Monday, May 21, 2018
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Diagnosis of Cancer -4

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We now continue with the diagnosis of colorectal cancer.

Known also as bowel cancer or colon cancer, it is the development of cancer from the colon (the large bowel)  or rectum (parts of the large intestine).

Globally more than 1 million people get colon cancer every year. It is more common in developed countries. It is the second highest cause of cancer occurrence and death for men and women in the United States combined. An estimated 141,210 cases were diagnosed in 2011. In the UK about 41,000 people a year get colon cancer making it the fourth most common type.

Australia has one of the highest rates of bowel cancer in the world. Bowel cancer affects men and women, young and old. It is one of the top five causes of premature death among Australians aged 45-74 and is the seventh leading cause of death among those aged 25-44. One in 19 men and one in 28 women will develop colon cancer before the age of 75.

Signs and symptoms may include blood in the stool, a change in bowel movements, weight loss, and feeling tired all the time.

Cancer occurring in the left side of the colon generally causes constipation alternating with diarrhoea, abdominal pain and obstructive symptoms, such as nausea and vomiting.

Right-sided colon produces vague, abdominal aching, chronic blood loss, weakness, weight loss and/or an abdominal mass.

Patients with the cancer may also present with a rectal fullness, urgency, or bleeding, and cramping rectal pain.

Colon cancer can affect any part of the large bowel (colon) or rectum.During the early stages of bowel cancer, patients may have no symptoms. As a cancerous tumour grows, it can narrow and block the bowel. Minor changes in bowel movements, with or without rectal bleeding are also seen, but they are often ignored or attributed to haemorrhoids. That is why early preventive screening is so important.

Mostly colon cancer is due to old age and lifestyle factors including diet, obesity, smoking, being overweight and lack of physical activity. Dietary factors that increase the risk include red (especially when charred) and processed meat (smoked, cured, salted or preserved) as well as alcohol. Another risk factor is inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis.

If a patient experiences some of the above symptoms for over two weeks, he shall consult a doctor.

Bowel cancer may be diagnosed by obtaining a sample of the colon during a  colonoscopy.

A colonoscopy is a detailed examination which looks at the lining of the entire large bowel.

During colonoscopy, small polyps may be removed if found.

Sometimes the first sign of bowel cancer is sudden blockage of the bowel. When this happens, bowel cancer is diagnosed by computed tomography (CT scan) and an emergency operation. Imaging tests such as PET and MRI may also be used in certain cases.

Cancer that is confined within the wall of the colon may be curable with surgery while cancer that has spread widely are usually not curable.

The good news is that, in Australia, bowel problems can be successfully treated in 90% of cases, if detected early.

In diagnosis, we shall differentiate colon cancer with dysentery, which also shows symptoms of diarrhea with blood, urgency, abdominal pain, and an inflammatory disorder of the colon. Dysentery is an infectious disease which comes acutely, starting with fever, vomiting, then diarrhea, urgency, and stool with blood.

Symptoms normally present themselves after one to three days, and are usually no longer present after a week. The frequency of urges to defecate, the large volume of liquid feces passed, and the presence of mucus, pus, and blood depends on the pathogen causing the disease.

Many of the symptoms of colorectal cancer can also be caused by something that isn’t cancer, such as infection, hemorrhoids, irritable bowel syndrome, or inflammatory bowel disease.

The signs and symptoms of hemorrhoids depend on the type present. Internal hemorrhoids often result in painless, bright red rectal bleeding when defecating. External hemorrhoids often result in pain and swelling in the area of the anus. If bleeding occurs it is usually darker. This may include constipation, diarrhea and sitting on the toilet for a long time. Symptoms frequently get better after a few days. Colonoscopy is reasonable to confirm the diagnosis and rule out more serious causes.

In most cases, people who have the above symptoms do not have cancer. Still, if you have any of these problems, it is a sign that you should go to the doctor so the cause can be found and treated, if needed:

  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
  • A feeling that you need to have a bowel movement that is not relieved by doing so
  • Rectal bleeding
  • Dark stools, or blood in the stool
  • Cramping or abdominal (belly) pain
  • Weakness and fatigue
  • Unintended weight loss

Current dietary recommendations to prevent these problems include increasing the consumption of whole grains, fruits and vegetables, and reducing the intake of red meat and processed meats. Higher physical activity is also recommended.

As surgery techniques improve, recurrence rates are decreasing; however, there is a chance that the cancer can return.

Following initial treatment, 30-50% of bowel cancer patients in remission develop recurrence, typically within the first 2 – 3 years. If it does, it may or may not cause symptoms.

So increasing surveillance, engaging in physical activity, consuming a diet high in fiber, and reducing smoking and alcohol consumption decrease the risk.

In Australia, The National Bowel Cancer Screening Program is sending out free bowel cancer screening tests to all Australians aged 50–74. The government has suggested the following for prevention: quit smoking, reduce alcohol consumption, maintain a healthy body weight, be active and sit less, and eat a healthy diet.

Experience in Australia shall be shared to people across the world.

Talk to you next time.

Isherwood

Diagnosis of Cancer -3

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Today we are going to talk about the diagnosis of liver cancer.

The liver is the largest organ in the body, sits on the right side of the abdomen, next to the stomach. It manufactures bile and blood proteins, filters the blood, rids the body of harmful chemicals, and has other vital functions.

Liver cancer can either be primary or metastatic. Primary liver cancer is when a malignant tumour starts in the liver. Cancer which has spread from elsewhere to the liver, known as liver metastasis, is more common.

It is reported that primary liver cancer is globally the sixth most frequent cancer and the second leading cause of death from cancer. Diagnosis is most frequent among those 55 to 65 years old. Five-year survival rates are 18% in the United States.

China records show that every year more than 110,000 people died of liver cancer, accounting for over 45% of the world’s total. China has also 50% of HCC cases (Hepatocellular carcinoma is the most common type of primary liver cancer in adults). More than 80% of total cases in sub-Saharan Africa or in East-Asia are due to hepatitis B virus.

Symptoms of liver cancer may include a lump or pain in the right side below the rib cage, swelling of the abdomen, yellowish skin, easy bruising, weight loss, and weakness. Other related symptoms are loss of appetite, pain in the upper back (around the right shoulder blade), unusual tiredness, or a feeling of discomfort on the upper right side of the abdomen. The signs and symptoms depend on what type of cancer is present.

Viral infection with either hepatitis C virus (HCV) or Hepatitis B virus (HBV) is the chief cause of liver cancer in the world today. The most common way that hepatitis B is spread is during birth, from mother to baby.

If liver cancer is suspected, the diagnosis may be supported by physical examination, blood tests, scanning/imaging of the liver and nearby organs, and imaging with confirmation by tissue biopsy.

For HCC these methods include sonography (ultrasound), computed tomography (CT) and magnetic resonance imaging (MRI). If the cause of bile duct obstruction is suspected to be malignant, endoscopic retrograde cholangiopancreatography (ERCP), ultrasound, CT, MRI and magnetic resonance cholangiopancreatography (MRCP) are used.

Treatment options may include surgery, targeted therapy, and radiation therapy. In certain cases ablation therapy, embolization therapy, or liver transplantation may be used. Until today few of these options have proved to be effective in term of complete cure.

A more suggested way is of cause by early prevention. To reduce the spread of hepatitis B and the incidence of primary liver cancer, all at-risk people should be vaccinated against the virus.

When it comes to diagnosis, we differentiate the signs of liver cancer from those of jaundice. The word jaundice is from the French jaunisse, meaning “yellow disease”.It is a yellowish or greenish pigmentation of the skin and whites of the eyes due to high bilirubin levels. Urine is dark in colour.

Jaundice itself is generally not considered a disease, but rather a sign of one of many possible underlying pathological processes in blood. Jaundice in babies occurs in over half in the first week following birth and in most cases is not a problem.

Most patients presenting with jaundice will have various predictable patterns of liver panel abnormalities, though significant variation does exist.

Swelling of the abdomen, or ascites, may be taken as a sign of liver cancer. That is the abnormal buildup of fluid in the abdomen. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath.

In the developed world, the most common cause is liver cirrhosis. Treatment often involves returning to a more healthier lifestyle, like a low salt diet.

If liver cancer is detected early, surgical removal is a suggested option, but unfortunately when most patients are diagnosed with the problem, it is already at a late stage and the time for surgery has passed. Chemotherapy has widely be adopted in modern western medicine, but side effects are apparent, and the treatment is not at all satisfactory.

We shall look into TCM treatments in later chapters.

Talk to you about diagnosis of bowel cancer next time.

Isherwood

Diagnosis of Cancer -2

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Today we talk about the diagnosis of lung cancer.

Lung cancer is one of the most common and serious types of cancer. It is a malignant tumour that grows in an uncontrolled way in one or both of the lungs. This growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body.

The most common symptoms are coughing (including coughing up blood), weight loss, shortness of breath, and chest pains. Other systemic symptoms include weakness, fever, or clubbing of the fingernails.

Most cases are not curable. Worldwide in 2012, lung cancer occurred in 1.8 million people and resulted in 1.6 million deaths.This makes it the most common cause of cancer-related death in men and second most common in women after breast cancer. The most common age at diagnosis is 70 years. Overall, 17.4% of people in the United States diagnosed with lung cancer survive five years after the diagnosis, while outcomes on average are worse in the developing world.

The population segment that is most likely to develop lung cancer is people aged over 50 who have a history of smoking. In China, the age for occurrence sets at over 40.

Tobacco smoking is by far the main contributor to lung cancer. The inhalation of smoke from another’s smoking is a cause of lung cancer in nonsmokers.

Asbestos can cause a variety of lung diseases such as lung cancer. Many houses built before 1990 contain asbestos cement materials, especially in the eaves, internal and external wall cladding, ceilings and fences.

Air pollution affects about 2.4 billion people worldwide, and it is believed to result in 1.5% of lung cancer deaths.

Performing a chest radiograph is one of the first investigative steps if a person reports symptoms that may suggest lung cancer.

CT imaging is typically used to provide more information about the type and extent of disease. But CT imaging should not be used for longer or more frequently than indicated, as the extended surveillance exposes people to increased radiation.

We shall differentiate lung cancer with tuberculosis (TB). The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss.

TB is an infectious disease,spread through the air when a patient cough, spit, speak, or sneeze. Tuberculosis generally affects the lungs, but can also affect other parts of the body.

TB is the number one cause of death from an infectious disease. The most important risk factor globally is HIV; 13% of all people with TB are infected by the virus, closely linked to poverty with overcrowding and malnutrition. Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.

We find similar symptoms of dry cough, chest pain, fever, and trouble breathing in pneumonia. Pneumonia is usually caused by infection with viruses or bacteria. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis.

Another similar disease we need to look at is bronchiectasis. It is a disease in which there is permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production. Other symptoms include shortness of breath, coughing up blood, and chest pain. Bronchiectasis is not as common and the diagnosis is suspected based on a person’s symptoms and confirmed using computed tomography.

Good news in diagnosis, modern technology of using Chest X-ray, CT, and cexfoliative cell examination of sputum has helped with determination of the early stages of lung cancer.

When a patient with possible lung cancer shows worsening signs of high heat and coughing, more detailed enquiry into his causes including family history is necessary, as the process can be both emotionally and practically challenging.

Keeping a healthy lifestyle is critical to prevent causing damage to your lungs. Don’t take tobacco smoking as a fashionable lifestyle. You are not just killing yourself. No one wants to be your passive smokers.

Talk to you next time.

Isherwood

Diagnosis of Cancer -1

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Different kinds of cancer start in different locations of the human body: the brain, the lung, the bowel/intestine, the kidney, the bladder, etc.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The spleen plays multiple supporting roles in the body. It acts as a filter for blood as part of the immune system. The kidneys perform the essential function of removing waste products from the blood and regulating the water fluid levels.That’s what we learn from western medicine.

In TCM, we define the functions of these organs differently: the liver regulates the pathways; the spleen is the source of qi (energy flow) and blood generation; the kidney manages the marrow,the storage of sex liquids (sperms and eggs). The above cancer types relate closely to the functions of liver, spleen and kidney.

We talk about the diagnosis separately.

Brain Cancer

A brain tumor occurs when abnormal cells form within the brain. The main clinical signs are headache, vomiting, problem with vision, difficulty in walking and speaking, mental change, etc.

People aged 20-40 have higher incidence rates of brain tumor. In the US, about 2,000 children and adolescents younger than 20 years of age are diagnosed with malignant brain tumors each year.

In western medicine, the cause of most brain tumors is unknown.

TCM diagnosis of brain cancer is based on the following factors:

  1. A patient has the symptoms of headache, vomiting, problem with vision, etc.
  2. The brain is divided into 4 lobes and each lobe or area has its own function. A tumor in any of these lobes may affect the area’s performance. The location of the tumor is often linked to the symptoms experienced but each person may experience something different.

The following locations are from Wikipedia:

– Frontal lobe: Tumors may contribute to poor reasoning, inappropriate social behavior, personality changes, poor planning, lower inhibition, and decreased production of speech.

– Temporal lobe: Tumors in this lobe may contribute to poor memory, loss of hearing, difficulty in language comprehension.

– Parietal lobe: Tumors here may result in poor interpretation of languages, decreased sense of touch and pain, and poor spatial and visual perception.

– Occipital lobe: Damage to this lobe may result in poor or loss of vision.

– Cerebellum: Tumors in this area may cause poor balance, muscle movement, and posture.

–  Brain stem: Tumors on this can affect blood pressure, swallowing, and heartbeat.

As the brain tumor may cause high blood pressure and paralysis of part of the body, we need to differentiate it with Cerebrovascular disease, a variety of medical conditions that affect the blood vessels of the brain and the cerebral circulation.

Cerebrovascular disease normally occurs in the elderly, with history of hypertension and atherosclerosis, the thickening and hardening of the walls of the arteries, occurring typically in old age. The patient may have sudden unconsciousness, besides the occurrence of high blood pressure and paralysis.

A patient with brain cancer may have the symptoms of epilepsy or neurological disorders such as headache, vomiting, vision problem and mental disorder, difficulty with movement and sensation. With brain cancer, these symptoms persist. In epilepsy, the symptoms are not apparent after the occurrence.

CT or MRI screening/imaging can help to detect the difference and is currently the main way of diagnosis.

This is about brain cancer. We shall continue with Lung Cancer next time.

Talk to you later.

Isherwood

Basic understanding of cancer

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Cancer is a family of malignant tumors, characteristic of abnormal generation of  tissues in internal organs.

In terms of clinical manifestations, a mass or lump grows bigger and bigger in size, uneven, hard. When it comes to the patient’s symptoms, he may feel pain, have a fever, together with bad appetite, weakness, and loss of weight as the days go by.

The understanding of a tumor in human body started thousands of years ago as we can see evidence in the oracle bone scripts. The Inner Cannon of the Yellow Emperor describes the symptoms as “the big bones become dry; the muscle collapses; the chest feels a stagnation of air flow; the patient has difficulty in breathing; his internal pain reaches to shoulders; the patient feels hot in his body; his bones look to be separated from bones; his internal organs seem apparent from outside. This patient must die within 10 months.”

The ancient classics also describes symptoms of a bowel cancer, “it’s like hemorrhoid. The anus wall is like bamboo knots or jellyfish;stool is thin and tender flat;stool water smells bad; the patient always feels feces remaining after stool. There is no care. “

These are the common symptoms of cancer. The causes vary. But it’s sure there is an imbalance of yin and yang, depression, damage of organs, etc. The stagnation of qi (energy flow) causes the block of blood flow. Over time, there is an accumulation of mass.

When it comes to treatment, TCM has many historical records, talking about the methods. Generally speaking, there are interior and exterior ways, single formula and compound formulas, using herbs or surgery. To sum up the main treatment options, there are four tactics: attack, ablate, dissipate, and nutritionize.

In a battle, we use weapons to attack the enemy; the blacksmith melts the metal with intense heat, or removes something by erosion or vaporization; similar to that, dissipation makes the tumor disappear by consuming, dissolving or passing away with stool. We use tonic herbs like ginseng to help our immune system to build a strong defense, that’s nutrition.

Cancer is a kind of disease that affects the whole body. It is difficult to cure because it starts in one place but relates to other parts of the body. There must be an overall consideration of interactions. TCM treatments are based on the principle of supporting the positive factors to beat the negative factors. It’s a battle of the righteousness against the evils.

In modern times, the combined therapies of TCM and Western Medicine will deliver better results. When proper methods are applied to different stages of the disease, we will see better improvement of the patient’s health.

In term of pathogenesis or pathology, when we look into the origin and development of the disease, its biological mechanism, maybe by way of analysis of tissue, cell or body liquids samples, we come to know more about its causes, mechanisms of development, structural alterations of cells and the consequences of clinical changes.

In TCM, we have found out the main causes to be weakness of internal qi or energy, contamination with toxin, depression, damage by bad diet, and chronic disease. All these make the organs malfunction, the flow of blood, qi, and liquids abnormal, a stagnation of them, congestion of blood, phlegm, dampness, or heat toxin. These developments work together to form the cancer.

The causes can be defined into five categories:

1, Inhale of polluted air, chemicals or radiation;

2, Depression as a result of anger, worry, sorrow, fear, shock, hatred or desires.

3, Bad diet like too hot or spicy foods, alcohol, smoking, etc.

4, Chronic disease and improper treatments, old trouble left over by internal injuries, etc.

5, Ageing, old age or long years of hard work weakening the body.

At the primary state, apparent symptoms are stagnation of energy (qi) flow, blockage of blood, congestion of phlegm, accumulation of dampness or heat. As the tumor develops, mass can be detected by screening, there shall be weakness of qi and blood, abnormal yin and yang, and conditions are becoming complicated. Different kinds of cancer shall show different symptoms. We need to look into each separately.

Again, cancer is a family of common disease. We are going to talk about the most common the following days like the brain cancer, lung cancer, liver caner, bowel cancer, kidney cancer and bladder cancer. And I hope my understanding will help those with symptoms of these diseases.

Talk to you later.

Isherwood

Cancer ……There is still no cure yet?

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Many have learned that in the US, 1 in 2 men and 1 in 3 women will develop cancer in their lifetime. Now, a similar rate has been reported in the UK, Canada, and other developed nations.

Cancer was not common in China thirty years ago. But with the industrialization, more and more people have cancer. Only because of severe air pollution in the past ten years, the number of people suffering from lung cancer has skyrocketed.

Cancer is the top killer worldwide, responsible for 7.4 million or 13 percent of all deaths annually.

I check Wikipedia, in 2015, about 90.5 million people had cancer. About 14.1 million new cases occur a year. With $200 billion spent and tens of millions of cancer deaths accumulated since 1971, most would say we are losing the war on cancer.

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

The most common types of cancer in males are lung cancer, prostate cancer, colorectal cancer and stomach cancer. In females, the most common types are breast cancer, colorectal cancer, lung cancer and cervical cancer.

Cancer develops over a period of many years and people between the ages 46-59 are most likely to have the disease, though unfortunately more and more young people are tested to be the bearers. For cancer in the United States, the average five-year survival rate is 66%.

Most cancers start in a particular organ, like the lung; this is called the primary tumor. Tumors can be benign (not cancer) or malignant (cancer). Benign tumors do not spread outside their normal boundary to other parts of the body; they are not treated as cancer.
Possible signs and symptoms include a mass or lump, abnormal bleeding, prolonged cough, unexplained weight loss and a change in bowel movements.

When cancer begins, it produces no symptoms or they are hard to be detected. Signs and symptoms appear as the mass grows or ulcerates.

The majority of cancers are due to genetic mutations from environmental factors. Environmental, as used by cancer researchers, means any cause that is not inherited genetically, such as lifestyle, economic and behavioral factors and not merely pollution. Common environmental factors that contribute to cancer death include tobacco, diet and obesity, infections, radiation, stress, lack of physical activity and pollution.

Over the years, there have been many treatment options for cancer. The primary ones include surgery, chemotherapy, radio-therapy, targeted therapy and palliative care.

Chemotherapy is the treatment of cancer with one or more drugs. Radio-therapy involves the use of radiation to either cure or improve symptoms. It works by damaging the DNA of cancerous tissue, killing it. Palliative care includes action to reduce physical, emotional, spiritual and psycho-social distress.

It is apparent that most treatments attempt to kill the cells, and I think they are going in the wrong direction. Instead of “killing” cells, we should focus on methods that change the environment in which tumor cells develop.

Besides, it’s a stupid way of testing on animals. As a matter of fact, from formulating new cancer drugs to testing dietary supplements, mice and rats play a critical role in most laboratories. Human is a different species. It won’t work finding cure to human cancer by looking into the body of a mouse?

I am not going to assume (as others have said) that this is a conspiracy between doctors and pharmaceutical companies who have funded this kind of “scientific” research.

A report from the Washington Post asks, “We’re spending $107 billion on cancer drugs, but is it worth it?”

They have evidence suggesting that it is time to forge much greater independence between the companies marketing the drugs, and the doctors prescribing them.

The report continues to say, “As $10,000-a-month cancer drugs have become a norm, doctors have begun to push back, insisting that many drugs aren’t worth the price.”

Other data reveals that between 2011 and 2015, pharmaceutical companies sponsored more than 116,000 events. Cancer was the most frequent area of focus of the events, accounting for 19.7% of the functions. Most of the events (82%) included medical doctors, many included different types of health professionals.

Cancer is not that frightening. But largely as a result of insufficient knowledge, many cancer patients are scared to death.

The question lies education.

Cancer is fundamentally a disease of tissue growth regulation. In order for a normal cell to transform into a cancer cell, the genes that regulate cell growth and differentiation must be altered.

Early prevention is the best cure for any diseases.

Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, vaccination against certain infectious diseases, not eating too much processed and red meat and avoiding too much sunlight exposure.

Many “cures” are at hand. Eliminating smoking would essentially end lung cancer, responsible for 30 percent of all cancer deaths. A diet rich in vegetables and whole grains reduces your cancer risk significantly.

Will cancer ever be cured?

The answer is Yes!

Last time we talked about the Five-phase Theory in TCM.

In the universe, the philosophy of regenerating and overcoming factors in cycles is everywhere. Since cancer or tumor cell is part of the universal phenomena, there must be some forces that can control or change it.

Next we are going to talk about the philosophy behind tumor cells and how cancer can be cured!

Talk to you soon.

Isherwood

Australians living longer but with more chronic disease……what can we do to improve?

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Good health is very important—it leads to longevity, and influences how we go about our everyday lives.

Australia is a good place to live. 85% of Australia’s 23 million residents aged 15 and over describe their health as good or better. This is good news.

The bad news is that a biennial Health Report reveals some astonishing facts that are troubling the population.

According to the Australian Institute of Health and Welfare’s Australia’s Health 2016 report, in 2014–15 more than 11 million Australians had at least one of eight chronic conditions. That’s half of the population.

Living long does not mean high quality of lives. We see daily many old people rely on medications or frequent visits to doctors to stay “living long”.

The single leading cause of death in Australia is coronary heart disease, followed by dementia, stroke, lung cancer, chronic obstructive pulmonary disease.

Grouped together, cancer has overtaken cardiovascular disease (heart disease and stroke) as Australia’s biggest killer.

Chronic diseases are becoming more common, due to population growth and ageing. Half of Australians have at least one chronic disease. One quarter have two or more.

The most common combination of chronic diseases is arthritis with cardiovascular disease.

In Australia, 381,000 visits are made to a GP on an average day, and 79,000 visits to a specialist.

Australians are struggling with their weight. About 63 per cent are overweight or obese. One in four children are overweight or obese.

Junk foods high in salt, fat and sugar account for about 35 per cent of adults’ energy intake and about 39 per cent of the energy intake for children and young people.

Australian health has these problems, and many more. Still healthcare study ranks Australia second best in developed world. We can imagine conditions in other parts of the world are much worse.

True, our healthcare system is sometimes criticized for being fragmented, disconnected and frequently failing its patients.

I myself have witnessed two cases of stupid treatments by specialists in Australian hospitals, one on severe burns and another on ulcerative colitis.

The GPs have their problems too.

I have read about reports in the US that “It’s not unusual for primary care doctors’ appointments to be scheduled at 15-minute intervals. Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes.” The situation in Australia is similar.

What can a doctor do in 15 minutes? When he has one eye on the patient and one eye on the clock, how can a doctor have an accurate diagnosis, not to mention establishing a relation with the patient? To work for money, some doctors even see patients in bulk.

Quality health care is extremely reliant on staff, and their unique skills. When doctors spend their days like this, how can they improve their skills and deliver outstanding care and treatment?

Why they do this? Besides moral code of conduct, many doctors have been trained on the philosophy of “one cure fits all”.

As a personalized medicine, TCM has been introduced to the western world for a short period of time. A lot of people only “heard of it”.

Although TCM has existed in China for over 3,000 years, people are skeptical of its safety and effectiveness.

The public need to be educated, because when it comes to treatment, you will never depend on something you are unsure about.

Let’s go back to the Australia Health Report.

According to the 2016 Health Report, Australian boys can now expect to live into their 80s (80.3), while the life expectancy for girls has reached the mid-80s (84.4).

Compared to Australia, China is relatively under-developed either socially or economically on average social welfare. But the average Chinese boy can live up to 79 years while the girl 82 years, not much lower than Australians.

To a great extend, the popular use of Traditional Chinese Medicine across the country (even in poor rural areas) has helped to achieve this.

History has proved that TCM works and is safe in proper hands.

Since its introduction to Australia, TCM has literally assisted thousands of people deal with health issues using specially designed treatments involving acupuncture, Chinese herbs and massage.

From 1 July 2012 Chinese medicine practitioners must be registered under the national registration and accreditation scheme with the Chinese Medicine Board of Australia and meet the Board’s Registration Standards, in order to practise in Australia.

Some officials and experts argue that the government is giving credibility to medicine that has not necessarily been proven, saying “They’re giving legitimacy to something that hasn’t been legitimized.”

When we see a drowning person, the important thing is trying to rescue him. It’s a waste of time to argue that “only sending a boat can save lives; whether throwing a stick helps still needs more hearings.”

Don’t always act as a judge. To be a judge of TCM, you need to know the law of TCM. Don’t assign a Western Medicine doctor to test a TCM doctor. Don’t make language an obstacle.

Besides, how can a 3 year old exam invigilator supervise a 3,000 year old student?

TCM has survived 3000 years. It must have some reasoning in itself.

So, instead of taking “legal” actions, we need to spend more time discussing how to open a TCM university, or introduce TCM to middle schools or high schools. We need to educate our kids so that they know which herb or grass in our gardens and playgrounds are good for our health.

Both our government and society should be more open-minded. There might be a few fake TCM doctors, but they won’t survive long. Give the public choices. Patients are not stupid: when you see a doctor never deliver good results, are you going to see him again and again?

Talk to you next time.

Isherwood

A universal solution for all, or a personalized treatment for each?

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Every day, millions of people are taking medications that will not help them. That is not just a waste of drugs; it has caused a lot of complicated problems beyond the health of the individual patient.

Every human is unique. We are different in sex, ages, races and colors, nationalities, and more. We live in different environment, with different lifestyles. We have different habits in diet. We often differ in how we develop diseases and respond to treatments.

Our health is determined or influenced by our inherent differences combined with our life choices and changes of living environment.

Scientific research proves that every person has a unique variation of the human genes, because we have different family histories. Although most of the variation between individuals may have no effect on health, an individual’s health stems from genetic variation with behaviors and influences from the environment.

Personalized medicine aims to tailor treatments to achieve the best outcome for individual patients, rather than treating patients with a ‘one size fits all’ approach.

During a medical procedure, the decisions we make, the practices we apply, the interventions we carry out, and the formulas we prescribe, all shall be tailored to the individual patient based on their predicted response or risk of disease. Even our clinical trials shall focus on individual, not average, responses to therapy.

Personalized medicine is precision medicine.

Precision Medicine allows us to better understand the individual characteristics of each patient. It sets a higher standard for qualified practitioners. As we analyze the cause of an individual patient’s disease at a deeper level, the patient’s response is then tracked as closely as possible, and then we can utilize unique and targeted treatments to address that individual patient’s disease process.

Having the ability to look at a patient on an individual basis will allow for a more accurate diagnosis and specific treatment plan.

Precision medicine may provide better diagnoses with earlier intervention, and more efficient drug development and therapies. Former US President Obama called precision medicine “one of the greatest opportunities for new medical breakthroughs that we have ever seen,” saying that it promised to deliver “the right treatments at the right time, every time, to the right person.”

The concept of personalized medicine is not new. For thousands of years, TCM has been a great example of personalized medicine. TCM formulas composed of different herbs are targeted treatments for individual patients.

Especially in the cure of cancer or tumor, TCM has developed very efficient methods for treatment, and in prevention.

Although in practice, the treatments involve a lot of “trial and error” strategy that seems not that “scientific”, they are based on firm traditional therapeutic theories. As diseases like cancer can never be a quick cure, this “trial and error” strategy is necessary for the most effective results. Compared to saving lives, making minor mistakes (maybe just minor adjustments) is a merit to be worth.

A patient with a warmer body nature or one with a cooler body nature has different abilities to confront the intervention of drugs. Even for the same patient, his dosage of a drug at different stages of his disease should not be the same. Speaking of side effects, the physician shall closely monitor the progress of treatment and recovery by applying the right amount of the same medicine (or a formula) and at the right intervals.

In the western world today, Personalized medicine is already a part of our healthcare. When a doctor uses family history or past medical events and results to make treatment decisions, it is a type of personalized medicine.

TCM is individualized medicine as well as precision medicine.

Some people worry that as personalized medicine is practiced more widely, a number of challenges arise, like approaches to intellectual property rights, reimbursement policies, patient privacy, etc. The purpose of medical science is to save lives and improve human health qualities. Anything that serves this purpose shall have more good reasons than bad to thrive.

Western medicine shall work with TCM to bring about more good news to the general public. Pride and prejudice will never give the patients the best results.

Talk to you next time.

Isherwood

 

Your body is a miniature version of the universe

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The universe is made up of four basic elements: soil, water, fire and wind.

In recent days, the Hawaii Kilauea volcano erupts and people are evacuated. The lava destroys everything as it flows; many trees are burnt down. We see smoke rising above the forest.

The scene gives us an idea of how the earth evolves with the changes of the four basic elements.

A tree is also made up of the four elements. Soil and water is easy to understand. When we say a tree bears the nature of fire in itself, it’s a bit difficult to understand. Under strong sunshine, a dead dry tree may start a fire, that sounds easier to understand.

Photosynthesis is the “wind” element functioning within a tree. It is the process by which green plants and certain other organisms transform light energy into chemical energy. So wind is the form of energy flow or transformation.

When a tree is burnt, we see how the elements of soil, water, fire and wind begin to change.

The human body is the same. Our bones and flesh are the soil; our blood, sweat, tear, and body liquid are all water. Over 70% of our body is made up of water. Our body temperature of about 36 degrees is the fire. Our body heat is the fire. When the human body is cold or frozen, it is a dead body. Our breath is the wind. The energy or qi flow within our body is also the wind.

So our body is also made up of the four basic elements. It is part of the universe, and also a miniature universe in itself.

Similar to this Four-Element Theory, we come across the Five-Phase Theory: wood, fire, soil, metal, water.

This also tells how the world around us is composed and changes (transformation and interaction of different phases).

In materialistic sense, soil, fire, water are the same. Wood and metal can be included into soil. Where is the wind? The transformation and interaction of each of them, how they assist, support each other or generate/overcome each other, the process defines the wind.

So we do not take these five phases of wood, fire, soil, metal and water as materialistic elements. They each represent a system, an array of phenomena that is part of a bigger system, like the universe.

We can also say that the Five-phase theory establishes a system of correspondences that groups phenomena in the universe into five categories. These categories represent tendencies of movement and transformation in the universe.

In terms of generation, water nourishes wood, wood engenders fire, fire engenders soil, soil engenders metal, metal engenders water. This is a supporting or assisting cycle.

In opposite terms of overcoming, metal controls wood, wood controls soil, soil controls water, water controls fire, fire controls metal. This is a destructive or conquering cycle.

The five phases can be defined in many other categories, like colors. Wood is green, fire is red, soil is yellow, metal is white, water is black.

When the reasons apply to our body, wood represents our liver, fire heart, soil spleen, metal lung, water kidney.

For example, wood engenders fire. The liver stores blood and supplements the blood to be regulated by the heart. Wood controls earth. The liver’s dredging effect prevents spleen qi (energy flow from spleen) from becoming stagnant.

In our body, fire goes up and water flows down. When we feel heat in our heart, the fire goes up towards the head, we shall have sleep problem. Instead of finding trouble with the heart, we might look into the kidney for a solution. When the kidney (water) is balanced, the heart problem can be solved. This way we treat the problem of fire with water.

The Five-phase theory is another basic theory on which TCM is based.

I will talk to you further next time.

Bye for now.

Isherwood

We have better options, you should know…

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Tonight I watched SBS TV programme “INSIGHT” and people were talking about “Joint Operations”.

After that I checked out the SBS website and found this article.


How do you know when surgery is the best option and who makes the call?

By age 31, Rhys Donnan had undergone 11 operations on his knees.

He started having problems with his knees as a junior footballer at 13, and had his first operation at 18. From there, he underwent many more procedures – and revisions of those procedures – at one point having operations every 18 months.

“To be honest, I’ve become fairly blasé about [surgery] in the end,” he tells Jenny Brockie on this week’s episode of Insight. “I’d had so many … it just seemed the natural course of action.”

About a million orthopaedic surgeries are done each year in Australia. Many of these are joint replacements or spinal surgeries to treat osteoarthritis. Hip and knee replacements alone cost the health system more than any other hospital procedure – over $2 billion a year.

And some of these surgeries are on the rise. A Victorian study found that between 1994 to 2014, the number of hip replacements done went up 175 per cent, while knee replacements went up 285 per cent.

But the evidence for many commonly performed operations is far from clear cut.

Research suggests that about half of orthopaedic procedures have no scientific evidence to prove they work better than non-surgical treatments, and another quarter are no more effective than alternatives such as physiotherapy, exercise and weight loss.

Orthopaedic surgeon, Professor Ian Harris, says that some operations, such as spinal fusions, are more controversial.

“The best evidence we have is that it is not better than a structured non-operative alternative, such as physiotherapy or cognitive behavioural therapy,” he says.

After suffering debilitating back pain for several years, Simone Smith felt surgery was her only option.

“I had done everything, imaging, traction, physios, chiros, osteos … I can remember having to sit in the bottom of the shower because I couldn’t stand,” she tells Jenny. She says her surgery worked well, and helped ease her pain.

Jessica King also underwent spinal surgery. She says she wasn’t given any other options after hurting her lower back while pregnant.

“I feel like it was probably the most drastic sort of step, and I went there too soon,” she says. Jess still has ongoing nerve pain and numbness.

By Nicola McCaskill


When I watched the patients talking, about their experience undergoing those procedures, I  saw the pain and fear still in their eyes.

I  felt deeply sorry for these patients. In my opinion, there are really much better options for most of these “victims”. Most of them did not have to go through all those long days of pain and sufferings.

I felt sorry too for the doctors. I could see embarrassment in the faces of some specialists there among the audience.

If these doctors had the knowledge of TCM…if they had not been so narrow-minded…if they had been able to offer a different view, another option, the stories could surely be different.

Osteoarthritis is a common disease not only in Australia, but in many countries. It is an illness that needs a longer process of recovery, but it is not that difficult to deal with. Surgery and joint replacement might be a quick fix, but it is never the best solution.

There are many reasons to osteoarthritis, mostly as a result of long exposure to cold, moisture environment that causes inflammation of the joints. For elderly, the ageing process plus living under humid conditions is a key factor. For the young, sports injury is often the direct cause.

For joint pain by inflammation, it’s quite easy to ease pain using common herbs. For the elderly, herbal plaster is a better solution together with acupuncture and moxibustion. For the youth with bone damages, surgery might be necessary to set the joints right, but the process of recovery shall rely on other means. On most occasions, plastic replacements shall be avoided.

Especially for young people or people under 40, they still have a long way to go in life. They are going to get married, have children, and more dreams in life. Please don’t ruin their dreams.

The causes may be more complicated, and treatments vary. Today I am not going into detail; we will have many more hours to talk about this in the future.

Here I just want to stress that as a doctor or specialist, we must be open-minded, open to all other options and solutions. Don’t be a frog watching at the bottom of the well.

Treat the patients as they are your own family members, your wife or kids. Feel their pain, have mercy for their sufferings, and always give the best solution.

Talk to you tomorrow.

Isherwood

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