Health Program

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3. Researchers have now found two genetic mutations that in some people may increase the risk of DNA damage caused by a by-product of alcohol, which can lead to cancer.

Q: I enjoy a glass of red wine with dinner. Am I encouraging tumor growth? 

A: Testing for mutations in the hereditary cancer genes BRCA2 and PALB2 is done for individuals who may be at high risk for hereditary cancer. But unless you know you carry these mutations, having a glass of red wine with dinner may not be something you need to worry about. 

—Scott Kern, MD, the Everett and Marjorie Kovler Professor of Pancreas Cancer Research at the Johns Hopkins University School of Medicine

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4. Caucasian men and women with larger waist sizes, regardless of body mass, may be more likely to die younger and to die from cardiovascular disease or respiratory problems, according to new research from the Mayo Clinic. 

Q: Why is belly fat so dangerous? 

A: A larger belly means more visceral fat, and current evidence suggests visceral fat cells produce cytokines. High levels of these may lead to muscle and liver cells that don’t respond to normal levels of insulin. Ultimately, this means a higher risk for diabetes and heart disease. A key message from this study is that for each increase of 2 inches in waist circumference, there was a 7 percent increase in mortality risk for men and a 9 percent increase for women. Also, mortality risk began rising above 35.4 inches in men and 27.5 inches in women, an effect seen even in people with a normal BMI. Decrease waist size through diet and regular physical activity. Even small decreases are likely to have long-term health benefits. 

—James Cerhan, MD, PhD, professor of epidemiology in the Mayo Clinic College of Medicine and chair of the Department of Health Sciences Research

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5. A recent study found that advanced computed tomography (CT) scans can assess coronary blockages without an invasive catheter procedure.

Q: Should I get a scan if I have a family history of heart disease?

A: Like any diagnostic test, coronary CT angiography should be considered only if the results are expected to impact clinical decision-making by the patient’s physician. For most people who are not experiencing symptoms, clinical history, physical examination, and blood test are sufficient assessment tools. 

—Paul Schoenhagen, MD, staff physician, Cleveland Clinic Miller Family Heart & Vascular Institute

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6. New research revealed that a by-product of cholesterol mimics estrogen and can help drive the growth 

of breast cancer.

Q: I have high cholesterol. Does that mean I am at greater risk for breast cancer?

A: At this time, research showing a possible link between cholesterol and risk of breast cancer is strictly theoretical. Interestingly, cholesterol-lowering statin drugs are being investigated for their potential to reduce cancer risk. The theory behind this is that statins have an anti-inflammatory property, and inflammation is believed to be a factor in cancer development. However, another possibility is that statins may control the by-product that is proposed to mimic estrogen and drive breast cancer growth. 

—Therese Bevers, MD, professor of Clinical Cancer Prevention at the University of Texas MD Anderson Cancer Center