by Dr. Iain Corness
Let’s discuss this over coffee
Did you have a cup of coffee this morning? If you did,
and you are pregnant, then one more cup in the next 24 hours is dangerous,
according to some researchers. However, if you are not pregnant, you may be
reducing your risk of ovarian cancer, one of the top six killer cancers!
Controversy has raged since the Middle
Ages as to the medicinal, or otherwise, effects of coffee. A 1661 tract
titled, “A character of coffee and coffee-houses”, listed some of the
“Tis extolled for drying up the
Crudities of the Stomack, and for expelling Fumes out of the Head.
Excellent Berry! which can cleanse the English-man’s Stomak of Flegm, and
expel Giddinesse out of his Head.”
However, just like today, there was
another side to the coffee bean. An anonymous “Women’s Petition Against
Coffee” in 1674 declared:
“ ...the Excessive Use of that
Newfangled, Abominable, Heathenish Liquor called Coffee has Eunucht our
Husbands, and Crippled our more kind Gallants, that they are become as
Impotent, as Age.”
So there you have it. In the Middle
Ages coffee cleared your head but had disastrous effects on the male dangly
These days we pride ourselves on being
much better educated on all fronts, with armies of researchers all over the
world looking at everything, including coffee. Every week in the lay press
you are bombarded with horror stories of what dangers we all face. These
horror stories come from reports done by legitimate researchers, picked up
by the media and away it goes from there.
On the surface, it all seems very
probable. Take the two cups of caffeine and be ready to miscarry item. Dr
De-Kun Li of Kaiser Permanente Division of Research, whose study involved
1063 pregnant women who never changed their caffeine consumption during
pregnancy. What they found was women who consumed the equivalent of two or
more cups of regular coffee or five 340 ml cans of caffeinated soft drink -
were twice as likely to miscarry as pregnant women who avoided caffeine.
However, this study of 1063 pregnant
women is also a very small percentage of women world-wide who drink coffee
while they are pregnant.
However, two days after the
shock-horror miscarriage item hit the world media, there was another
report. Researchers now claim the much-demonized substance may fight
After studying more than 80,000 women,
US and Australian experts found foods containing caffeine - such as coffee,
tea, cola and chocolate - may reduce the risk of ovarian cancer, the
sixth-most common cause of cancer deaths among Australian women.
According to Assistant Professor
Shelley Tworoger of Harvard University in Boston and her colleagues -
including medical epidemiologist Associate Professor Dorota Gertig of the
University of Melbourne and Victorian Cytology Service - caffeine was
beneficial, but decaffeinated coffee showed no health benefit at all.
For reasons they cannot yet explain,
the group also found the beneficial effect of caffeine was strongest for
women who had never used oral contraceptives or postmenopausal replacement
The researchers analyzed data from the
Nurses’ Health Study, an ongoing assessment of the well-being of 212,701
female registered nurses that began in 1976 when the nurses were aged 30-35.
Every two years, researchers at
Boston's Brigham and Women’s Hospital checked up on the surviving women.
After studying the nurses’ history, Professor Tworoger and Professor
Gertig’s group found only a very small association between smoking and
mucinous tumours, a rare form of ovarian cancer. They also found no
connection between alcohol consumption and ovarian cancer.
Oncologist Ian Olver, head of Cancer
Council Australia, said, “It’s well worth looking into further,” and even
coffee and chocolate couldn’t hurt and might even help. “My standard advice
is everything in moderation,” he said.
The whole research really hangs on
Professor Olver’s statement, “It’s well worth looking into further.” And
research salaries and equipment costs money, and where does it come from?
Make the biggest claims with the greatest amount of shock-horror and funding
will be forthcoming. Mark my words, the chocolate manufacturers will jump
on this like blowflies on a dead donkey.
Now I must go and have a cup of
coffee. I don’t have to worry, I’m male!
More avian diseases?
With Bird Flu apparently on the rise again in Cambodia,
will it fly across the Mekong and infect Thailand? Of course it will, and
probably has done already. But since the world statistics from Bird Flu
(A/H5N1) has only been 564 cases over eight years, you are more likely to be
run over on the road (especially during Songkran).
However, there is another “chicken”
disease, Chicken pox! Actually, chicken pox (AKA Varicella) is not really
caused by chickens, nor even carried by them. Chicken pox is a very common
disease caused by the varicella zoster virus which is a member of the herpes
virus family. It is very contagious and all communities experience
A few years back there was a real
outbreak in Thailand, with 22,833 patients with the complaint between
January and May. This nasty condition never actually leaves the community,
lying quiet for a while and then attacking in epidemic proportions. Make no
mistake about this one, it is a most aggressive disease that sweeps through
schools and institutions and while generally a disease of children, it can
attack adults too with devastating results.
The varicella zoster virus is known for
the characteristic chickenpox lesions. These come out very quickly after an
initial period of vague symptoms such as fever and aches in muscles and
joints. The lesions (vesicles) are very superficial on the skin and grow
like a mini-Vesuvius, burst and then crust over. That cycle of events takes
around four days, but new crops of vesicles come up in waves in the first
three or four days, so you can have some vesicles growing bigger while
earlier ones are drying up and crusting over.
The vesicles generally come out on the
trunk and face first, but can spread to all over the body and even inside
the mouth and on the tongue. Now while scarring is always a worry for the
Mums of this world, there are far worse effects from this little virus.
There is a distinct possibility of an encephalitis in older children and
adults can actually develop a varicella pneumonia. Pregnant women who get
chickenpox also run the risk of infecting the unborn child, and this can run
as high as 10 percent. Very often, especially if the child scratches the
lesions, there can be an added infection by an opportunistic bacterium on
top of the viral lesions, so you get a double problem.
So what do you do when chickenpox is
doing the rounds? The first thing is to keep away from those who have the
disease. It is highly contagious and is spread by inhalation of micro
droplets in the air, or by direct contact with weeping vesicles. In a
family, this means that little Johnny gets his own towel that no-one else
must use and a bed-time kiss is strictly forbidden.
Calomine lotion does help with itchy
and weeping vesicles and trim the fingernails in young children to lessen
the chances of scratching. With very little ones, I even suggest putting
their hands in socks, just as you do with little babies.
If the temperature is raised (more than
37.5 Celsius) then a little paracetamol will help (but not aspirin as this
drug should not be used with children), and if there is the
“super-infection” by a bacterium it will be necessary for your doctor to
prescribe an appropriate antibiotic.
The other important duty that you have
as a parent, is do not send little Johnny back to school until the very last
vesicle has dried up. This is generally around a week to ten days, but is
so important in trying to stop the epidemic.
The other nasty part of this virus is
that it lies dormant in your system and can strike back many years later as
Shingles, or as we medico’s call it, Herpes Zoster. No, chickenpox is not
fun, and to those of you who are struggling with it right now, you have my
However, we do have a varicella vaccine
these days, and vaccination is recommended from about 12 months of age.
Like all vaccination programs, this will radically reduce the impact of
The Japanese Connection
How much of your living is dedicated to try and avoid
dying? Every second magazine (especially women’s mags) has some advert for
something that will extend the readers’ lives, be that taking megavitamins
or doing colonic washouts.
I have dealt with the megavitamin myth
before, so I won’t cover that again today, but colonic washouts have been
spared my pen dipped in hemlock - until now. Just how, pray tell me, does
sticking 300 mm of garden hose up your fundamental orifice assist you to
become more healthy? Let me assure you that the colon was designed to cope
with human poo. It was not designed to cope with garden hose loaded with
mystical ingredients that will make you live longer. Put the garden hose
away. It will not work. However, I should point out that a medical
colleague does believe and attributes his recovery from cancer on his coffee
However, we still all want to be
immortal, so if your ambition is to live to be 100, the Okinawa Express is
now leaving from platform number three. According to an article I have
read, the Japanese Health Ministry claims that Okinawans have an average
life expectancy of 81.2 years - 86 for women and 75 for men (note for the
marriageable - choose an Okinawan woman 11 years older than you are and go
for a double cremation).
The other amazing fact was that
Okinawan centenarians come in at about 34 per 100,000 of the population,
almost three and a half times more than the figures from America.
So what are the Okinawans doing right?
Is it the center of colonic washouts? Or what is it that we are doing
wrong? When you look at this conundrum, it is interesting to note that if
you take the Okinawans out of Japan and relocate them in another culture,
they end up with the same statistics as the culture in which they are now
living. The same has been shown in comparative statistical examinations of
all races, for all diseases. East Africans do not get tooth decay, but when
working for British Rail (“Mind the gap!”) and living in the UK, end up with
a set of typical British rotting teeth - or a fine set of NHS dentures (mind
the gap, again)!
So the true story is probably not lucky
genes, but revolves around diet and lifestyle. Okinawans are doing better
because their lifestyle suits them better, and their diet isn’t poisoning
them or blocking their arteries.
The lifestyle on Okinawa is apparently
very slow and the stress experienced by the local populace is not high. Now
if this were the be all and end all, my car washer will live to be 134 years
old, but Thais, despite a nice slow pace don’t do all that well in the
longevity stakes either. So there’s more.
The researchers cite diet, and the
Okinawans are apparently strong on fruits, vegetables, fish and
‘moderation’. (Once again, the middle way looks like being the best, as a
simple Buddhist observation.) Looking at one of their recipes, it ends up
being a tofu mish-mash with 59 calories per serving. It is certainly not
the high cholesterol stew that we as farangs tend to eat.
The other factors associated with
longevity - or the lack of it - cigarettes and booze, were not mentioned in
the article - because I think it would be there that you would find another
clue. Despite Uncle Ernie who lived to be 103 and smoked 60 cigarettes a
day and drank a bottle of bourbon before lunch and died when shot by a
jealous husband, we do know that smoking doesn’t help you live longer (when
I typed that last phrase, I had inadvertently put “love” longer - but that’s
true too). Like wise, we know that with alcohol, the middle way is also
So, rather than take
the train to Okinawa, look at your diet, look at your stresses in life, stop
smoking, drink in moderation and you too may make a 100. Of course, if you
die of boredom aged 103, it wasn’t really worth it, was it! Has anyone seen
my garden hose?
Prostate Cancer - demystified
Most males as they get older have a subconscious fear -
Prostate problems are extremely common,
something we men have to live with. After all, our women are always telling
us how lucky we are to be men and not have to go through childbirth, so it’s
probably only right and equitable that there is a male downside. In fact
this year in the United States, almost 180,000 men will be told that they
have prostate cancer. That’s 180,000 downsides.
With all our older friends getting
prostate problems, does this mean there is a rise in the incidence? Are our
underpants too tight? One reason for the ‘apparent’ increase is the fact
that prostate cancer is a disease of aging, and we are all living longer.
The statistics show that by age 50, almost 50 percent of American men will
have microscopic signs of prostate cancer. By age 75, almost 75 percent of
men will have some cancerous changes in their prostate glands. Do the
maths. By 100 we’ve all got it!
So does this mean that life really ends
at around 76? Fortunately no. Most of these cancers stay within the
prostate, producing no signs or symptoms, or are so slow-growing, that they
never become a serious threat to health. The good news is you die of
something else before the prostate gets you! You die with it, rather than
The real situation is that a much
smaller number of men will actually be treated for prostate cancer. About
16 percent of American men will be diagnosed with prostate cancer during
their lives; 8 percent will develop significant symptoms; but only 3 percent
will die of the disease. Put another much more positive way, 97 percent
won’t die from prostate cancer.
While prostate cancer can be
‘aggressive’, breaking out from the prostate gland itself and attacking
other tissues, including brain and bone, fortunately this is the minority
scenario. The great majority of prostate cancers are slow growing, and it
can be decades between the early diagnosis and the cancer growing large
enough to produce symptoms.
So let’s look at diagnosis and get the
“blood test” out of the way first. The blood test is called Prostate
Specific Antigen, or PSA for short (we medico’s love acronyms). Up till
then we had another test called DRE (digital rectal examination), which,
quite frankly, was not all that popular. As medical students, we were
taught, “If you don’t put your finger in it, you’ll put your foot in it!”
Despite this, ‘buyer resistance’ was high, so when news came through about a
“blood test”, millions of men began rejoicing and the sale of rubber gloves
plummeted. Unfortunately, PSA is not a go/no-go test. A normal range test
doesn’t guarantee you haven’t got it, and an elevated result doesn’t
automatically mean that you are about to claim early on your life insurance
(or your dependants, anyway).
However, there is good news. We are
becoming smarter with the PSA test. Elevated PSA levels in the blood
correlate roughly with the volume of cancer in the prostate, with the stage
and grade of the tumor, and with the presence or absence of cancer
metastases or growths in other tissues. Serial PSA examinations can also
show the rate of this growth, and the rate of increase is very significant.
Like many other cancers, prostate
cancer can only be fully diagnosed and ‘staged’ by microscopic analysis.
‘Staging’ has four main grades. Stage I cannot be felt and is diagnosed
through pathological testing. Stage II can be felt, but it is confined to
the prostate. Stage III is coming out of the gland and Stage IV has grown
into nearby tissues.
This is where you need to discuss your
options with your doctor. If you are a young man with stage IV, then you
have to make up your mind quickly. But if you are 75 with stage I or II,
then you have more time, as you will most likely die of other causes before
the prostate cancer gets you. For these people, “Watch and Wait” has much
going for it, but you must be prepared to get to know your urologist.
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