We all love the fall when the leaves turn beautiful colors and the migrating birds start to fly south. The world becomes so busy and exciting. One factor we might or might not like is that the winter is coming! What can we expect or prepare for during the winter? What diseases could occur in winter? How can we prevent them to happen to us?

Start with the fall - we know this time of the year we could get seasonal allergy symptoms with ragweed. If you have had an allergy to ragweed in the past you may want to see your doctor to prevent it. When allergies get out of hand, secondary infections with virus or bacteria could occur.

Winter brings the cold air and wind that could penetrate our clothing. The cold temperature could cause frostbite, so first thing is to make sure we all dress for the weather; dress warmly. For parents who have small children, please check the weather report and have your children wear comfortable winter clothes. Hat and mittens may be needed for outdoor activities.

Winter will also bring viruses and bacteria close to our body. The human body is a good hiding place for them causing people to come down with upper respiratory infections including the common cold, bronchitis, sinusitis and Influenza, all of which could be deadly to young people and the elderly. If you are 50 years or older, have children under 3 years old, or medical conditions such as heart disease, diabetes, renal failure, auto immune diseases, etc, you need to get a FLU shot.

Winter means we are not so active outside and more cooped up inside. We may lack sun exposure and fresh air. Indoor allergens caused by hot air heat blowing around cause allergy symptoms such as sneezing, nasal congestion, watery eyes, coughing and asthma attacks. Subsequently, the allergy can become sinusitis, bronchitis, COPD exacerbation (chronic obstructive bronchitis, especially in smokers) or pneumonia. Many people have to be admitted to hospitals for breathing problems in winter. See your family doctor if you start to get sick - do not wait until complications occur. People who are 65 or older should have Pneumonia vaccinations at least once

Winter also is the time to take precautions against meningococcal meningitis. This disease tends to occur among school students. That is why college students should have vaccination to prevent it from occurring.

Snow will come during the winter season. Preventing falling in the snow or ice is very important. Falling in the street or other hard surface can cause bone fracture, especially in people who have osteoporosis. Car accidents occur more frequently during snowy or icy conditions. Safety is one thing we should all keep in mind during this time of year.

The tips mentioned above are just a few ways to take precautions during the winter season. Remaining healthy during the winter will help us prepare for the future. Don’t forget when winter comes, spring isn’t far away!

Do you know any cancer can be caught by contact with certain bacteria or viruses? Are cancers contagious? Can we prevent cancers by immune vaccination?

Scientists and physicians have been asking the same questions for decades and trying to understand the causes and pathology of cancers, yet they are still the most difficult to treat and the most devastating diseases in existence. Everyone has known of a loved one or close friend or neighbor who has suffered from cancer. There are several cancers that have been linked to certain bacteria and viruses:

Stomach cancer may be linked to a bacteria called H. Pylori which is transmitted by eating contaminated food.

Cervical cancer may be linked to a Virus called Human Papilloma virus (HPV) by sexual contact.

Liver cancer may be linked to the viruses Hepatitis B and Hepatitis C by blood.

T-cell Leukemia may be linked to certain retroviruses (such as HTLV) by blood.

Nasopharyngeal Carcinoma may be linked to a virus called Epstein-Barr Virus by respiratory infection

Prostate cancer may be linked to a virus called XMRV which may or may not be sexually transmitted.

It is possible that more and more viruses could be linked to cancers. It seems that the viruses and bacteria linked to cancer mostly are through parts of the human body that open to the outer environment such as mouth, nose, gut, vagina, prostate though eating, breathing or sexual activity.

The mechanism of developing cancer through these viruses or bacteria is that the DNA or RNA of these viruses or bacteria incorporate into human DNA and change the function of the human gene. The changed cells start to over grow and over power the human immune system. Eventually, it leads to an abnormal growth called Tumor/Cancer.

Cancer cells are generated everyday and in everyone. Why some people get cancer and others do not get cancer? The answer lays in our immune system. We have millions of immune cells patrolling through our body daily. The powerful immune system destroys cancer cells constantly. Only when our immune system is weaker than the production of the cancer cells, does the human body developer tumors.

If cancer can be infected by viruses and bacteria, can we prevent them by immune vaccination?
We now have a vaccine for Human Papilloma Virus to prevent cervical cancer; it is recommended to be given to pre-teen girls. We also have a vaccine for Hepatitis B to prevent liver cancer; it should be given to everyone. We may also take antibiotics to kill bacterium H. Pylori to prevent stomach cancer.

Scientists and medical professionals are continually searching for and finding the causes and treatments for cancer. Many cancers can be detected earlier and therefore cured, such as having a PAP smear to detect cervical cancer; Mammograms are used to detect breast cancer, PSA for detecting prostate cancer.

Prevention and early detection are important for fighting cancer. As an individual, one thing we could do in the battle against cancer is to check one’s life style, reduce risk factors, build up a strong immune system and learn about any and all available preventive measures.

STATISTICS Breast cancer is a cancer that starts in the cells of the breast in men and women. It is the second most common type of cancer after lung cancer and the fifth most common cause of cancer death. Women in the United States have the highest incidence rates of breast cancer in the world; in 100,000 women, the occurrence were 141 among white women and 122 among African American women. Women in the US have a 1 in 8 (12.5%) lifetime chance of developing invasive breast cancer and a 1 in 35 (3%) chance of breast cancer causing their death. In 2007, breast cancer was expected to cause 40,910 deaths in the US (7% of cancer deaths; almost 2% of all deaths). Incidences of breast cancer in men are approximately 100 times less common than in women, but men with breast cancer are considered to have the same statistical survival rates as women.

PREVENTION:
Naturally:
1. Lower age of first childbirth (< 24 year old)
2. Having more children (reduce breast cancer risk 7% per child)
3. Breast feeding (reduce breast cancer risk 4% per year of breast feeding)
4. Exercising three time times a week for one hour reduce breast cancer risk by 40 %

Nutritionally:
1. Taking Phytoestrogens found in soybeans or soy products, in early adolescence may protect against breast cancer later in life. However, taking soy product later in life has no positive or negative effect for breast cancer risk.
2. Foods rich in folate include citrus fruits, citrus juices, dark green leafy vegetables, such as spinach, dried beans and peas. Vitamin B9 can also be taken in a multivitamin pill.

Environmentally:
1. Breathing secondhand smoke increases breast cancer risk by 70% in younger, primarily pre-menopausal women. Stop secondhand smoking reduces breast cancer risk.
2. Food high in processed oil, trans fatty acid increases the chance of obesity and breast cancer risk. Obesity increase the breast cancer risk.

Medical Intervention:
1. Oophorectomy and mastectomy, in high risk individuals, when child-bearing is complete, reduces the breast cancer risk by 60% as well as reduces ovarian cancer risk 96%.
2. Medication: Hormonal therapy for chemoprevention in high risk women, such as Tamoxifen, Raloxifene. The relative risk reduction is 50%-76%. But the risk of hypertension, venous thromboembolism and fatal stroke would be increased. So the risk and the benefits should be weighed.

Screening -
Breast cancer screening is an attempt to find unsuspected cancers. The most common screening methods are self and clinical breast exams, x-ray mammography, and breast Magnetic resonance imaging (MRI)

X-ray mammography -
Mammography is still the modality of choice for screening of early breast cancer, since it is relatively fast, reasonably accurate, and widely available in developed countries. A clinical practice guideline by the US Preventive Services Task Force recommended "screening mammography, with or without clinical breast examination (CBE), every 1 to 2 years for women aged 40 and older. Mammography has been estimated to reduce breast cancer-related mortality by 20-30%.
Ultrasound - Used in conjunct with x-ray mammography for detecting lesions in the breast for further evaluation of breast lump or nodules.

Magnetic resonance imaging (MRI) -
MRI has been shown to detect cancers not visible on mammograms, but has long been regarded to have disadvantages. For example, although it is 27-36% more sensitive, it is less specific than mammography. As a result, MRI studies will have more false positives (up to 5%), which may have undesirable financial and psychological costs.

Who needs Breast MRI? Those with a strong family history, patients with BRCA-1 or BRCA-2 tumor suppressor gene mutations, women with breast implants, those with a history of previous lumpectomy or breast biopsy surgeries, axillary metastasis with an unknown primary tumor or people with very dense or scarred breast tissue.

Breast self-exam and Clinical Breast Exam -
It is recommended to have yearly physical exam with primary care or gyn doctor for women to have a clinical breast exam. Breast self-examination is optional method of breast cancer screening because women taught to self-exam tended to detect more breast nodules but they were just as likely to die of breast cancer.

Genetic testing -
The most-used test for detecting breast cancer susceptibility genes are the test of BRCA1 and BRCA2 genes. It is recommended for women with a strong family history of breast cancer to have genetic counseling and evaluation for BRCA testing. The high risk group is about 2 % of the women who have breast cancer.

Who is among the high risk group for developing breast cancer? Two first-degree relatives with breast cancer, 1 of whom received the diagnosis at age 50 years or younger, Three or more first- or second-degree relatives with breast cancer regardless of age at diagnosis, both breast and ovarian cancer among first- and second- degree relatives. A first-degree relative with bilateral breast cancer, a combination of 2 or more first- or second-degree relatives with ovarian cancer regardless of age at diagnosis, a first- or second-degree relative with both breast and ovarian cancer at any age, a history of breast cancer in a male relative and women of Ashkenazi Jewish heritage, an increased-risk family history includes any first-degree relative (or 2 second-degree relatives on the same side of the family) with breast or ovarian cancer.

All medical information gathered is meant to increase our knowledge about diseases that we are trying to avoid or fight against. It is important to individually apply this knowledge to our daily life. To prevent and fight against breast cancer, like all other cancers, we need to go out and exercise 20-30 minutes every day, take our vegetables and soybean products, avoid being overweight, and keep your BMI under 25. Visit your doctor each year for breast exams and mammograms when age appropriate. Finally, talk to your doctor about genetic counseling if there is a strong family history of breast cancer.

1. Make sure the screening tests and immunizations that are appropriate are up to date.

2. Complete an Advanced Health Care Directive.

3. Exercise " aerobically" , enough to raise your heart rate to about (220-your age) x 70%. Your goal is at least 30 minutes every day.

4. Achieve and maintain normal body weight. Ideal weight is BMI<25.

5. Eat foods low in saturated fat and trans fatty acids and high in calcium, Vitamin D and fiber, with plenty of fruits and vegetables. Take a calcium/Vitamin D supplement, if necessary.

6. Practice safe sex, use condoms and a reliable method of contraception.

7. Do not smoke, and avoid inhaling others' cigarette smoke. If you need help quitting, please ask.

8. "Safety-proof" your home to prevent falls, poisoning, accidental use of firearms and fire.

9. Do not drive or allow others to drive while under the influence of alcohol or other mind-altering substances. Use sport helmets appropriately, regardless of your age. Know the safety regulations for automobile airbags.

10. Seek help early for depression, mood changes, alcohol or drug abuse.

11. Perform regular skin self-examinations. Protect your skin from sun damage with sunblock, hat and clothing.

12. Women should seek medical attention for breast changes.

13. Men should seek medical attention for testicular changes.

14. Find balance in your life between work, home and play time. Include stress reduction activities every day.

It is also recommended that:

1. Routine breast exam should start at age 20, every 3 years should have your doctor to do the exam. Routine breast mammograms for women should start at age 40. If you have family history of breast cancer, you may start mammogram exam earlier.

2. Routine PAP smear for cervical cancer screening should start at beginning of sexual contact annually. No later than age 21. After you reach age 30, you may have PAP smear every 3 years if you have had three normal PAP test.

3. Colon cancer screening should begin at age 50. If you have family history of colon cancer then test earlier. If test is normal, you may repeat the colonoscopy in 10 years.

4. Women age 65 and older should have a DEXA scan for detecting osteoporosis.

5. Lipid screening for men should start at age 35, and for women at age 45. Keep your good cholesterol (HDL) high (man >40, woman>50) by exercising and eating foods high in Omega-3.

6. Prostate cancer screening may start at age 50. If you have family history of prostate cancer, screening test should start earlier.

6. Diphtheria-Tetanus Booster should be given every 10 years for men, women and children.

7. Get another Tetanus shot with Pertussis (DTaP) at age 12 and as an adult when working as a health professional.

8. HPV vaccination may prevent cervical cancer, starting at age 9-12.

Americans are getting better on prevention and early detection of Heart disease, Diabetes and Cancer, etc. But we still have a long way to go. For the problem of obesity, we are loosing the battle every day. 20 years ago, there are average 16% of American are obese. Now we have over 35%-55% people who are obese. There is a Chinese saying: “All diseases started from your mouth!” We really need to watch our mouth to prevent diseases. What you eat , how you eat and how much you eat will make a big difference. Let us all think for five seconds before we put anything into our mouth!