The highly addictive nature of nicotine is widely recognized, and eliminating this addiction is an arduous task requiring a strong will and great determination, albeit there are alternative techniques, such as acupuncture, NLP, and hypnotherapy that have proven successful for some individuals. Irrespective of the alternatives for cessation of smoking, the fact is that smoking is once again rising as a habit across a wide spectrum of individuals, of varying ages and socioeconomic status.

Smoking on the Rise

Estimates approximate that 1,000 individuals begin the nicotine habit each day in America. This figure accounts for a one percent rise in the number of smokers in the country in 2008, when health officials were celebrating an all time low in the smoking rate for the US.  The figures make for depressing reading, particularly for health professionals and anti-smoking campaigners, who have worked tirelessly over the past 50 years to reduce the number of smoking related illnesses and deaths in countries throughout the world.

Fighting Smoking Related Illness

While the first generations to die of cigarette related cancers could not have known what fate their habit might bring, the same cannot be said for the smokers of today, which makes the decision to start or continue smoking even more incomprehensible. And while work to address the numbers of smokers will continue, some have begun to question what can be done by way of damage mitigation for those who insist upon continuing this unhealthy habit.

Supplements for Smokers

Some holistic practitioners have begun to suggest that perhaps health levels amongst smokers might be improved by education on counteracting the damaging effects of the chemicals contained in cigarette smoke, which toxins have been shown to correlate with diseases such as lung, bladder and bowel cancer, as well as an array of cardiovascular diseases.

One school of thought is that supplements should be introduced to the diet to balance the chemical intake caused by smoking. While nearly every individual would benefit from a premium multivitamin supplement, smokers may wish to consider additional supplements tailored to meet the specific needs of their weakened immune systems.

A vitamin C supplement is an excellent addition to the smoker’s regime as this nutrient is quickly depleted by nicotine in the blood stream. Other recommended dietary supplements for smokers include CoQ10 – an enzyme with antioxidant properties currently undergoing scientific testing as a possible weapon in the fight against cancers – and grape seed extract, which contains antioxidants useful in the prevention of heart disease.

Smokers Should Protect Themselves

While the best defense against smoking related illness is cease the habit entirely, smokers who find this difficult should explore alternative techniques while paying enhanced attention to their nutritional needs, supplementing their diet with vitamins and antioxidants where possible to provide the best possibility of resisting cigarette related damage.

The disease is caused by the development of cancerous cells in neural crest nerve cells, which play a key role in the development of the nervous system. This leads to the growth of tumors in nerve tissues in areas such as the adrenal glands, neck, chest, abdomen and pelvis.

Neuroblastoma Treatments

Currently the cancer is treated through a variety of means including surgery, chemotherapy, radiotherapy and stem cell replacement with six in ten patients experiencing a successful outcome from these traditional methods of treatment.  However, a recent study in the US appears to indicate that immunotherapy may improve a patient’s long-term chances of outwitting the disease.

Immunotherapy for Neuroblastoma

The study, led by Dr Alice Yu, a professor of pediatric hematology and oncology at the University Of California San Diego School Of Medicine and the Moores UCSD Cancer Center, examined the effects of immunotherapy on the relapse rate of neuroblastoma patients.

Immunotherapy involves boosting the body’s immune system by introducing agents that attach themselves to neuroblastoma cells that may have survived previous treatments. The agents operate as antibody markers for the patient’s own immune system, encouraging it to attack and destroy the lingering cancer cells, thus reducing the risk of relapse.

After two years, 66 percent of the surviving study patients receiving the immunotherapy were deemed free of cancer as compared with 46 percent of those who did not receive the treatment. As a result, all of the patients involved in the trial were started on a course of immunotherapy alongside the standard treatment. Dr. Yu noted, “This is the first time in many years that we have been able to improve the ‘cure rate’ for neuroblastoma patients. This new therapy can help us improve care and perhaps offer new hope to many patients and families.”

UK Immunotherapy Trial for Neuroblastoma Patients

The encouraging result has paved the way for further investigation of the effects of immunotherapy on neuroblastoma patients, with Cancer Research UK now funding a four year trial involving 160 young patients in the UK.

The UK trial is to be led by Dr. Penelope Brock, consultant pediatric oncologist at Great Ormond Street Children’s Hospital.  Dr. Brock stated, “The launch of this trial in the UK is really fantastic news for our patients. Early results from the US trial found that children who received the immunotherapy treatment had less chance of the disease coming back two years later, compared with the patients who did not receive the immunotherapy. We need to build on these results and devise better immunotherapy approaches that improve survival further. We have worked very closely with the doctors involved in the US trial to design the European study and we very much hope that it will lead to another treatment option for children with high risk neuroblastoma, who have more chance of the disease coming back.”

Most of us are aware of the addictive qualities of such drugs as heroin, cocaine, or methamphetamines, and the potential fatal side effects of overuse with respect to these substances. But, with the exception of the death of a famous personality, most are unaware of the devastating impacts of prescription painkillers that millions of Americans are prescribed on a daily basis. According to recent numbers published by the Centers for Disease Control and Prevention, there are more than 26,000 fatal overdoses every year as a direct result of prescription drug medication addiction. According to the CDC, the number of overdose deaths from opioid painkillers such as morphine and codeine more than tripled from 1999 to 2006, with nearly 14,000 reported deaths in 2006 alone. Even more alarming is the statement that prescription pain killer deaths have now surpassed those of heroin and cocaine as the leading cause of fatal overdoses. According to the experts, it is an unrecognized epidemic.

The problem is most prevalent in the United States where prescription medications, especially painkillers, are prescribed to too many patients on a regular basis. The European Union has far more stringent regulations on the prescription of antibiotics, painkillers, antidepressants, and otherwise, and the CDC notes that one of the reasons why so many Americans are abusing painkillers is a direct result of the obesity epidemic. As Americans grow older and heavier, issues associated with weight gain are more prevalent: joints bearing heavier weight deteriorate more rapidly; arthritis has increased, as has diabetes, cardiovascular issues and various ligament, tendon and muscle damage.  Unfortunately, rather than pursue a longer-term solution to the underlying condition through lifestyle, dietary, fitness and wellness regimens, many seek a quick fix to the symptoms.

The statistics released by the CDC are fairly shocking in their revelation. Obesity has become far more than just an epidemic affecting the overall quality of individuals’ lives; it has evolved to the point where individuals are combating their attendant pain with prescription painkillers and are becoming addicted in the process, leading to a dangerous spiral that must be halted. There are alternatives, it is time to stop seeking the simple answer and focus upon alternatives which will lead to optimal health on all levels.

Think about everyone you know, whether it is in the workplace or in your circle of family and friends, and the first thing almost every individuals will do, almost without thought, when presented with a symptom of an illness or an unusual condition, is to perform a “Google” search. 20 years ago, the same person would have called their doctor, or if especially informed, might have checked a medical dictionary. These days, the sharing of information has created an information overload quagmire where the first step taken by an individual is to search the Internet for the purposes of self-diagnosis and self-medication.

Self-medication was formerly something reserved for those who were part of alternative medicine circles, or those who followed traditional Chinese medicine practices. In the past, such groups were viewed with disdain, largely because there was not sufficient information on the practices and techniques utilized. However, as an adjunct to the spread of knowledge via global Internet access, a new situation has developed where research facilities now have access to information that previously was unavailable due to communication barriers. The past several decades have seen the complexity of scientific and medical communication significantly reduced by institutional, social, and technological changes that have allowed individuals to become more informed.

Indubitably, no one believes that they need to rely upon archaic methods to diagnose an issue. If someone is suffering from a rash, unusual headache or even after being given a diagnosis from a doctor, they now can perform the necessary research using the Internet, ‘Google’ (now used as a verb) the topic, and find a variety of alternative medicines and techniques that can be used to alleviate the problem, without resorting to traditional medicine. While of course there is no question that self-medication is not appropriate in many circumstances, access to information sufficient to make informed decisions is indeed appropriate and provides the individual a measure of control over their condition, whether alternative or allopathic care is chosen.

The advantage of alternative medicine is that in most cases it is convenient, effective, and safe. Science has proven the effectiveness of alternative techniques for a variety of symptoms and conditions, and as the effectiveness of an increasing number of alternative methods is demonstrated, individuals have become more comfortable using them.

Be wary though about using such techniques as your exclusive source of medical care – you might be running a risk with your own or your family’s health if a doctor is not first consulted about potentially serious symptoms of illness.

Additives

In particular, Dr. Epstein has publicly criticized Avon—one of the largest and most influential cosmetic companies in the world—for their use of what he considers harmful toxins in many of their products. This is despite the fact that Avon has openly called for the National Cancer Institute to create a computerized program to research and track incidents of breast cancers to determine whether or not cosmetic products play a causative role in the development of such cancers. Many professionals in the industry consider the NCI to be more style than substance, and indeed a ‘font’ used by the additive industry to placate the public, a debatable claim to be sure.

What is known is that the cosmetic industry as a whole, with very few exceptions, relies heavily upon preservatives. According to Dr. Epstein one of the most harmful preservatives being used in the market today are those in a class known as parabens. Indeed, they are so widely used because they are effective and inexpensive.

Parabens

Parabens are a class of chemicals utilized primarily as preservatives in the pharmaceutical and cosmetic industries, used largely for their bactericidal and fungicidal properties. They are most commonly found in shampoos, moisturizers, shaving gels, personal lubricants, and toothpastes, to name but a few. However, there has been mounting evidence in recent years that suggests that parabens are carcinogenic in nature, and estrogenic when used over time. In some cases, parabens have upset the hormonal balance, stimulating premature uterine growth in mice. Considering that excess estrogen has been linked to cancer, and the fact that lab tests have created cancer cells using parabens, Dr. Epstein is concerned, and he believes that more than a decade worth of research should be sufficient time to enable scientists to prove to consumers that the products they are using on a daily basis may be doing more harm than good. While it is not conclusive in any way, his book does provide an interesting look at the underbelly of the cosmetics industry and the potential harmful effects of many of the products we never think twice about applying to our bodies.

Appendix viewed as vestigial organ

Humans were thought to be one of the few animals to have an appendix, the only others being wombats, opossums and rabbits whose appendix is significantly different from that of humans. However it is now acknowledged that the appendix is more widespread than previously thought, some primates, rats, lemmings and other rodents also possess an appendix.

For many years the appendix had been considered to have no function, merely being a vestigial survivor of a former digestive process. The only time that notice was taken of this small organ was when it became infected with potentially life-threatening consequences. However, it seems that medical professionals may have been wrong about the appendix; it may have a function after all.

Role of appendix in protecting good bacteria

Investigators at the Duke University Medical Center say that their observations and experiments suggest that the appendix acts as a safe house for beneficial bacteria allowing them to survive an attack of diarrhea that empties the intestines. Once the danger has passed the bacteria can emerge from the appendix and repopulate the gut.

The human gut provides a habitat for a large and dynamic population of microbes, many of which have still not been described. They are important in helping the digestive system to break down food and produce important vitamins such as vitamin K and biotin. In return the gut offers the microbes a safe environment and nourishment. William Parker PhD, assistant professor of experimental surgery and R. Randal Bollinger M.D, PhD, Duke, professor emeritus of general surgery, say that their analysis has led them to believe that the immune tissue in the appendix serves to protect the good bacteria.

Parker has spent the last 10 years examining the interaction between the different gut bacteria and during his investigations he noticed that the gut contained what is known as a biofilm. This is a delicate thin layer consisting of microbes, immune system and mucous molecules that live together on top of the lining of the intestines. Parker says that his studies have shown that the immune system nourishes and protects the colonies of microbes living in the biofilm. The survival of the colonies of good microbes means that harmful bacteria find it much harder to populate the gut. Biofilms are most common in the appendix and as the distance from the appendix increases the prevalence of biofilms decreases.

This new function of the appendix may be particularly important in countries that lack modern sanitation and health practices. Diseases that cause severe diarrhea such as cholera are endemic in such countries and this can result in loss of the biofilms and good bacteria. Under these circumstances the appendix could play a vital role, as its location would make it difficult for anything to enter as the bowels are evacuated. This would leave the bacteria in the appendix free to move out and repopulate the gut. In developed countries the appendix would be less important, which ties in with the observation that removal of the appendix has no negative effects, although there is a suggestion of a slight increase in risk for some diseases such as Crohn’s disease.

Appendix and hygiene hypothesis

For a number of years scientists have suggested that the high rate of appendicitis in industrialized countries could be due to improved hygiene. Known as the hygiene hypothesis the theory suggests that the increase in allergies and autoimmune diseases seen in modern industrialized societies is caused by the lack of challenges faced by the immune system. In the past the immune system would have had to deal with parasites and other disease-causing organisms commonly found in the environment. In our modern more hygienic societies such challenges have been removed and now when the immune system is challenged it may overreact. The over-reactive immune system could cause the inflammation associated with appendicitis, which could in turn lead to the blockage of the intestines which causes acute appendicitis.

Appendix and immune function

In addition to providing a safe house for bacteria the appendix may have other uses. Past studies have suggested that the appendix can help make, train and direct white blood cells. In the developing fetus the appendix starts making endocrine cells just 11 weeks after conception. The appendix endocrine cells secrete peptide hormones and amines that assist with biological balances and checks as the fetus develops. In adults the appendix acts as a lymphoid organ, which makes white blood cells and antibodies. The appendix is part of a complicated chain that manufactures B-lymphocytes and immunoglobulin A antibodies. The appendix also helps to direct white blood cells to where they are needed by producing certain chemicals. It has been suggested that the by exposing white blood cells to the wide variety of foreign substances and antigens in the gastrointestinal tract the appendix helps to promote local immunity and potentially destructive humoral antibody responses. By age 20 to 30 the appendix has reached its peak production of white blood cells and antibodies, and after that age production declines rapidly. By age 60 the appendix appears to serve very little purpose.

Appendix – reasons for removal

There are good reasons for having the appendix removed. Statistics from the CDC show that more than 320,000 individuals are hospitalized each year with appendicitis, and as many as 400 individuals will die from the condition. However, in some cases the appendix is merely removed as part of unrelated abdominal surgery.

Loss of appetite, pain that starts around the navel and moves to the lower right abdomen and pain when the individual jumps up and down are all signs that the appendix may be infected. Women may benefit from an ultrasound or CT scan before surgery as a study in Radiology revealed that women who had a scan before surgery only had a healthy appendix removed 7 percent of the time whilst for those who had no scan the figure was 28 percent.

When Does Heartburn Occur?

Heartburn is common after eating a meal heavy in fatty foods or acidic foods. It can also occur after smoking or taking aspirin, eating chocolate, or drinking alcohol. Other factors can trigger heartburn, such as tension, pregnancy, hiatal hernia, or obesity. In most instances, even frequent heartburn is no cause for alarm, although it is uncomfortable.

What Is Heartburn?

Heartburn occurs when the products of the stomach reflux back into the esophagus. The esophagus connects the stomach and the mouth, and pushes food down to the stomach in wave-like motions. Food is generally prevented from refluxing by the lower esophageal sphincter (LES), a muscle that is located where the stomach and esophagus meet.

In the stomach the food is mixed with enzymes and acids, and the process of digestion begins. Cells lining the stomach stop inflammation by the acid. There is no similar protection in the esophagus; inflammation in the lining of the esophagus occurs when stomach contents reflux into the esophagus. This inflammation causes heartburn.

Heartburn is not really a condition, but in fact it is a symptom of gastro-esophageal reflux disease, or GERD. It can also be triggered by laying in a prone position or leaning forwards.

Symptoms of Heartburn

Heartburn manifests as a pain or burning sensation behind the sternum, either as a sharp pain or as a spasm – which is also typically experienced during an angina attack. The pain may remain in the chest or rise into the throat causing a sour taste, which is associated with water-brash. Coughing can occur if the reflux is close to the larynx. In a few instances, recurring bouts of severe heartburn may cause tooth decay by wearing away the tooth enamel.

Although heartburn itself is usually not problematic, it can lead to complications over time if not treated. Frequent inflammation and irritation can cause ulcers, as well as stricture and scarring of the esophagus. Where reflux causes a cell change in the lining of the esophagus, Barrett’s esophagus can ensue, bringing about an elevated risk of esophageal cancer.

Diagnosing Heartburn

The nature of heartburn means that it can easily be confused with other conditions. To obtain an accurate diagnosis, it is necessary for a doctor to perform a physical examination and obtain a full history. In the majority of cases this will provide sufficient information for a diagnosis, but sometimes additional testing may be required.

This will generally begin with an X-ray after a barium meal, after which the contrast of the barium is traced through the esophagus to determine if the esophageal muscles are functioning normally, as well as detecting inflammation or irregularities in the esophagus. An alternative is an endoscopy, in which a scope with an external camera attached is inserted into the esophagus and spooled into the stomach. This allows the gastroenterologist to detect any ulcers and inflammation in the esophagus.

Treating Heartburn

Most individuals will treat heartburn with over the counter antacids. These come in many forms, and rely on several active ingredients – calcium carbonate, sodium bicarbonate, aluminum hydroxide, or magnesium. However, there are several natural remedies available for heartburn, which can prove just as effective as those from a pharmacy, but without the chemicals.

Slippery elm is an herb that was part of the United States Pharmacopeia until 1960. It was commonly used for sore throats, and is drawn from the slippery elm tree that can be mostly found in eastern North America. It is still an important ingredient in herbal lozenges for sore throats.

The inner bark of the slippery elm contains mucilage. When combined with water, this gel-like substance swells. It is believed to reduce irritation in the esophagus by coating the lining. So far no studies have been conducted on slippery elm as a treatment for heartburn, although it is widely used. It should be noted, however, that it has not been determined whether it is safe for pregnant women.

Deglycyrrhizinated licorice, also known as DGL, is a form of the licorice herb where the glycyrrhizin has been removed to eliminate side effects, such as water retention and high blood pressure. Although no clinical studies have been conducted on DGL, research indicates that it can limit the growth of harmful stomach bacteria and can decrease the inflammation of the esophagus.

Adults have used a juice produced from the aloe vera plant as a natural remedy for heartburn for centuries. One-quarter cup of the juice, taken 20 minutes before a meal can relieve the irritation of the esophagus. It is important, though, that the aloe vera contains no aloe-emoin compounds, aloin, or aloe latex. To date no scientific evidence of the effectiveness of aloe vera juice has been determined.

Marshmallow root tea is often suggested for heartburn. One teaspoon of the root is added to a cup of boiling water. After steeping for 10 minutes, it is strained and consumed. The suggested dosage is three cups a day. Since marshmallow contains mucilage, it coats the esophageal lining. Those suffering from diabetes should consult a doctor before taking marshmallow root tea, and it should not be used by women who are pregnant or nursing.

Lifestyle Changes

Changes in lifestyle can bring about a reduction in the incidence of heartburn. Since smoking can cause a weakening of the lower esophageal sphincter, stopping smoking can be beneficial. Stress has been an identifiable factor in incidences of heartburn. Lowering the stress level can in turn reduce the instances of heartburn in a sufferer.

Those who eat more slowly, eat smaller portions of food, and take their last meal two or three hours before sleep reduce the effects of heartburn.

A number of foods and drinks act as heartburn triggers. Avoiding these can reduce the risk of heartburn. They include alcoholic and carbonated beverages, as well as citrus juice and coffee. Spicy and fatty foods can also cause heartburn, as can chocolate, raw onions, garlic, citrus fruit, vinegar, black pepper, tomatoes, peppermint and spearmint.

Trigger finger manifests in pain in the palm, and finger movement can be uneven at the onset. When the condition remains untreated, it develops into a snapping of the finger when making a fist, and over time the finger will lock unexpectedly when trying to grasp and hold an object. Eventually the finger will lock in the bent position, which occurs as the tendon locks outside the flexor tendon sheath. In rare instances this can lead to the inability to form a full fist. Under normal circumstances the tendon will move easily through the sheath, but when the tendon becomes swollen and inflamed, the act of bending the finger can cause the inflamed tendon to be pulled through the narrow sheath; causing it to pop.

The tendons join bone and muscle and are fibrous white cords that enable the bones to move when the muscle contracts. Tendons in the hand run down the bones to the fingers, and attach to the muscles in the forearm. They are held in place on the bones by a series of ligaments, shaped like an arch. A tunnel is formed, commonly known as a sheath, on the surface of the bone. The tendon slides through the arch.

Trigger finger can be associated with rheumatoid arthritis and in 2005, at a meeting of the American College of Rheumatology, it was suggested that most patients with rheumatoid arthritis suffer from inflammation in the palm of the hand, surrounding the tendons, which could lead to trigger finger syndrome. The condition can occur simultaneously in more than one finger, or at different times in different fingers.

Who Is Susceptible

Trigger finger affects between two and three percent of the population at some point in their lives. It is most commonly found in females over the age of 40. Those who suffer from Dupuytren’s contracture or from diabetes are more susceptible to trigger finger; in fact, 10 percent of those with diabetes develop the condition. Of course, where a job or hobby involves significant repetitive gripping motion, patients are more prone to developing trigger finger.

Symptoms

The first symptom of trigger finger a patient is usually tenderness at the base of the digit, although most commonly the symptom first noticed will be snapping or clicking of the finger when the patient tries to extend or flex the finger. This often loosens up after some movement, but can worsen with periods of inactivity.

Diagnosis

It generally only takes an examination by a physician to diagnose trigger finger; it will be evident without tests or X-rays. There can at times be nodules over the finger joint in the palm. Where the finger is locked in a bent position, diagnosis will be self-evident.

Treatment

It is possible to treat trigger finger at home. Applying ice for between five and 15 minutes on the swollen, tender area is effective, as is avoiding any exercises that involve repeated squeezing. Where trigger finger occurs during the night, a splint is recommended for keeping the finger straight. As an emergency measure, try a wrist support splint designed for the opposite hand, but worn upside down so the fingers are supported.

Restricting joint movement is the standard first step in treating trigger finger. Splinting the finger is very effective, although the splint must remain on the finger for at least six weeks. The success rate for such treatment is 80 percent.

The patient can also opt for percutaneous trigger finger release, which is performed under local anesthetic and has a 95 percent success rate. A needle is inserted into the skin, although no incision is necessary. In the vast majority of cases, patients can return to work the same day, although those experiencing stiffness in the fingers will require several days of therapy.

As an alternative, some doctors have recommended acupuncture, or phonophoresis, which is ultrasound using a dexamethasone cream, which is an anti-inflammatory.

Ibuprofen and Naproxen are effective as temporary anti-inflammatory treatments, although the doctor might recommend a cortisone injection into the tendon sheath. In most cases patients will respond within two cortisone treatments.

In a few instances a doctor might recommend open surgery, although as a general rule, non-surgical options are clearly preferable. A surgical procedure involves removal of the scarred or inflamed tissue, and is performed as an ambulatory outpatient procedure. Elevation of the hand following surgery reduces swelling and pain. Typically, recovery will be completed in less than a month.

Where the injections or surgery have been successful, it is rare to experience a recurrence of trigger finger. Where the problems do persist, they may not be due to trigger finger, but to other causes, thus it is advisable to check with a physician if symptoms are not alleviated by the above-referenced treatment options.

While Seasonal Affective Disorder is generally associated with the fall and winter, there are some people who suffer from it in the summertime – in some instances instead of winter, in some instances in addition to winter. This is known as Reverse Seasonal Affective Disorder.

The generally accepted theory is that those who are affected react to the colder temperatures and the lower amounts of light that occur as autumn and winter progress. Although there are no firm figures available, it is estimated that some two percent of people in the US and four percent of those in Canada suffer from SAD. Within the Arctic region the rates of SAD are much higher; in Finland 9.5 percent of the population suffers from it.

One theory is that melatonin, which is linked to depression, might contribute to SAD. As exposure to light becomes less in the winter, the body produces less melatonin, and there is also less serotonin in the body. From these, the extrapolation is that an imbalance in brain chemistry is created, triggering the condition.

There is also a condition called Subsyndromal Seasonal Affective Disorder, which affects a greater percentage of the population. It is milder than SAD, with an estimated 14.3 percent of the population being affected. Exercise, as well as exposing oneself to sunlight whenever possible in the winter, can alleviate this.

Diagnosis

The American Psychiatric Association does not classify SAD as a separate disorder, but rather as a “course specifier” applied to major depressive episodes among patients suffering from bipolar disorder and major depressive disorder.

To meet the criteria, the Seasonal Pattern Specifier must consist of episodes of depression at a particular time of the year, have lasted for two years without depressive episodes that are non-seasonal, have remissions at a characteristic time of the year, and the episodes have to outnumber other episodes of the depression during the lifetime of the patient.

The Mayo Clinic defines three separate types of SAD, each of which has its own symptoms.

Symptoms

There is a range of symptoms associated with Seasonal Affective Disorder; these can vary from mild to very severe, exacerbated when people work in conditions without natural light, or where skies remain cloudy for long periods. The symptoms typically start in the fall and stretch until spring, peaking during the darkest period of winter.

Fatigue is very common with SAD. There is a desire, and often a tendency, to oversleep, although often the body rarely feels rested even after long periods of sleep.

Those suffering from SAD typically experience hibernation syndrome, where they lose interest in all social activities, preferring to remain alone at home. There can commonly even be a withdrawal from family and friends while SAD affects an individual.

Overeating, especially of candy and carbohydrates, is an extremely common symptom. Weight gain is a corollary of this.

Mood changes and depression commonly present themselves as SAD symptoms. In extreme cases of SAD, the depression can include suicidal thoughts. More commonly, feelings of hopelessness, sadness, irritability, trouble focusing, a depleted sex drive, and even crying spells are the expressed symptoms.

When SAD occurs in summer, depression still occurs, although it is often accompanied by weight loss, insomnia, and poor appetite.

Treating Seasonal Affective Disorder

It is quite common to find antidepressants prescribed as a way to combat SAD. Especially effective are medications from the serotonin selective reuptake inhibitor family, although this has actually proved to be better for summer SAD, while still being prescribed for fall and winter. However, the side effects of drugs from this family can include diarrhea, nausea, and a decreased sex drive.

Antidepressants are often used in conjunction with psychotherapy, especially talk therapy or behavioral therapy.

The most effective way of combating seasonal affective disorder is with light. Exposure to bright fluorescent light has been proven to reduce depression among those who suffer SAD in the fall and throughout the winter. Phototherapy, as it is called, can work even when it is temporary – a vacation in a sunny place with bright light relieves SAD.

Unfortunately, the majority of people suffering from Seasonal Affective Disorder cannot afford to take vacations in the middle of winter. A better and more affordable alternative form of phototherapy is the light box, which is widely commercially available.

It is used by the patient for about 30 to 90 minutes every day, and gives out a bright light 25 times that of the typical living room light. While sunlight is the best for phototherapy or light therapy, the light to alleviate SAD does not need to be sunlight. More important is the quantity of the light, rather than the quality, in the treatment of SAD.

The light should be in doses of 2,500 to 10,000 lux, and the person receiving treatment should sit between one and two feet from the light box. The eyes should be open, but the patient should not stare at the light.

The patient can continue working throughout the light therapy. What is vital is the close exposure to light that mimics outdoor sunlight. It is believed, although not proven, that the exposure to this light alters the circadian rhythms of the body as well as suppressing the natural release of melatonin. These combine to create biochemical changes in the brain that can control or reduce the symptoms of Seasonal Affective Disorder. It is not without the risk of side effects, though, and these can typically be insomnia, eyestrain, headaches, and irritability.

Studies have been conducted into light therapy, and have revealed that among 50 to 80 percent of SAD sufferers it is a completely effective treatment, as long as it is continued for the entire winter.

What Is PSA Screening?

PSA is an acronym for prostate-specific antigen. Found in the blood, this protein is produced by cells in the prostate gland and presumed to determine a patient’s likelihood of prostate cancer – the higher the PSA level, the greater the risk. Widespread PSA testing began in 1987 as a means to support early detection of prostate cancer and to decrease patient mortality rates.

The Controversy

While patients with prostate cancer do have significantly higher rates of PSA in their blood, cancer is not the only cause of high PSA levels. Additionally, even the smallest and slowest-spreading prostate cancers can be detected by a PSA test. These cancers very rarely lead to death and most patients maintain an active, healthy lifestyle. Conversely, PSA screening has no measurable benefit for patients with aggressive or rapidly growing prostate tumors.

One in six men will be diagnosed with prostate cancer in their lifetime, but only one in 35 will ever die from the disease. In fact, the majority of prostate cancer diagnoses may require no treatment at all.

Experts have long debated the merits of PSA testing. Supporters of the initiative believe that the screening saves lives, diagnosing cancer early enough so that patients can receive life-saving treatment before tumors spread to other organs. Detractors argue that the testing is largely inconclusive and subjects hundreds of thousands of men to unnecessary worry, treatment, harmful side effects, and medical expenses.

One study recently published in 2009 in the Journal of the National Cancer Institute found that from the start of the PSA initiative until 2005, instances of prostate cancer increased by nearly 30 percent. Furthermore, new diagnoses rose steadily from 1986 until 1992 when the numbers stabilized at a rate much higher than that of the pre-PSA era. The study estimated that more than one million unnecessary diagnoses have amassed since 1986. Even more troubling, study authors H. Gilbert Welch, MD and Peter C. Albertsen, MD note, is the monumental increase in prostate cancer diagnoses of men in their 40s – once believed to be too young for prostate cancer – since the inception of PSA screening.

“I was surprised by how much growth there has been in younger men,” said Welch, speaking about his study. “We are taking what was an old man’s disease and turning it into a young man’s disease. And some of the treatment side effects such as impotence and incontinence are even bigger problems when they start occurring in younger men.”

According to Welch, of Dartmouth Medical School, and Albertsen, of the University of Connecticut, there is only one explanation for these dramatic increases. “Given the considerable time that has passed since PSA screening began, most of this excess incidence must represent overdiagnosis,” the study concluded.

While their study points out the success of using the PSA to diagnose prostate cancer, Welch and Albertsen assert that little is yet known about the effects of screening to prevent prostate cancer deaths.

“Using the most optimistic assumption about the benefit of this additional diagnosis and treatment – namely, that the entire decline in prostate cancer mortality observed during this period is attributable to screening – we estimate that approximately 56,500 prostate cancer deaths have been averted and that approximately 23 men had to be diagnosed and approximately 18 treated for each man experiencing the presumed benefit,” the authors wrote. This means that for every one man whose life was saved by PSA testing, more than 20 others were either unnecessarily diagnosed or treated for cancer.

Most physicians are slow, however, to completely dismiss the validity of PSA screening. “We need to develop a strategy by which we take the good things from screening and protect from the bad things,” says Dr. Christopher J. Logothetis of the M.D. Anderson Cancer Center at the University of Texas. “Don’t throw the baby out with the bathwater.” What is crucial, according to Dr. Logothetis, is “to know if it is a cancer that possesses the potential to be lethal.”

The problem, as most critics of the PSA initiative assert, is that this kind of specificity is beyond the current scope of PSA screening.

Sound Advice?

Dr. Logothetis and those who share his reservations about PSA testing advocate for more communication between doctors and patients in instances of prostate cancer diagnosis. In another study, led by Richard M. Hoffman, MD of the University of New Mexico School of Medicine and the New Mexico Veteran’s Affairs Health Care System, researchers found that many men who had been screened for prostate cancer had little or no understanding of the test or how to interpret its results.

Over the course of several months in 2006 and 2007, Hoffman’s team surveyed 375 men who had either undergone or discussed PSA screening with their primary care physician in the previous two years. Of those, nearly 70 percent had discussed the test with their doctor, while only 14 percent declined the screening. In almost 65 percent of cases, the treating physician was the first to mention PSA screening or the need for testing. When surveyors posed basic questions about PSA screening and prostate cancer, slightly less than 48 percent of the respondents could correctly answer even one question correctly.

“Although respondents generally endorsed shared decision-making process and felt informed, only 69.9 percent actually discussed screening before making a testing decision, few subjects (32 percent) reported having discussed the cons of screening, 45.2 percent said they were not asked for their preference about PSA testing and performance on knowledge testing was poor,” the study’s authors wrote. “Therefore, these discussions – when held – did not meet criteria for shared decision making. Our findings suggest that patients need a greater level of involvement in screening discussions and to be better informed about prostate cancer screening issues.”

It is critical that physicians and patients have frank discussions about the screening process, including its benefits and shortcomings. Patients need to be made aware that early detection is not always conclusive and treatment may not be necessary for medically insignificant cancers. Physicians should also openly communicate potential risks and side effects of treatment. Having ample information is the only way patients can make truly educated decisions about their healthcare.

“Screening needs to be continued, but patients need to be informed that not all prostate cancers require an intervention,” echoes Dr. Logothetis. “A high PSA doesn’t mean you have cancer, and if you do, it does not [necessarily] mean it needs treatment.”

It may be of interest to note that the American Cancer Society, a trusted proponent of cancer research and education, does not currently support routine PSA screening for prostate cancer. Instead, the organization recommends that doctors and their patients weigh benefits and risks before making a determination.