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FDA proposes rule to notify women with dense breasts about increased cancer risk and imprecise mammograms

The FDA is proposing a rule for breast cancer screenings that would require doctors to give women more information about the risks associated with dense breasts.  Read the full article here.

Caduceus Chief Medical Officer, Gregg DeNicola MD, shares his take for our patients.

“Informing women that their amount of breast density may affect results of the mammogram and their risks be outlined just makes common sense; it’s hard to imagine any body opposing this recommendation. Yes; it is more time necessary to advise patients as the physician, but it is essential women are educated on the details of their mammogram.  In California, such a requirement already exists and is enforced so it will have little impact for our patients, but to set this as a national standard is just smart medicine.”

April 2, 2019 Posted by | The latest in medicine, Uncategorized | , , | Leave a comment

Hormone replacement therapy for women- Is it right for you?

There have been many recent articles and online buzz about hormone replacement therapy for women and our Chief Medical Officer and Caduceus physician Gregg DeNicola MD wanted to weigh in on the discussion.

To provide some perspective, in 2002, an extensive study of over 16,000 women supported by the National Institutes of Health, was halted after discovering that the drugs, a combination of estrogen and progestin, caused small increases in breast cancer, heart attacks, strokes and blood clots. Those risks outweighed the drugs’ benefits -a small decrease in hip fractures and a decrease in colorectal cancer. A year later a comparable study was also stopped in the UK after comparable findings.

Chief Medical Officer Dr. DeNicola agrees, “The fact is a large, prospective study has never been executed proving hormone replacement therapy is indeed safe.  This is an emotional issue and the data is definitely conflicting. Both sides have ample data to support their position.  At Caduceus, we do not routinely recommend or dissuade the use of HRT. The decision is individualized after discussion between the patient and provider. Until the evidence is more definitive, it is the most prudent policy for our patients.”

More questions?  Schedule an in-office or virtual video chat with your Caduceus provider.

 

February 12, 2019 Posted by | The latest in medicine, Uncategorized | , | Leave a comment

Millions of Americans incorrectly think they have food allergies, study finds

You may have read the story recently that new research suggests Americans may be over-diagnosing themselves with food allergies. A study published in the medical journal JAMA Network Open estimates that nearly 19 percent of adults think they have food allergies, but less than 11 percent actually do.

Caduceus Chief Medical Officer Gregg Denicola MD adds, “I have felt this way for a long time and agree less than 10 percent of Americans have documented food allergies.  Most allergies are to fish and nuts.  They have become so popular that many people self-diagnose and claim one for any type with even minor reactions.  Most restaurants are perpetuating this and now are inquiring regularly with customers of any food allergies,  reinforcing that claim it is now almost expected.  Prior to assuming one has a food allergy, it is always best to be checked and diagnosed by an allergist.”

Allergist Sunil Saini MD sees patients at Caduceus Specialty in Yorba Linda.  Read his bio and/or reserve an appointment.

January 15, 2019 Posted by | The latest in medicine, Uncategorized | | Leave a comment

New Peanut Allergy Drug Shows ‘Lifesaving’ Potential

Results from a new study may lead to approval of what could be the first drug that ameliorates potentially deadly reactions in children with severe peanut allergies.  Caduceus physician and Chief Medical Officer Gregg DeNicola MD weighs in, “I agree with the spirit of the article; a breakthrough and very promising, but not necessarily a cure. Peanut allergy sufferers will need to abstain until further evidence can support the findings.”


https://www.nytimes.com/2018/11/18/well/live/new-peanut-allergy-drug-shows-lifesaving-potential.html\

December 5, 2018 Posted by | Uncategorized | Leave a comment

Colorectal cancer screening? To screen or not to screen before 50?

As CMO for Caduceus Medical Group, Gregg Denicola MD agrees that colon cancer is striking at a younger age than previous years.  Especially in high-risk populations, earlier screening may be beneficial.

He shares that the data that the American Cancer Society is using appears to be somewhat mixed and does not definitively show a benefit for screening prior to age 50. Also he notes, there would be increased costs in earlier screening recommendations and whether finding a cancer a few years earlier would decrease mortality has not been proven effective.

Dr. DeNicola shares, “It is a likely most insurance carriers will continue deny coverage for the test prior to age 50. Our patients should be aware they may bear the cost of a screening prior to age 50.  The American Cancer Society is a lay organization. Although their aim is admirable, they are not an independent non-invested group. It would make sense they would advocate for any recommendation that could potentially reduce cancer. They may not be as interested in a critical look at the data in comparison to a less biased group made up of only physicians.”

At this time Caduceus Medical Group advises following the guidelines of the USPSTF, which currently recommends beginning colorectal screening in average risk patients at age 50.

 

June 8, 2018 Posted by | Uncategorized | Leave a comment

 

Recently several publications have been reporting on the AAP’s recommendation regarding fruit juice consumption for children. We asked Caduceus medical director Gregg DeNicola MD to “weigh in” for parents of our pediatric patients at Caduceus 4 Kids.

“As medical director and Caduceus provider I have actually told my patients for many years to avoid fruit juices until after their first birthday due to the high sugar concentration.  Many infants love apple juice as a variant from sugar water, but I’ve always advised diluting it. There is little need for anything other than breast milk or formula simulating the mother’s milk in the first 12 months. Rice cereal is an easy start into solids and has little sugar.

Caduceus Medical Group supports the findings of the AAP (American Academy of Pediatrics) and feels it should have come sooner.”  If you have any other medical questions for your physician about this post please email us at mousecalls@caduceusmedicalgroup.com.

June 1, 2017 Posted by | Uncategorized | , , , | Leave a comment

Is eating a healthy breakfast really necessary?

breakfast

Many of you may have seen the article recently in the New York Times discussing the association and validity between skipping breakfast and poor health.  You can read the article here.

Our medical director, Gregg DeNicola MD, share his insight on this subject,

“There is very little peer-reviewed literature on this topic. As the article states, most are sponsored by food companies which would have a bias.  It’s common sense that eating meals regularly throughout the day would be healthy. The way our metabolism works, we should not go from 7 PM until 12 noon without calories. However, humans are very adaptable and there is little evidence to say that IQ or life expectancy would be influenced by whether or not breakfast has been consumed.

We need a lot more research into this topic before any conclusions can be made. In the meantime, Caduceus encourages our patients to have some type of calorie intake first thing in the morning since that is when cortisol is excreted and the calories expended most effectively.”  If you have a medical question about this article, please email us at mousecalls@caduceusmedicalgroup.com.

January 16, 2017 Posted by | Uncategorized | Leave a comment

Are multivitamins a waste of money? Editorial in medical journal says yes.

More than half of all adults in the United States take some sort of multivitamin; many do so in hopes of preventing heart disease and cancer or even to aid with memory. But an editorial published in this week’s Annals of Internal Medicine says that using supplements and multivitamins to prevent chronic conditions is a waste of money. “The (vitamin and supplement) industry is based on anecdote, people saying ‘I take this, and it makes me feel better,’ said Dr. Edgar Miller, professor of medicine and epidemiology at Johns Hopkins University School of Medicine and co-author of the editorial. “It’s perpetuated. But when you put it to the test, there’s no evidence of benefit in the long term. It can’t prevent mortality, stroke or heart attack.”

The editorial, “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” is based on three studies looking at the effects of multivitamins on preventing heart attacks and cancer, as well as improving cognitive function in men older than 65. All three studies were also published in this week’s Annals of Internal Medicine.

The first study was a meta-analysis of 27 studies that covered more than 450,000 participants and found that multivitamins had no beneficial effect on preventing cardiovascular disease or cancer. In addition, taking vitamins didn’t prevent mortality in any way. However, the analysis did confirm that smokers who took only beta carotene supplements increased their risk of lung cancer.

When taking multivitamins to prevent a second heart attack, authors again found no beneficial evidence.
The second study looked at 1,700 patients who previously had heart attacks. They were assigned to take three multivitamins or placebos twice a day for five years. However, with more than 50% of patients stopping their medications, it was difficult for authors to come to any real conclusions about the vitamins’ effectiveness.
With such a high drop-out rate, “interpretation is very difficult,” said Miller.

The final study followed nearly 6,000 men older than 65, who took either a multivitamin or a placebo for 12 years. The men were administered cognitive functioning tests, and test results found no differences between the two groups. However, Gladys Block, a professor of nutrition and epidemiology at University of California Berkeley, pointed out that the group of men followed in the cognitive study were all physicians with no health problems.
“These are very well-nourished, very health-conscious people,” she said.

In fact, she says none of the studies accurately represents the American population.

Block has spent her life studying the role of Vitamin C, in particular, on disease risk factors and says that most Americans are undernourished. She says that most Americans don’t have a healthy diet, and therefore don’t get the vitamins and minerals they need. “You’re not getting any of these micronutrients from Coke and Twinkies,” said Block. “Two-thirds of us are overweight, a quarter over 50 have two or more chronic conditions, so there’s a substantial population that one would hesitate to call healthy.”

Block went on to say, “There’s always a nontrivial minority that’s actually getting a questionable level of some micronutrients. So multivitamins are a backstop against our poor diet.” Cara Welch, senior vice president of the Natural Products Association, agreed with Block. “It is pretty common that in this day and age with the lifestyle many of us lead that we don’t always take the time to have a balanced diet, and even if you do have a balanced diet, you can still have nutritional deficiencies.”

The Natural Products Association is the largest trade organization representing the manufacturers and retailers of the natural products industry, including vitamins. The vitamin and supplement industry rakes in nearly $12 billion annually, according to the researchers, with multivitamins its most popular product. “Multivitamins address the nutritional deficiencies in people,” Welch said. “We don’t believe they are the answer to all life’s ailments, as the editorial suggests.”

Miller, however, disagreed that the studies didn’t represent the general public. “They didn’t select people who eat good diets or bad diets,” he said. “You assume that these people selected are the typical American diet. Taking a supplement in place of a poor diet doesn’t work.”

Some groups, however, do need supplements, he said.

“For people with deficiencies, malabsorption issues, and to prevent neural tube defects in pregnancy — there are a small number of conditions where we prescribe them.” Miller also said the jury is still out on Vitamin D, which can help strengthen bones, and omega-3 fatty acids, including DHA and EPA. Miller said the studies were unlikely to change any clinical standards, and that focusing on diet and exercise remain key to maintaining a healthy lifestyle.

It’s something with which Block can agree. “Eat fruits and vegetables,” she said.

Source: CNN Health

vitamins

December 24, 2013 Posted by | The latest in medicine, Uncategorized | , , | Leave a comment

Doctors warn of breast-cancer link to keeping cell phone in bra.

Could where you carry your cell phone make you sick? Some doctors say they’re seeing evidence of breast cancer that could be linked to where some women keep their mobile phones.

Tiffany Frantz and other young women tell KTVU it’s convenient way to hold on to their cell phone. “I put my cellphone right in my bra,” said Frantz. However, her mother Traci Frantz  expressed misgivings. “We never took it seriously until after she was diagnosed,” said Traci Frantz.

At the age of 21 years old, Tiffany got breast cancer. “Her tumors were exactly where her cellphone had been against her skin her bare skin for about six years,” said Traci Frantz. Their family has no genetic or other risk factors. Surgeons ended up removing Tiffany’s left breast.

“It’s kinda coincidental that it’s right where I kept my cellphone,” said Tiffany. Coincidence? Donna Jaynes got breast cancer at 39. Her family also no had risk factors for cancer. Her doctor showed KTVU the dots where her tumors developed  just a half an inch beneath her skin.

“All in this area right here, which is where I tucked my cellphone,” said Jaynes. She said she did just that for ten years. She had a mastectomy. “I thought cellphones were safe. I was under the impression that they were,” said Jaynes.

Breast surgeon Lisa Bailey believes cellphone-related breast cancer may be common. But doctors rarely ask about phones. “I would never wear a cellphone immediately next to my body and I would advise all women not to do that,” said Bailey.

Nevertheless, new bras are now on the market with pockets for cellphones. This may be convenient, but doctors said they are risky, especially for younger women. “These young breast in the early evolution are more sensitive to changes that might lead to cancer,” said Dr. John West, a breast cancer surgeon.

West, his colleague Dr. Lisa Bailey and others are now sounding an alarm. They say men are also getting breast cancer by putting their cellphones in their shirt pockets. The wireless industry denies any problem citing a lack of scientific evidence that cellphones cause breast cancer.

“Until further data either supports it or disproves it, I would keep cellphones away from the body, in particular the breasts,” said Dr. June Chen. Doctors recommend cell phone users read manufacturers fine print. For instance, iPhone manuals suggest users keep their phone at least 5/8 of an inch away from any body part.

“It’s as simple as that and it might save a life. It might avoid a mastectomy, chemotherapy. It’s easy enough to do. Why take a chance?” asked West. Tiffany’s mom says she wishes she’d spoken up. “I am convinced her cellphone has caused her breast cancer,” said Traci Frantz.

“If there is a risk and we don’t find out about it for five or ten years from now, we’re going to see a whole cluster of young people with breast cancer,” said Dr. John West.

Source: KTVU.com

June 1, 2013 Posted by | Uncategorized | , , | Leave a comment

New Method May Help Pinpoint Woman’s Final Menstrual Period.

A new formula to predict a woman’s final menstrual period could help menopausal women fight bone loss and reduce their heart disease risk, a new study reports. 

The formula is based on the changing levels of two hormones: estradiol, which is found in the ovaries; and follicle-stimulating hormone, which is present in the brain and gives instructions to the ovaries.

Estradiol levels fall and follicle-stimulating hormone levels rise as women go through menopause, the University of California, Los Angeles, researchers explained in a news release from the Endocrine Society.

Currently, doctors monitor women’s menstrual bleeding patterns to determine the menopause transition phase. However, this phase is an imprecise indicator of when the final menstrual period will occur, according to the authors of the study published in the April issue of the Journal of Clinical Endocrinology & Metabolism. 

“We need a better way to answer women’s questions about when to expect the final menstrual period,” lead author Dr. Gail Greendale, of UCLA’s David Geffen School of Medicine, said in the news release.

 

Source:  HealthDay News

March 26, 2013 Posted by | Uncategorized | , , , | Leave a comment

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