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The Pearl of the Orient Seas

What's Up Doc?

By Philip S. Chua, MD, FACS, FPCS

Sunscreen Contamination

Ninety-seven percent of Americans "are contaminated with a widely-used sunscreen ingredient called oxybensone that has been linked to allergies, hormone disruption, and cell damage," revealed the US Centers for Disease Control (CDC) study, which was circulated March 25, 2008 . In a separate study published a day earlier showed that "oxybenzone, which is also a penetration enhancer, a chemical that helps other chemicals penetrate the skin is linked to low birth weight in baby girls whose mothers are exposed during pregnancy." About 910 sunscreens (facial, body, lipsticks) sold in the United States contain oxybenzone.  The Environmental Working Group stated that "84% of 910 name-brand sunscreen products offer inadequate protection from the sun, or contain ingredients, like oxybenzone, with significant safety concerns."  Swimming pool water may also be contaminated by bathers who wear sunscreen. Chemical-free organic sunscreen, although more expensive, is an option.

Obesity Adds to Global Warming

While this may sound funny or weird, obesity does contribute to global warming, reported a team at the London School of Hygiene and Tropical Medicine via Reuter ( Geneva ). The study stated that "obese and overweight people require more fuel to transport them and the food they eat, and the problem will worsen as the population literally swells in size." "We are all becoming heavier and it is a global responsibility' Obesity is a key part of the big picture… this adds to food shortages and higher energy prices," wrote Phil Edwards and Ian Roberts, the school's researchers, in the journal Lancet. According to the World Health Organization, at least 400 million adults worldwide are obese, and it "projects by 2015, 2.3 billion adults will be overweight and more than 700 million will be obese."

Length of Sex

There is a general impression that sex lasts longer than what it actually does. To set the record straight, a survey was conducted by 34 sex therapists in the United and Canada , 45% of who were men and who, on the average, had 26 years of clinical experience. Their findings revealed that "sex lasts between 3 minutes to 13 minutes, with 3-7 minutes deemed 'acceptable' and 7 to 13 minutes dubbed 'desirable'." "Many sex therapists consider coitus that lasts as little as 3 minutes to be of adequate length," according to the researchers, who included Eric Corty, PhD, of Penn State Erie. Dr. Corty and his associates stated in the May edition of The Journal of Sexual Medicine that "the survey may correct the public's 'unrealistic' expectations for sexual performance to last longer." Indeed, this scientific study is a reality check and a relief for both men and women.

Folic Acid "Ineffective"

Folic Acid and vitamin B supplements, once thought to lower the risk of cardiovascular disease (CVD) by significantly lowering the blood level of the amino acid homocysteine (a major CVD risk), have been found to be ineffective in reducing heart disease and stroke.

In a 7-year clinical research involving 5,000 women at high risk for CVD, it was shown that Folic Acid (Vitamin B-9) and vitamins B-6 and B-12 decreased the homocysteine level by 18.5%  but failed to reduce the rate of cardiovascular events, according to the study that was published in the May 7 issue of The Journal of the American Medical Association.

The researchers reported that their results "are consistent with prior randomized trials performed primarily among men with established vascular disease and do not support the use of folic acid and B vitamin supplements as preventive interventions for (cardiovascular disease) in these high-risk fortified populations."

"Deadly" Canned Soda

In the past, we have alluded to the extra high sugar contents of soft drinks which, together with other high-carbo foods, contribute to the development of type 2 diabetes. All types of soft drinks, including the diet or light version, have also been implicated in a "grand slam" condition so called Metabolic Syndrome (combination of hypertension, diabetes, heart disease/stroke), a triple slap of major illnesses.

This topic today relates to an incident where a woman, on a Sunday boating trip, drank a can of soft drink from a boat refrigerator. She fell ill and was taken to the hospital the following day. She died two days later. The autopsy revealed she died of Leptospirosis, a deadly infection caused by dried rat urine, which contains highly toxic substances. Obviously, the can from which the victim drank, without washing, was contaminated with rat urine. These canned beverages (and all canned, bottled and packaged foods) are typically stored in warehouses prior to distribution to stores, where rodents may be present in either places. For canned soft drinks, its best to clean the top before opening, to use a straw or to drink from a glass. Obviously, general precautions must be taken for anything we ingest. #

Colonoscpy

The recent news about the discovery of colon cancer in former President Cory Aquino has put the spotlight on a dreaded disease which, today, could be detected early with a relatively simple diagnostic regimen, which includes colonoscopy.

What is Colonoscopy?

Colonoscopy is a procedure where a flexible endoscope (malleable tube like a telescope), equipped with fiberoptic lighting and (video CCD) camera, is passed through the anus, to view and examine the inner walls of the colon (large bowels) and distal part of the small bowels for any abnormality, like bleeding, ulcers, or the presence of benign poly(s), or cancer. Thru the colonoscope, excision of polyps, or biopsies may also be performed for a definitive microscopic tissue diagnosis. A sigmoidoscope is another scope that examines the final two feet of the colon, while the colonoscope examines the rest of the entire colon which is about four to five feet long. Many times it is done in conjunction with colonoscopy.

How common is cancer of the colon and rectum?

Colorectal cancer is the third-most common cancer in humans, topped only by cancer of the lungs and female breasts. More than 150,000 people in the United States each year discover they have cancer of the colon or rectum, and approximately 46,000 will die from it this year alone. The incidence starts to rise at the age 40 and the peak is between ages 60 to 75. Colon cancer is more common among women and cancer of the rectum among men. About 5% of the patients have both (synchronous cancer).

Are meat-eaters more prone to colorectal cancer?

It appears to be so, because colorectal cancer is found more prevalent in populations whose diet is low in fiber and high in animal proteins, fats, and refined carbohydrates. The incidence of colorectal cancer is indeed high among those who eat red meat (pork, beef, etc) compared to those who eat high fiber diets (vegetables, fruits, wheat, bran, etc) and fish. The other predisposing factors include chronic ulcerative colitis, ganulomatous colitis, and familial polyposis.  The older the person is, the higher the risk. Smoking, in general, severely increases the risk for cancer formation of the lungs and various organs in the body, not to mention pulmonary diseases, heart attack and stroke.

What are the signs and symptoms of colorectal cancer?

The person may not have symptoms at all. It could be so subtle, like fatigue and anemia. Blood in the stool (black or bloody red stools) is one common sign. The others include change in the bowel habits, diarrhea or constipation, stools more slender or flatter than usual, stomach discomfort, bloating, fullness, abdominal cramps, frequent gas pains, unexplained weight loss, a sensation that the rectum does not empty completely. Not all these symptoms and signs need to be present or necessary, to suspect possible presence colorectal cancer. Any one of these, if persistent, should alert one to seek medical help.

When should colonoscopy be done?

Everyone 50 years old and older should have an annual fecal occult blood test (FOBT), a rectal digital exam, and a prophylactic colonoscopy every 3 to 5 years. Since blood in the feces is one of the earliest signs of colorectal cancer, testing for blood in the stools yearly among those 50 and older is essential, and could be lifesaving. And so with prophylactic rectal digital examination and colonoscopy.

How do we prevent colorectal cancer?

High-fiber (fruits and vegetables, bran, oat, wheat) and fish diet will tremendously reduce the risk of colorectal cancer. Therefore, staying away from animal protein, like red meat (pork, beef and anything made of these) is a big factor in preventing the development of colorectal cancer, besides heart attack and stroke. Daily exercises make our body healthier and more resistant to illnesses. Abstinence from tobacco is a must. Checking your stools for blood every time you defecate and reporting any warning signs listed above to your physician will help. Recta Exam and colonoscopy are strongly recommended as stipulated above.

What is the treatment for colorectal cancer?

Depending on the stage and location of the colorectal cancer, the primary strategy is wide surgical resection of the cancer and regional lymphatic drainage. Cure is possible in 75% of surgical patients. For cancer limited to the mucosa (surface lining of the wall of the colon), 5-year survival is about 90%; those cancer going deeper into the mucularis propia (muscle-layer of colon), 80%; those with positive lymph nodes, meaning cancer already spreading to the lymph nodes, 30%. Other modalities of treatment include pre-operative radiotherapy, adjuvant radiotherapy, and chemotherapy. When surgery and/or any of these other modalities are indicated will depend on the location, extent and stage of the colorectal cancer.

What is the outlook for colorectal cancer patients?

There is no question that the outlook for colorectal cancer and most other cancers in general, is much better today, depending on their stages when first diagnosed. This is why we cannot overemphasize the common-sense wisdom that prevention is the best "treatment," especially when dealing with any potentially deadly disease like cancer, heart attack, stroke, AIDS, etc. New hopes for cancer victims are in the pipeline of dozens of research/clinical laboratories in the United States and other countries around the world. Before the advent of the oral medications for pulmonary tuberculosis, this disease acted like cancer, spreading from the lungs to the brain, bones, liver, kidneys, spleen, lymph nodes, etc.  We predict that someday, hopefully in the not too distant future, many forms of cancers, if not all, will be cured by simply taking anti-cancer pills. In the meantime, it behooves each one of us to play an active role in protecting ourselves from becoming cancer victims by living a healthy lifestyle and by being ever-vigilant about our health and that of our loved ones. #

Who's the Writer?

The writer is a Cardiac Surgeon from Northwest Indiana , where he established the Cardiovascular Surgery Associates in the autumn of 1972, immediately after his Cardiac Surgery Fellowship at the Texas Heart Institute, in Houston , under the world-renowned heart transplant surgeon, Dr. Denton A. Cooley. After almost 3 decades of private practice in cardiovascular surgery, he retired in 2001, to pursue other interests. In 1996, he was appointed Chairman of Cardiovascular Surgery at the Cebu Doctors' University Hospital , in Cebu , Philippines , where he shuttles to every other month, from the USA , to perform cardiac surgery with his local heart team in Cebu . Philip is a Fellow of the American College of Surgeons, the Philippine College of Surgeons and the International College of Surgeons. He is a Member of the Board of Trustees and the Vice-President for Far East Operations of Cardiovascular Hospitals of America (CHA), a company that builds medical centers in the United States , based in Wichita , Kansas , now expanding to the Far East . CHA has chosen Cebu City for its planned pilot project outside of the United States: to build the American Medical Center – Cebu, an American-standard, world-class, state-of-the-art surgical specialty hospital to be accredited by the Joint Commission International, US Blue Cross/Blue Shield and Medicare. Dr. Chua is spearheading this venture. Dr. Chua is a member of the Board of Trustees of his alma mater, the Far Eastern University Dr. Nicanor Reyes Medical Foundation in Fairview , Quezon City , Philippines , and the Chairman Emeritus of the FEU-School of Medicine Alumni Foundation in the United States . Dr. Chua is a Fellow and past president of the Denton A. Cooley Cardiac Surgery Society, an exclusive association of more than 800 cardiac surgeons from 50 countries around the world, who trained under Dr. Cooley at the Texas Heart Institute. He is also past president of the Association of Philippine Physicians in America (APPA) and the Society of Philippine Surgeons in America , the Philippine Medical Association in Chicago , and the American Heart Association, Indiana Chapter. In 1995, he was bestowed the Sagamore of the Wabash Award by then Indiana Governor, now US Senator Evan Bayh. Dr. Chua, writes a weekly health column for five Fil-Am newspapers, one magazine in the United States,  five newspapers and one health magazine in the Philippines, and for nine other different websites. He is Chairman of the Filipino United Network (USA), a advocacy coalition group, which, last year (2007),  launched the Dollar Moral Crusade Against Graft and Corruption in the Philippines , and for Good governance. He is Vice Chairman of FALCON, the Filipino-American Leadership Council in the United States . Dr. Chua is married to his classmate, Farida I. Chua, M.D., a retired pediatrician in Northwest Indiana . They have five children who are all physicians, and four of them married to physicians also. They have 9 grandchildren.

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