GUY’S GOTTA TALK ABOUT…Alzheimer’s #4 – Magic Bullets?

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

This comes at a good time because the other day, my dad called me about some drug he’d seen advertised on late-night TV called “Cebria”. He said he was thinking about getting a supply of the drug because the advertising slogan is so…enticing: “Think Faster & Remember More with Cebria^® Improve Your Memory in just 30 Days!**Results may vary!”

He knows he has Alzheimer’s and to the best of my estimation capabilities, he is in Stage 5 or 6 – if he’s in 6, he’s slipped into it recently. I just realized that I haven’t ever defined those stages. Here you go:

Stage 1: Alzheimer’s disease is not detectable and no memory problems or other symptoms of dementia are evident.

Stage 2: Minor memory problems like losing things around the house though indistinguishable from normal age related memory loss. Undetectable via testing.

Stage 3: Friends and family members begin to notice memory and cognitive problems. Physicians using tests can detect impaired cognitive function. The person can’t find the right word during conversation, forget names of new acquaintances, trouble planning and organizing, frequently lose personal possessions, including valuables.

Stage 4: Difficulty with simple arithmetic, forgetting details about life history, poor short term memory, inability to manage finances.

Stage 5: Need help with many day to day activities, significant confusion, inability to recall simple details about themselves (phone number, address, age); difficulty dressing appropriately; they DO maintain functionality: bathe and toilet independently; know family members and some detail about their personal histories.

Stage 6: Need constant supervision and frequently require professional care; confusion or unawareness of environment and surroundings; major personality changes and potential behavior problems; need assistance with activities of daily living; inability to recognize faces except closest friends and relatives; inability to remember most details of personal history; loss of bowel and bladder control; wandering

Stage 7: Alzheimer’s is terminal, patients in stage seven are nearing death. Lose ability to respond to their environment or communicate. While they may still be able to utter words and phrases, they have no insight into their condition and need assistance with all activities of daily living. In the final stages of the illness, patients may lose their ability to swallow.

Truth? I can’t imagine that “Cebria” or any other nootropic pill will make Dad remember any better. My biggest problem is that a person takes the pill and the first place it hits is the stomach. The hydrochloric acid in the stomach helps the molecules that break down food work better, the to “acidity” can vary between 1.5 to 5 (car battery acid up to acid rain). I can’t imagine the lactose, glutamic acid, lysine, leucine, arginine, aspartic acid, serine, phenylalanine, valine, threonine, tyrosine, isoleucine, histidine, methionine, and tryptophan (the ingredients of the pill: http://www.topcognitiveenhancers.com/nootropic-reviews-seniors/cebria) will last long in the stomach. Moreover, I can’t imagine that they will then be taken up by the bloodstream and passed to the brain – which has a barrier set up specifically to filter out “junk”. OK – so according to Wikipedia, it DOES allow the passage of amino acids through the barrier (“ The blood–brain barrier allows the passage of water, some gases, and lipid-soluble molecules by passive diffusion, as well as the selective transport of molecules such as glucose and amino acids that are crucial to neural function.”)

The fact is that these nootropic companies are in direct competition with real medicine – which can’t find a cure (or even an effective treatment) of Alzheimer’s. The niche is open at this moment and there’s a mad scramble to make a buck any way possible. I include Big Pharma in that scramble as well…

HOWEVER…as I’ve started to realize in my writing: “Evil” forces – especially in Humans – rarely view THEMSELVES as evil. They’re just trying to find a solution to a problem they perceive as life-threatening. While I am sure that there are drug manufacturers whose sole goal is to rake in untold wealth while not caring a fig about the destruction they leave in their wake; most of these companies “sincerely believe” that they are doing good.

And therein lies the tale…

Resource: http://www.forbes.com/sites/matthewherper/2016/12/09/how-much-hope-is-there-for-alzheimers-drugs/#1bf392712602, http://www.health.harvard.edu/mind-and-mood/mind-and-memory-supplement-scorecard, http://www.alzheimers.net/stages-of-alzheimers-disease/

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg

ENCORE #52! – “HOLD ON THERE BABA LOUIE!” – Exercise “reduces cytokines in adipose tissue” might be PURE HYPE!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in May of 2012 and goes with this article: http://breastcancerreaper.blogspot.com/2012/05/another-hold-on-there-baba-louie-moment.html

Doctors harp on exercise.

Despite the harping – or in my case, perversely because of it – I avoid exercise like the plague.

Even so, as I read more and more sites promoting the “exercise makes you better if you have breast cancer” meme, I found that almost none of them give any kind of evidence as to WHY exercise fights cancer and promotes healing.

So I dug into the sites and finally found some evidence supporting this wild, “Do this one weird thing…” kind of meme. This week, it’s number:

1)                  Increased levels of pro-inflammatory factors and decreased levels of anti-inflammatory factors have been linked with increased cancer risk. Physical activity might reduce systemic inflammation alone or in combination with reduction in body weight or composition through reducing inflammatory cytokines in adipose tissue.

What are pro and anti-inflammatory factors?

Let’s start with CYTOKINES and let me warn you, even researchers are still a bit fuzzy about these molecules, which explains the “might” in the paragraph above. We’ll take this subject as a “details at 11” kind of thing – it’s changing every day, but TODAY and to the best of our knowledge, we can say that we’re pretty sure that cytokines are small molecules that are given off by numerous cells and are used to communicate with each other. Cytokines are a large and diverse family of molecules with many jobs. One thing we are pretty sure they do to control the immune system – that collection of white blood cells and chemicals that spring to work when you’re hurt or sick and the body has to fight off an infection. The line between cytokines and hormones is also pretty blurry but PROBABLY, cytokines come from lots of places and there are only set amounts in the blood – though that amount can leap up during trauma or infection. Hormone levels are steady. Many cells produce cytokines. Most hormones come from specific glands (adrenal, pancreas, etc). Also, while usually specific, some cytokines act like hormones to have an effect on the entire body. Last of all, some cytokines act outside the immune system and affect the development of the human body.

As to breast cancer, at least one cytokine affects both the presence of and severity of breast cancer: “In a study published in the January 15th issue of Cancer Research…researchers showed that activation of the CXCR4 [cytokine] receptors [on the cancer cells] resulted in increased tumor growth and metastasis…and less dependent on estrogen for continued growth…to become metastatic and resistant to endocrine therapy…[in] A second study published in the current issue of Surgery…authors reported that all benign breast tissues had no detectable CXCR4 levels, whereas all 101 breast cancer patients showed at least some level of this cytokine receptor.  Of these breast cancer patients, 79 had low levels of CXCR4 and 22 had high levels of CXCR4.  These high CXCR4 levels were linked with increased breast cancer recurrence and worse chances of survival…overexpression of CXCR4 cytokine receptors is linked to worse breast cancer outcomes…blocking this pathway might become a valuable breast cancer treatment for patients overexpressing this cytokine receptor.”

The big “might” up above has given breast cancer, cytokines and exercise a high level of interest. The third reference below cites a study that, as of my referencing of it, was still recruiting participants.

So – I’m going to label THIS particular aspect of exercise and breast cancer as a big MAYBE, LET’S WAIT AND SEE. So don’t go spreading the word that exercise reduces cytokines and decreases breast cancer.

Nobody knows enough yet to say one way or the other.

Resources: http://en.wikipedia.org/wiki/Cytokine, http://breastcancerfightnowbydraarontabor.blogspot.com/2011/01/cytokine-receptor-cxcr4-worsens-breast.html, http://clinicaltrials.gov/ct2/show/NCT00851812

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT #31…Breast Cancer: Cameroon

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

In the 1980s, I traveled with an organization to West Africa. I spent three months in Cameroon, so I still follow news about the country. Recently it seemed a natural extension of my reading about Breast Cancer to check the stats regarding the disease in that country.(Essay on BC:Nigeria is here -- http://breastcancerreaper.blogspot.com/2016/11/guys-gotta-talk-about-30breast-cancer.html)

I found this: “Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.”

OMG! This is truly horrifying. Where we – justifiably – celebrate the survival of American breast cancer victims, the mortality rate of the women in Cameroon is THREE TIMES ours.

What’s being done? How can we help?

The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need.” (Emphasis mine)

Why should this matter to you? Why should the matter to me?

I COULD wallow in guilt. That would be both easy and satisfying! Instead, I’ve decided I’m going to take a character I’ve created in a science fiction short story, and send him on a few adventures. Most likely, he’ll be travelling with a hard-thinking woman who will become his perfect match. They’ve already started out rebuilding the educational infrastructure of Liberia in the future middle of this century. I’m thinking the two of them need to make a trip to Cameroon. Separately – where they’ll meet and butt heads.

The driving issue will be breast cancer education, diagnosis, and treatment in these three West African countries that hold a special place in my heart. From the sale of the stories, I’ll donate the money to breast cancer research in those places…

As for current work going on there, there does seem to be movement and as you’d expect, it’s in the area of EDUCATION AND AWARENESS. “A recent review using the most recent data available for the entire continent showed that breast cancer was the most commonly diagnosed cancer among women in 2008. There were an estimated 92,600 cases…breast cancer recently overtook cervical cancer as the most commonly diagnosed cancer in several countries in sub-Saharan Africa, including Nigeria, Chad, Sudan, Cameroon, Central African Republic, Niger, Namibia, Congo, Kenya, and Somalia. This change was attributed to increases in the prevalence of breast cancer risk factors associated with urbanization and economic development, such as earlier menarche, later childbearing, having fewer children, obesity, and increased awareness and detection.”

As well, “Worldwide, breast cancer mostly occurs after the age of 50 years. The situation is different in our context where it occurs at a relatively younger age, 46 years. The majority of these cases in our setting are diagnosed at advanced stages of the disease because of difficulties in access to health care among other factors, underscoring the importance of early diagnosis through screening. According to the WHO, breast cancer is responsible for 25% of cancer deaths in the world with the majority of these deaths occurring in the developing countries. Although incidence of breast cancer is lowest in African countries, survival rates are also lowest. The majority of breast cancer deaths, 69%, occur in developing countries.”

A ray of hope? Run for a Cure, Africa has this as its mission: “To Win the fight against breast cancer in Africa by erasing societal stigmas; providing affordable breast cancer screenings, and creating more access to quality breast care. Their vision is to “…turn the current 90% breast cancer mortality rate in Africa into the 99% survival rate.”

So…the fight goes on in places most of us have never heard of. Hallelujah!

Resource: http://file.scirp.org/pdf/ABCR_2015033017061944.pdf, http://allafrica.com/stories/201607181336.html, http://file.scirp.org/pdf/OJOG_2016110715230808.pdf, http://us8.campaign-archive1.com/?u=9921334c92e792139971fa508&id=22224a0179&e=7c62834bc7

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #51! – Metastatic Breast Cancer: Skin Cancer (aka Melanoma)

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared November of 2013.

“Where’d this come from?”

Well, see, my brother, sister, and sister-in-law were all diagnosed with skin cancer and successfully treated. As well, an old friend and teaching colleague of mine was recently diagnosed and treated for skin cancer. (The worst part there was that he’d posted a picture of the excision on Facebook and many (if not all) of US teased him about bonking his head, etc. Thoroughly stung when he later announced that it was a cancerous spot removed, I apologized both on his timeline and to him in person. NOT that I “should have known”, even so...)

Lately, I’ve had these dry, red patches on my face and while using lotion makes them fade, I have (duh) been wondering if they were signs of skin cancer. That led – at least in my mind – to wondering if there was any connection between breast cancer and skin cancer.

Not surprisingly, there is: “Since breast cancer is the most frequently diagnosed non-cutaneous (non-skin) cancer among women in the United States, it is not surprising that many individuals with breast cancer will develop melanoma (the deadliest form of skin cancer) and vice versa...recent studies exploring how often individual patients develop both cancers suggest that it [is] more than just coincidence: A recent study by Murphy, et al, for example, found that patients with either breast cancer or melanoma were almost four times more likely to develop the other malignancy than probability would lead researchers to expect. Specific causes linking the diseases may be in play, and genetic or environmental factors may also contribute. On the other hand, the association may at least partly result from more rigorous detection – in other words, a detection bias. This occurs when health care providers who carefully monitor cancer patients detect a second cancer that might otherwise have been missed.”

Also: “Sometimes cancer cells can start growing in the skin. This is not the same as having skin cancer, melanoma, or cutaneous T cell lymphoma (a type of lymphoma that affects the skin). The secondary cancer may start to grow on or near an operation scar where the primary cancer was removed. Or sometimes secondary skin cancers can grow in other parts of the body.

A secondary skin cancer looks like a pink or red raised lump (a bit like a boil). Skin nodules can be treated. It is important to tell your doctor if you think you have one, because if it is not treated, it may become ulcerated [has a ‘cauliflower’ look to it; also, it can be weeping].”

So, it appears that breast cancer CAN spread to the skin – yet it doesn’t seem to be a common occurrence. I had a bit of trouble even finding places where the two kinds of cancers were linked. That doesn’t make it comforting – just one less-likely thing to worry about.

Resources: http://www.skincancer.org/skin-cancer-information/melanoma/breast-cancer-melanoma-link, http://www.cancerresearchuk.org/cancer-help/about-cancer/what-is-cancer/grow/where-a-cancer-spreads

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT...Alzheimer's #3 “I don’t want to be here anymore…”

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

Every few days, my father calls me to tell me that he doesn’t want to live in the retirement community any more. Of course, it’s not because of any one thing. Usually he believes that if he just got back to his old place, he’d know the people again.

Because he doesn’t know anyone in this place.

My dad has NEVER been a social butterfly. Once he gets a friend, he holds onto them forever. Examples include – the childhood friend who started a “supper club” a year before or after I was born. The place was in the far wilderness and practically on the edge of civilization! When they went to the place the first time, my mother declared, “If you don’t get there in the next ten minutes, we turn around and go back!” They got there – and he’s been going there ever since. It’s also the only restaurant he’ll go to and NOT get upset because of the food or service…at least when he’s with me. Another is a guy he hung out with when he was in the Air Force during the Korean Conflict. He’s been calling and talking to this guy since they reconnected about thirty years ago. Then there’s the former next-door-neighbors from the house they sold nearly 20 years ago. He still wants to see them – but they’re fifteen years his junior and they have their own lives to live that rarely include him.

Driving is another big issue. I took his car keys away when we moved them into the senior facility a little over a year ago. He constantly talks about getting a car and driving around. When I ask who he’d go see, he just starts to mutter about having a car…

I read once that someone with Alzheimer’s have a profound desire to return to a time when they had control over their lives. My dad WAS someone who always had to have control. His effort though wasn’t overt. It was always covert. Maybe even a little delusional, because it was MOM who was in charge. He just thought he was! He equates his truck, and going to the store with his freedom. He doesn’t have a clear idea of where he’d go or who he’d see, he’s just certain he’d be happier if things were all the way they used to be.

That seems to be the lot of Humanity though. I’ve no doubt that Adam and Eve wanted things to be the way they were before they broke from God. I’ve no doubt that the world would readily return to the way things were before nuclear weapons were abundant. I’m pretty sure that some people who be happy to go back to the time when Europeans were just one tribe among many.

But we can neither turn back the clock and go back to the way things were; we also, however don’t well remember “the way things were”. For example, I don’t remember my dad going out an awful lot. When I first stepped in to intervene in my parent’s decline, Dad would get angry and upset when he and I went grocery shopping. Mom would fight me when I wanted her go to the doctor; the meals she’d cook before we moved them to the senior facility were often burned; she also spent most of her time sitting in her chair, ignoring doctor’s orders to move. Dad would spend most of his time in the basement, watching TV and ignoring Mom…

So. What’s next? According to how I’m reading the signs, Dad is moving more firmly into Stage 6 (http://www.best-alzheimers-products.com/seven-stages-of-alzheimers.html). He’s been sundowning for months – long before Mom died; daily since then (four-and-a-half months ago). Sundowning is defined as “…a symptom of Alzheimer’s disease and other forms of dementia. It’s also known as “late-day confusion.” If someone you care for has dementia, their confusion and agitation may get worse in the late afternoon and evening. In comparison, their symptoms may be less pronounced earlier in the day.”

He hasn’t shown many other of the Stage 6 symptoms, but it seems like their appearance is only a matter of time. *sigh*

Resource: http://www.aplaceformom.com/blog/12-17-15-alzheimers-behaviors-to-track/, http://www.alzheimersweekly.com/, http://www.alz.org/, http://www.healthline.com/health-slideshow/dementia-sundowning

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg