Posted by on September 3, 2009 - 10:31am

After reading Alison’s excellent blog entry regarding the efficacy of self-exams at detecting breast cancer, I’ve been thinking more about women’s choices regarding both prevention, as well as treatment, for breast cancer. I think Christina Applegate’s decision to have a mastectomy to treat her breast cancer really surprised me; it seemed such a drastic choice for a young, seemingly healthy woman, especially one who makes a living based partly on her physical appearance.

I found a study, published in the Journal of Clinical Oncology (full article can be read for free here)  that found that women who were most involved in their treatment decisions were more likely to choose mastectomy over a breast conserving surgery. This is slightly counter to the charges I’ve heard lain at physicians doors: namely that they’re responsible for increasingly invasive, and sometimes unnecessary, procedures. The study insists instead, that women are so frightened of disease recurrence that they would rather lose both breasts rather than face the possibility of the disease coming back.

That choice still seems rather odd to me, especially since, according to the American Cancer Society, white women have a 91% 5-year survival rate for breast cancer, higher than any other cancer studied (African American women have a 78% rate, which is still higher than other cancers for this group). One possible reason for the results about mastectomy choice is that the researchers used women with an average age of 60. I don’t want to sound ageist, but it seems likely that women at that age could have fewer conflicts with the idea of a mastectomy than their younger counterparts, who may still be considering childbirth and breastfeeding.

What do you guys think? Under which conditions would opt for a complete mastectomy over a more conservative option? Does knowing the high probability of surviving the disease influence your decision?

Posted by on August 31, 2009 - 8:57am

Research has shown that portion control may be the most  effective form of dieting when you take into account longevity and sustained weight loss and management.  The reason, according to Dr. Everett Logue et al. in Obesity (http://www.nature.com/oby/journal/v12/n9/full/oby2004187a.html) may be that portion control is an easier behavioral target than planned exercise.  Although increasing consumption of fruits and vegetables may be the easiest way to change behaviorally, it does not appear to be as effective in long term weight reduction.

Okay, so all I have to do is eat a little less, and move a little more.  Well, it’s not that simple.  If you’ve tried portion control in the past like I have, you might be rolling your eyes.  Actually, 36% of women in the Illinois Women’s Health Registry are currently using portion control to lose weight, while only 20% are trying exercise.   So how can we make portion control work for us?  The important thing to understand is that portion sizes are often FAR LESS than we think they are.  In fact, research has shown that Americans typically underestimate their caloric intake by as much as 25%.  So if I think I’m only eating 1600 Calories (a typical weight loss goal), I might actually be eating 2,000.  It’s also important to know that women and men of similar height and weight do NOT have the same caloric needs.   Metabolism in women works differently; men generally have a higher Basal Metabolic Rate (BMR), which is the rate at which our bodies break down calories.  In other words, we don’t need to eat as much as our male counterparts…sorry ladies, but try leaving that second helping to him.

So what is the correct portion size?  Well we are probably all familiar with the serving size values:

1 cup green and leafy vegetables or ½ cup mashed potatoes for the veggies
½ - 1 cup of fruit or 1 oz dried fruit
½ cup rice, 1 cup (cooked) pasta, or a bagel for the grains
3 oz chicken, beef or fish for protein
1 cookie or a ½ cup ice cream for the sweets

But what do these sizes actually look like?  Well, sadly, a lot less than we’d like to think.  Here’s the run down:

Portions Table

For more portion size tips, see this cool tool at http://www.webmd.com/diet/healthtool-portion-size-plate

Even though portion control can be an effective weight loss method, it is still important to keep an active lifestyle and exercise regularly for a healthy weight AND a healthy heart!  Happy and Mindful Eating!

Posted by on August 26, 2009 - 11:07am

News related to obesity has recently been splattered all over the news, even more than usual in my opinion.  The latest headline is that obese or overweight patients had significantly less brain matter than those whose weights were considered normal.  The research article, "Brain Structure and Obesity," resulted from a collaboration between the University of Pittsburgh and the University of California, Los Angeles (UCLA) and was published online this month in the scientific journal Human Brain Mapping.  The senior author on the publication was quoted in the U. S. News & World Report as saying, "The brains of obese people looked 16 years older than their healthy counterparts while [those of] overweight people looked 8 years older."

An important thing to note about the research article is that their test subjects were an average age of 77 years old; therefore, these specific results are only applicable to the elderly population.  I looked through the research article itself and was happy to see that the genders were fairly represented in the test groups, with women comprising approximately 50% of the patients tested in normal, overweight, and obese groups.  As presented in the paper, authors did not find any striking differences correlated to gender; their results were equally applicable to both men and women.  It was acknowledged that there is some controversy among scientists regarding the association between brain volume and gender, and the authors cited additional published studies from other laboratories.  It was noted in their conclusion that gender effects are an important variable to pay attention to in future studies.  You can access a summary of the research article here.

Obesity is a sensitive issue for everyone, but a 2006 study suggested that it may affect the quality of life of women more than men.  A team led by Dr. Peter Muennig of Columbia University looked at existing data from a 2000 survey on health and quality of life.  More than 13,000 adults participated in this survey administered by the U. S. Department of Health and Human Services.  Dr. Muennig and colleagues also incorporated data from 1990-1995 on death rates in the U. S. into their study.  They concluded that health-related drops in quality of life scores were four times higher for overweight women than overweight men, and more than two times higher for obese women than obese men.  More strikingly, the authors found that there were about twice as many deaths among overweight and obese women than for men (when compared to their normal-weight counterparts) for the time represented in their study.  WebMD has a nice summary of the article here (including its caveats), or you can access the full article for free through PubMed Central.

You can help further these studies by participating in ventures such as the Illinois Women's Health Registry, or similar surveys administered in your state (or country, etc.)!  What do you think about these studies and their results?   Has obesity affected you or your loved ones in any way?

Posted by on August 18, 2009 - 12:53pm
skheart

Photo: Lamis Eli, Sarah Kiesewetter

A study was recently published online in the journal Circulation, the journal of the American Heart Association, showing that optimistic women are less likely to suffer from, or die of, heart disease. The study is actually really fascinating (the article abstract and the downloadable entire article can be found here.)

I think this particular study highlights some important points:

1. The study participants are very much like the group that we are trying to collect through the Illinois Women's Health Registry (if you’re an Illinois resident, go join!). They were women in the government-funded Women's Health Initiative, and the sheer number and racial diversity of participants allowed researchers to make new connections, simply by following the women’s health progress for a couple of years and administering very short questionnaires. It’s amazing what we can do when we all participate in these kind of registries!

2. I think the connection between mental well-being and physical health is really starting to become a key research topic and is likely changing the way patients are treated. As an admitted pessimistic cynic, I really do understand that those stress headaches and upset stomachs are taking their toll, and can be largely under my control. That’s pretty empowering, even for a pessimist.

3. It’s a great example of the benefits of studying several groups of people in scientific studies. The researchers found several statistical differences between the white and black women studied (the disparity in health outcomes between optimists and pessimists was much more striking in the black women studied, for example.) These differences would have been missed if men or white women were allowed to portray some standard of the everyperson.

So go read up! The questions used to classify a person as optimistic or hostile and cynical are particularly amusing, such as having to answer true or false to “ I have often had to take orders from someone who did not know as much as I did,” or “It is safer to trust nobody.”   I know I’ll be thinking twice about those negative thoughts about my higher-ups!

Posted by on August 10, 2009 - 3:03pm

Currently 4% of women enrolled in the Illinois Womens Health Registry suffer from this skin condition that causes itchy or sore red patches of skin with silvery scales.

Psoriasis occurs when the normal life cycle of skin cells is accelerated by the immune system, causing buildup of dead skin cells, which form the thick, silvery scale-like appearance.  There are several types of psoriasis, the most common of which include Plaque Psoriasis, causing the red, scaly lesions; Scalp Psoriasis; Nail Psoriasis, causing abnormal nail growth; and Psoriatic Arthritis, causing stiffness and progressive joint damage.  For many people, psoriasis is just a nuisance, however patients usually seek medical advice if their psoriasis causes discomfort and pain, interferes with daily tasks, or causes concern about the appearance of skin.  There is no cure for psoriasis, but many treatments exist to interrupt the overproduction of skin cells and to provide significant relief.

Resources at Northwestern for Psoriasis:

Northwestern Memorial Hospital’s Department of Dermatology offers state-of-the-art treatment options for dermatology conditions such as psoriasis.  The department also provides cosmetic treatments to patients with various dermatological symptoms.  Treatment options include laser surgery, microdermabrasion, camouflage makeup, skin peels and phototherapy (PUVA).

http://www.nmh.org/nmh/specialtiesandservices/medicalspecialties/dermatology/main.htm

The Department of Dermatology at Northwestern’s Feinberg School of Medicine runs a Psoriasis and Psoriatic Arthritis Clinic on Tuesday mornings.  The clinic is headed by Prashant Singri, MD from dermatology and by Eric Ruderman, MD from Rheumatology.  The clinic is ideal for patients with both psoriasis and psoriatic arthritis.

For more information or to schedule an appointment, contact the clinic at 312-695-8106.

Northwestern Physicians/Researchers Specializing in Psoriasis Treatment:
The Department of Dermatology at Feinberg School of Medicine has active areas of laboratory and clinical outcomes research.  Nearly all of the clinical faculty in the department serve as principle investigators in clinical trials.  Dr. Amy Paller, Chair of the Northwestern Department of Dermatology and Professor of Pediatrics conducts laboratory research related to Psoriasis and other hyper-proliferative skin disorders.  Also conducting research involving psoriasis is Dr. Prashant Singri, head of the Psoriasis clinic.

IWHR Highlighted Researcher
Dr. Anne Laumann, MBChB, MRCP (UK), FAAD is an Associate Professor of Dermatology in the Feinberg School of Medicine.  She is an active member of many dermatology organizations including the American Academy of Dermatology, the Society of Investigative Dermatology, the Scleroderma Foundation, the Vitiligo Foundation, and the Psoriasis Foundation.  Dr. Laumann is the principal investigator on a number of clinical trials related to Raynaud’s phenomenon, psoriasis, and itching. Currently she is conducting clinical trials to evaluate the use of different medications for the treatment of active secondary Raynaud’s disease. She is the local principal investigator in a study studying the outcome and safety of the use of infliximab and golimumab in patients with chronic moderate to severe plaque psoriasis.  This study is a multicenter, prospective, 8-year surveillance study involving patients on biologics.

Useful Links and Resources:
http://www.nlm.nih.gov/medlineplus/psoriasis.html
http://www.psoriasis.org/

Posted by on August 4, 2009 - 10:42am

Trademarked logoHave you noticed the Institute for Women’s Health Research logo?

Our logo features two "dancing" X-chromosomes shaded in spring green - representing fresh approaches to conducting research, and purple to show our commitment to creating interdisciplinary research teams in search of breakthrough sex- and gender-specific research at NU, whose official color is purple.

Now, onto the lesson plan, the following is what you will read in a physiology textbook.....With the exception of egg and sperm cells (germline cells), each cell (somatic cells) in the human body contains 46 chromosomes. These 46 chromosomes are divided into 22 pairs of autosomes and 1 pair of sex chromosomes.  Autosomes contain genes that are responsible for the development of the human body; they give us characteristics such hair and eye color or blood type. Sex chromosomes determine genetic sex and are generally made up of two X chromosomes (XX) in women or an X and a Y chromosome (XY) in men. The sex chromosomes contain genes that are responsible for the development of internal and external sex organs.

What is not discussed in traditional physiology textbooks are the relatively newer scientific discoveries surrounding the fact that EVERY cell in your body has a sex (not just your egg or sperm cells). For instance, a pancreatic islet cell will contain 22 pairs of autosomes and an XY pair in a male, but in a female the pancreatic islet cell will contain 22 pairs of autosomes and an XX pair. In other words a pancreatic islet is not exactly the same in a female and a male. Genes on the sex chromosomes are expressed differently in males and females and therefore the sex of cells needs to be taken into account when we conduct scientfic research. Because of these basic molecular differences scientists are starting to uncover distinct health differences (beyond the reproductive system) between males and females. The incessant problem of the past is that most research has been conducted in males (XY) and then applied to both women and men with sometimes devastating effects to women. The Institute for Women's Health Research promotes scientific discoveries regarding the contribution of sex and gender to the overall experience of health and disease. Not only do we advocate for increased inclusion of females in research studies, we stress the importance of designing studies so they look specifically at sex and gender variables and that the results are reported appropriately to reflect any differences.

Posted by on July 31, 2009 - 11:39am

CNN has posted a very interesting article about blind women in Germany who are being trained to perform breast examinations.  The program, called "Discovering Hands," is based on the theory that the blind have a keener, more sensitive sense of touch and may be able to detect small lumps that may have otherwise been overlooked.

There is some debate about the utility of breast self-examinations.  A 2001 study published by the Canadian Task Force on Preventive Health Care argued that self exams do not benefit but rather cause harm to patients.  They associated self exams with a higher incidence of physician's visits and unnecessary biopsies.  (You can access a summary of the article for free here.)

Based on my personal experience, I am an advocate of self exams.  One of my family members discovered a small lump while doing a self exam at home, which indeed turned out to be a tumor.  Luckily, it had not spread and required a lumpectomy and six weeks of radiation to remove.  In our case, there was a family history of breast cancer and my relative was vigilant about doing self exams.  Since lumpiness of the breasts varies from woman to woman and depends on the time of the month, I can see how self exams can also be confounding and unreliable.  What are your opinions on breast self-examinations?

For more information on breast self-examination:

  • A guide from the American Cancer Society
  • A guide from the Susan G. Komen Foundation
Posted by on July 30, 2009 - 8:21am

That scary title brought to you by a new study that was performed by the International Agency for Research on Cancer (IARC), a division of the World Health Organization, which shows that people who begin using tanning beds regularly before age 30 increase their risk of developing skin cancer by 75%.  The group has said that this makes regular tanning bed use as carcinogenic (cancer-causing) as smoking cigarettes, and as dangerous as arsenic. (You can read the entire article here, if you have log-in credentials).

Photo: Borba.com

Photo: Borba.com

The interesting part about these statistics is that women currently have a far lower chance of developing skin cancer than men do, for both melanomas and the most common nonmelanoma carcinomas. Still, it seems that we’re just aching to catch up, because the predominant users of tanning beds are young women. According to a large study of American teenagers, girls are far more likely to think it was worth getting burned to get a tan, to believe that some, most, or all their friends tanned, and to put a high value on tanned skin. It seems quite obvious that this is an issue that starts far before a teenage girl gets in the tanning bed; it involves a clear societal value or beauty ideal being placed above health.  These seem all to common among women today, from unhealthy dieting to risking surgery and back problems simply to have larger breasts.

Now that we know the risks, and we understand that it is really our young women who are in the most danger, what should we do at a personal or political level? Already, several states have enacted laws that require parental permission for teens to use tanning beds, require a doctor’s note, or simply ban tanning by persons under a certain age altogether. What do you think? Knowing the risks, will you still use a tanning bed? Do you think that adults should be unfettered by the government in this risky practice, even as we protect our nation’s teenagers?

Posted by on July 29, 2009 - 9:01am
OSA students learning laparoscopic techniques

OSA students learning laparoscopic techniques

A priority of the Institute for Women’s Health Research is to develop and deliver educational experiences focused on women’s health for students and professionals at all levels of training and practice.  IWHR has created an innovative educational program call the Women’s Health Science Program for High School Girls and Beyond (WHSP and Beyond).  The purpose of this program is to prepare and inspire a diverse population of high school girls to become the next generation of women leaders in science and medicine.  Despite many efforts over the last three decades to overcome the gender and racial/ethnic disparities the problem still penetrates our society.  Thus, there is a definite need to continue to invest in the exploration and development of approaches that will once and for all change the face of the science and medical community to include more women and minorities.

WHSP and Beyond consists of four academies – Oncofertility Saturday Academy, Cardiology Summer Academy, Infectious Disease Summer Academy, and the Physical Science Summer Academy.  The notion is to provide multiple opportunities for high school students to explore the basic science research, clinical application and career options of a variety of science disciplines.  The academies offered in WHSP and Beyond share four common overarching goals –
➢    To actively engage high school girls in hands-on laboratory and clinical activities, college level lectures and group projects to learn and apply science concepts and inquiry skills.
➢    To empower high school girls by providing relevant and applicable learning experiences on women’s health topics that they can use to make informed, authoritative decisions about their own personal health and share with their families and communities.
➢    To provide high school girls with exposure and the opportunity to explore the wide variety of academic programs and career options in science and medicine.
➢    To support high school girls during the transition from high school into college with an on-going mentoring network of scientists, clinicians, teachers, alumni and family.

To date there have been 47 high school students who have participated in the Oncofertility Saturday Academy and 14 high school students who have participated in the Cardiology Summer Academy.  The plan is to initiate the other two academies during the summer of 2010.

If we project out to 2020, approximately 650 students will have participated in WHSP and Beyond and the girls from the first cohort of 2007 will be 30 year-old women.  How many of the WHSP and Beyond participants will be on track or have reached their goal of becoming scientists, doctors, or engineers? Does WHSP and Beyond have the potential to change the face of the science community?

Posted by on July 24, 2009 - 3:26pm

This Post written by Victor O'Halloran

Last night was the world premiere of OSA: Sisters In Science, a documentary detailing the Oncofertility Saturday Academy. This documentary told the story of what happens when young women from a small south side Chicago high school get introduced to an emerging science like Oncofertility (for more information, click here).  The film documented the hands-on experiences, classes, and testimonies of the young women of Young Women’s Leadership Charter School as they spent their Saturdays interacting with the Woodruff lab and other resources from Northwestern in 2009.

OSA

Photo: Roark Johnson

A very personal story was told about how these high school students, intrepidly took on challenging experiments dissecting mice, ovaries in the uterus, isolating follicles, embedding them in alginate, measuring hormones, fertilizing real mouse eggs, and spending exclusive time on the Da Vinci Surgical Robot.

Most importantly, the documentary chronicled the evolution of the OSA students, from passionate young women in high school waiting to be sparked by inspiration, to JOSAS (Junior OSA Sisters) to SOSAS (Senior OSA Sisters).  It also told the story of these young women’s families and the role this experience had in reaffirming a relationship of empowerment through education.  It was clear that every parent thought their child capable of any achievement, and OSA gave that potential a shape and form that many parents can’t imagine.

Directors of the program, Megan Faurot and Teresa Woodruff held a panel along with the film’s creators; producer Harlan Wallach, director Stefani Foster, and the film’s editor Erin Kitzinger.  The panel was a source of reflection and enthusiasm for the whole audience, including OSA alumni, POSA (Parents in OSA), as well as attendees of the Oncofertility Consortium’s on-going Annual Summit.

“This is a story of expanding horizons…you all have the potential to be the next generation of leaders, of teachers of scientists and creative thinkers. You have the opportunity to pass on to the next generation a world more vibrant, more creative and with more opportunity than the world you inherited.” –From Teresa Woodruff’s opening remarks.

The program is in its third year and is continuing strong.

More information about the Oncofertility Saturday Academy:

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