Tuesday, 19 June 2012

Good News!

Nice to have some good news to blog about ..... we have a new grandson, born 8th June. He is the first boy grandchild, and has three girl cousins. The sad part is that we are 10,000 miles away, but all being well he will be visiting with mum and dad this coming Christmas ....... can't wait!!


Saturday, 16 June 2012

On being a pain!

Thought it might help to jot down a few things for future reference, as its always difficult to remember when a symptom started or when exactly I last saw a doctor for something!

Have not been feeling too good for the past few of weeks ... the pains in my left ear and through my temple have been occurring more frequently and I've also developed a high pitched whistling in both ears. Another 'new' symptom has been "toothache" in my back left molars, top and bottom. I have also started waking in the night with excruciating pain in my left big toe and sometimes my left ankle joint!! So I trotted of to the GP just over a week ago to discuss what might be wrong and what to do about it.

She suggested that I increase the nightly dose of amitriptyline from 10mg to 20mg (this has definitely helped with the shooting pains in my ear and temple, and also with the toothache, so that's great!), and to wean myself off Prozac if I felt that my depression was under control. On the whole I think that my mood has generally improved and I feel less stressed. Although, how much of that is due to Prozac and how much to reducing my commitments, I don't know! Anyhow, I have started to wean myself off those particular tablets and we'll see how it goes ..........

The doc examined my left foot and could not find anything of note so does not think it is gout! However, she noticed a skin lesion on my left lower leg and asked me about it. This lesion has been there for a long time (years) but never heals up, and has slowly, slowly increased in size. Currently it is about 2.5cm x 1cm. Other doctors have seen it in the past and diagnosed a venous ulcer although it is completely dry and never oozes. This doctor was concerned about it as it could be a pre-cancerous lesion and has given me an anti-cancer cream (fluorouracil) to be applied twice a day for four weeks. If this does not heal it up then she will take a biopsy. I've had some blood taken to check for gout, also for thyroid and renal function.

This Friday I had my last session with the counsellor. It has been good to have someone non-judgemental to talk to and I have been able to off load some worries to her. Somewhat like keeping this blog, really so I will probably have to write in it more often now!!

Wednesday, 6 June 2012

Brian Alexander writes about meningioma

By Brian Alexander

"When news broke that singer Sheryl Crow has a benign brain tumor called a meningioma, her representative swatted away concern by saying that “half of us are walking around with [a meningioma] but you don’t really know unless you happen to have an MRI.”

Well, no.

Despite that unnamed representative’s effort to make a brain tumor sound like a pimple, meningiomas are not anywhere near so universal, and, despite the “benign” designation, can be dangerous, leading to severe disabilities, and, in rare cases, death.

“About 2 to 3 percent are malignant,” Dr. Elizabeth Claus, director of medical research at the Yale School of Public Health, a neurosurgeon at Boston’s Brigham and Women’s Hospital, and the principal investigator for the multi-institution Meningioma Consortium, explained in an interview. “Then that is a very serious situation because there’s not much in the way of great treatments. They can metastasize, say to the lungs, and no chemotherapy will work for it.

As the name indicates, a meningioma is a cancer of the meninges, the protective lining that surrounds the brain and spinal cord, often also called the dura.

It’s true that meningiomas are one of the most common types of brain tumors, comprising about one-third of all benign brain tumors, but meningiomas are not nearly as common as Crow’s rep would have you believe. As of 2005, approximately 138,000 Americans were known to have been diagnosed of meningioma.

However, explained Dr. Marc Mayberg, a neurosurgeon at Seattle’s Swedish Neuroscience Institute, “there may be many more, up to 10 times more patients but these people are unaware of it because the tumor is asymptomatic.” 

Sheryl Crow fits perfectly into the meningioma demographic. She’s 50, and rates of meningiomas are highest in middle-aged women.

Recently, medicine, which has focused on treating very deadly brain tumors like gliomas, has realized that it’s been giving benign brain tumors short shrift, so meningiomas have been the subject of renewed scientific interest.

Radiation to the head and neck is the only well-defined cause found so far. A study released last month from UCLA identified 27 cases of meningiomas over a 10-year-period that appear to have arisen following radiation to the head. While such treatments have usually been used to attack other cancers, “in the 1940s and 1950s,” Claus said, “kids were sometimes treated with radiation for all kinds of things, even ringworm, and those kids have a ten-fold increased chance of developing a meningioma.”  

A more common source of radiation may also spark meningiomas.

A study by Claus in the April issue of Cancer linked the tumors to dental x-rays. “Over a lifetime, cases were more than twice as likely as controls…to report having ever had a bitewing examination.”

Claus and her co-authors stressed that the elevated risk primarily resulted from X-ray exams “performed in the past, when radiation exposure was greater than in the current era.”

Studies of cell phone radiation have shown that use of the devices presents no increased risk of meningioma.

The fact that meningiomas are more than twice as common in women as in men, and that they have hormone receptors on their cells, may indicate that estrogen levels or progesterone exposures may also be involved with the tumors’ development. There’s a family association, too, so genetic heritage may play a role. 

The danger of meningiomas usually comes from the neural structures they can affect, often by pressing on neurons as the tumors grow. “Basically it is size and symptoms,” Claus explained. “The larger it is, the more likely to cause problems. It can actually be wrapped around the eye and you can lose vision. You can lose speech, and on down the list.” Meningiomas can affect one’s sense of smell, equilibrium, and physical strength.

Meningiomas are treated, or not, depending on how fast growing they are and what structures, if any, they are affecting. About half of people diagnosed with one require no treatment. Often, Mayberg explained, the tumor simply stops growing. Nobody knows why. When treatment is required, doctors typically opt for surgical removal, or radiation therapy to shrink the tumor.

According to Mayberg, the risk of recurrence depends on a patient’s age – the longer one lives the greater chance you’ll live long enough to have a regrowth – and how much of the original tumor was removed. If any tumor remains after surgery, the risk of recurrence is more than 20 percent."

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of "The Chemistry Between Us: Love Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com)  to be published Sept. 13.


Sunday, 3 June 2012

Dental X-rays - friend or foe?

A recent study suggests a relationship between dental xrays and the development of meningioma.

Dental x-rays linked to common brain tumour

By Andrew M. Seaman
NEW YORK | Tue Apr 10, 2012 7:48am EDT

(Reuters Health) - A new study suggests people who had certain kinds of dental X-rays in the past may be at an increased risk for meningioma, the most commonly diagnosed brain tumor in the U.S.

The findings cannot prove that radiation from the imaging caused the tumors, and the results are based on people who were likely exposed to higher levels of radiation during dental X-rays than most are today.

"It's likely that the exposure association we're seeing here is past exposure, and past exposure levels were much higher," said Dr. Elizabeth Claus, the study's lead author and a professor at the Yale School of Medicine in New Haven, Connecticut.

Claus and her colleagues write in the journal Cancer that dental X-rays are the most common source of exposure to ionizing radiation -- which has been linked to meningiomas in the past -- but most research on the connection is based on people who were exposed to atomic bombs or received radiation therapy

There have been some studies that looked at dental X-rays, but they were from years ago and included fewer people than the current study, Claus noted. Still, they were generally in agreement with the new findings.

For her study, Claus' team recruited 1,433 people diagnosed with intracranial meningioma -- a tumor that forms in the tissues lining the brain -- between May 2006 and April 2011. All of the participants were diagnosed when they were between 20 and 79 years old and they were all from Connecticut, Massachusetts, North Carolina or the Houston or San Francisco Bay areas.

For comparison, the researchers also followed 1,350 people who were similar in age, sex and state of residence as the study group, but who had not been diagnosed with a tumor.

The study looked at how often people had three different types of dental X-rays. They included a focused image of one area, a number of images of the full mouth and a single panoramic view of the entire mouth. These are known in dentistry parlance as bitewing, full-mouth and panorex films, respectively.

Each person was interviewed by someone trained to administer a questionnaire that asked about demographic details, family history of cancer, pregnancy and medical history. The interviewers also asked -- among other things -- about the person's history of dental work and the number of times they had the three types of dental x-rays taken throughout their life.

The researchers found that those diagnosed with meningiomas were more than twice as likely as the comparison group to report ever having had bitewing images taken.

And regardless of the age when the bitewings were taken, those who had them yearly or more frequently were at between 40 percent and 90 percent higher risk at all ages to be diagnosed with a brain tumor.

To put that in perspective, Dr. Paul Pharoah, a cancer researcher at the University of Cambridge said in a statement the results would mean an increase in lifetime risk of intracranial meningioma in the U.K. from 15 out of every 10,000 people to 22 in 10,000 people.

Panoramic X-rays taken at a young age, especially if done yearly or more often before age 10, also raised the risk of meningiomas by up to five times.

There was no association between full-mouth X-rays and the tumors, although the authors note they saw a trend similar to that seen for the bitewing X-rays.

The lack of association with full-mouth X-rays led one expert to question the connection.

"They found a small risk (from) a pair of bitewings, but not a full mouth series, which is multiple bitewings. That inconsistency is impossible to understand to me," said Dr. Alan Lurie, president of the American Academy of Oral and Maxillofacial Radiology.

Lurie also echoed Claus' caution that radiation levels from dental X-rays when some of the participants were younger was much greater than is used now.

He does warn, however, patients shouldn't assume it's fine for the dentist to take X-rays.

"They should ask why are (dentists) taking this image and what is the benefit to me," he said.

The American Dental Association put out a statement in response to the study noting that the interviews relied on participants' memories of how often they had different types of X-rays years earlier.

The statement added, "The ADA's long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. Since 1989, the ADA has published recommendations to help dentists ensure that radiation exposure is as low as reasonably achievable."

Dr. Sanjay Mallya, an assistant professor the UCLA School of Dentistry in Los Angeles, said that patients should be concerned whenever they are exposed to radiation, but "it's important to emphasize that this concern should not mean that we shouldn't get X-rays at all."

According to the researchers, "while dental X-rays are an important tool in well selected patients, efforts to moderate exposure to (ionizing radiation) to the head is likely to be of benefit to patients and health care providers alike."

SOURCE: bit.ly/HwspDv Cancer, online April 10, 2012

I know that I had a lot of 'drill and fill' as a child but certainly cannot remember if I had dental x-rays or, if I did, which type of x-ray they were or how many. I have had quite a number as an adult though.

It is known that there is an increased risk of tumour development following radiotherapy to the brain itself or to head/neck tumours, as there is with over-exposure to gamma rays in industrial radiography or nuclear fall-out.

I suppose the lesson is for everyone, - dentists, doctors and patients, to be more aware and to keep exposure to an absolute minimum.