Participants: Christine Salter
Series Code: WM
Program Code: WM000342
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00:37 Welcome to Wonderfully Made.
00:39 Our topic today prevention screening 00:41 across the lifespan. Hello my name is 00:46 Dr. Christine Salter. I am a board certified 00:48 family physician and I am the 00:50 Medical Director of Vibrant Health Family 00:53 Medicine at St. Louis, Missouri. 00:54 Today, we want to discuss prevention 00:57 and screening across the lifespan. 01:01 Let's get an idea what we mean by prevention 01:04 versus screening. Let's say that you have a 01:08 brand new car and every 3 months you take 01:12 it to auto zone for them to check the tires, 01:16 check the oil and check under the hood, 01:22 but you don't ever do anything yourself, 01:25 you don't put the air in the tires, 01:28 you don't change the oil, you use 01:32 whatever gas you want to use. 01:35 Would that be prevention for your car 01:38 or would that just be screening? 01:41 You have got it, it would be screening. 01:44 Simply just looking for a problem 01:48 that is different from prevention, 01:49 where you actively try to do something to make 01:53 a difference or to prevent something 01:55 from happening that's why you use 01:57 the correct gasoline designed for that car, 02:01 that's why you check the oil levels, 02:03 that's why you check the tires, 02:06 that's why you winterize the car. 02:09 That is prevention and in addition 02:11 you want to take it into the checks 02:13 so that other things are detected that 02:16 you may not have detected. 02:18 That is the same concept that we are 02:21 talking about for human beings because truly 02:26 we are faithfully Wonderfully Made 02:27 and we want to do the best that we can do 02:30 to prevent certain diseases occurring 02:33 and to screen for other diseases so that 02:37 we can intervene quickly. And so 02:41 let's talk about prevention for the 02:44 infants and toddlers. The number one cause 02:48 of death for infants and toddlers are 02:52 unintentional injury or accidents. 02:55 In the infant, accidents are a concern leaving 03:02 the child unattended, thinking that 03:04 the infant will not rollover, he can fall 03:07 and have an injury, not properly restraining 03:11 that infant in a car seat. Can the infant 03:14 in your arms thinking that if those are impact 03:18 you would hold on to that infant. 03:20 But in fact physiologically speaking 03:23 you would not because with the impact 03:26 you would automatically release that infant 03:29 who would then proceed towards the windscreen 03:32 and get a very damaging injury. 03:36 So infants should be properly restrained 03:39 in their car seats. What else causes death 03:43 in infants? Sudden infant death syndrome. 03:47 What can we done to prevent that? 03:50 There is a large campaign called 03:52 Back to Sleep, that is put your infant to sleep 03:56 on his or her back. Not on the front, 04:00 on the front seat shown to increase the risk 04:04 for sudden infant death, where there is no 04:07 obvious reason as to why the child died. 04:11 Place your child to sleep on the back 04:13 or on the sides to prevent sudden 04:17 infant death. If you are a smoker, 04:21 you will increase the risk for 04:24 sudden infant death in your child. 04:27 If you breastfeed your infant you will decrease 04:31 the risk for sudden infant death. 04:33 So there are three major things that 04:35 you can do to prevent sudden infant 04:37 death syndrome. Back to sleep, 04:41 breastfeed your infant and clearly avoid 04:46 smoking around that child. Even if you go to 04:51 smoke outside those particles of smokes 04:54 are still on your clothes and so when you 04:56 come to pick up your infant, 04:58 your infant is inhaling that smoke 05:00 from your clothes. So sudden infant death 05:05 and accidents are a concern in infants 05:08 and what about toddlers. There number one killer 05:12 is also unintentional injury or accidents. 05:16 Toddlers just like to investigate 05:20 that's what they do. They go into places 05:24 they take things out, they put things 05:26 in their mouth. It is important that 05:30 you toddler proof your home, 05:32 get down in your hands and knees, 05:34 crawl around your house. Look for things 05:37 that a toddler or crawling infant 05:40 will get into. Codes that are hanging 05:43 down too low, lose screws, outlets that are 05:48 unprotected, that little curious finger will put, 05:51 little finger right into that outlet 05:54 and cause electrocution, unintentional injury, 05:59 accidents, drowning. Leaving a toddler 06:03 or infant unsupervised in a bath. 06:08 Hard to believe, but even just a few inches 06:11 of water can cause drowning 06:13 an infant or toddler. Leaving buckets 06:18 unattended that have water in it, 06:20 toddler will go down to go into that bucket 06:23 make it stuck, make it stuck in the toilet 06:26 and cause drowning and so having a safety 06:32 latch on that toilet seat would be 06:34 very important. It's important so 06:38 you can talk to your physician, 06:39 your family doctor, your child's doctor 06:42 and ask them for a checklist so that 06:45 you can safe proof your home from these 06:49 unintentional injuries. And what about 06:53 the young child? The young child is a 06:56 vivacious and very active, loves to ride 07:01 the bicycle but parents it's up to 07:04 you to make sure that you impress upon 07:07 your young child to always wear a 07:10 bicycle helmet. And you need to show by example 07:15 if you don't wear a helmet your child 07:18 certainly will not wear a helmet. 07:19 But if your child is riding along 07:22 and it is not have to be at high speed 07:24 and bums onto a curve on a stone and goes over 07:28 that handle bar. When that child's head hits 07:31 the concrete which one do you think is going 07:34 to give? It's not the concrete, 07:37 traumatic head injuries in children occur 07:41 because they are not wearing 07:43 protective headgear. The young child, 07:48 what about the teenager, car accidents, 07:56 riding in a car without wearing a seatbelt 07:59 it's unfortunate that teenagers think that 08:02 they will live forever and that they 08:04 can do daring acts. They drive at high speed 08:10 unrestrained sometimes under the 08:13 influence of alcohol. That is a recipe 08:16 for a head injury it may not be death, 08:19 but that teenager will never be the same again. 08:22 Prevention, prevention, prevention is the key. 08:28 Do not drive in a car with somebody else 08:31 has been on to the influence of alcohol. 08:33 Always wear your seatbelt when you drive. 08:38 Always wear a helmet if you're riding a bicycle 08:41 or if you're rollerblading. 08:44 If there is risk for a head injury with the 08:48 solid object you need to wear 08:50 protective headgear. Also in teenagers 08:58 depending on your location, 09:00 infection is also a common killer. 09:05 In particular, we are talking about 09:08 sexually transmitted diseases 09:10 and in particular we are referring to HIV 09:14 in subsequent age. It is important that teenagers 09:21 recognize the danger of multiple sexual partners 09:26 or even sexual activity before marriage. 09:30 Multiple sexual partners increases the risk for 09:34 sexual transmit disease, Herpes, Chlamydia, 09:38 HIV and HIV can result in death. 09:42 Although some of the other 09:45 sexually transmitted disease do not result 09:47 in death they certainly result in problem 09:50 such as infertility. And so our recommendation 09:53 for teenagers is chastity not just 09:57 abstinence, but chastity a lifestyle of purity 10:02 before marriage and continued into marriage 10:05 with one partner, your husband or wife. 10:11 And teens, so from teenagers we go onto 10:14 young adults and what we are finding 10:20 as we traverse the lifespan is that it goes 10:23 from unintentional injuries to more 10:26 lifestyle conditions that become the major 10:30 killers and so in the young and even 10:36 middle age adult accidents continued 10:38 to be the number one killer. 10:41 Again wearing your seatbelts, 10:46 not doing things that are dangerous, 10:49 driving under the influence of alcohol, 10:51 these are all important preventive strategies 10:55 to decrease the risk for injury and death. 11:01 But as we approach the middle years 11:03 and on into the older years then what comes 11:08 to the forefront is heart disease 11:11 and cancer. Cancer, we can prevent 11:18 as well as screenful, what are the cancers 11:21 that we are concerned about? 11:24 When in young man we are concerned about 11:27 testicular cancer and that can easily be 11:31 screenful by the young man himself doing 11:34 monthly testicular exams you may notice a lump 11:37 on the testicle. It's not necessary painful 11:41 and is not necessary large, 11:43 but it is something that is unusual 11:46 and different. If you find this 11:49 you need to see your physician 11:50 so the appropriate workup can be done. 11:53 Testicular cancer. Colorectal cancer is the 12:01 number two cancer killer. Number one is 12:05 lung cancer and we associate lung cancer 12:10 with tobacco smoking. So avoiding tobacco smoke 12:16 will dramatically decrease your risk 12:19 or prevent lung cancer from occurring 12:24 but not just you actively smoking 12:28 we are also concerned about passive smoking. 12:32 What is passive smoking? You inhaling 12:36 the cigarette smoke from somebody else may be 12:40 your husband or wife smokes. 12:43 Well they increase in their risk as well as 12:46 your risk for smoking related illnesses 12:50 and is not just lung cancer, heart disease, 12:54 bladder cancer, cervical cancer, renal cancer. 13:00 There are problems with actively smoking 13:04 and passive smoking, so we do want you to avoid 13:10 tobacco smoke in all its forms. 13:12 Some my patients say I don't smoke, 13:15 but I chew tobacco. Well that's a problem 13:17 because when you chew tobacco you increase 13:20 the risk for cancer of the mouth and throat 13:25 and if you are smoking and drinking alcohol 13:29 together that is a very bad combination. 13:34 Smoking will initiate a cancer. 13:36 Alcohol will fan the flames of that, 13:42 so it is a promoter we say the initiator 13:47 is a tobacco smoke, the promoter is the alcohol. 13:50 Alcohol and tobacco smoke increases the risk 13:53 for head and neck cancers. So how would 13:57 you want to prevent those quit smoking, 14:00 don't drink alcohol. So tobacco smoking 14:07 and lung cancer is well established. 14:09 What about the second cancer? 14:13 That's a leading cause of death that is 14:16 colorectal cancer. How do we prevent 14:19 that there was a large trial that was done 14:23 that look to the lifestyle that promoted 14:27 colorectal cancer and it was found that a diet 14:32 that was plant based fruits, vegetable, 14:37 whole grains, low fat dairy, lean meats 14:41 if at all was associated with a very low risk 14:45 of colorectal cancer. On the other hand, 14:48 a diet that had cakes, pastries, ice cream, 14:54 pan cakes, pretzels, soda's that was 14:59 associated with a high risk of 15:02 colorectal cancer. So, we see prevention 15:07 would be to change your diet and your lifestyle. 15:12 Also exercises shown to lower 15:14 colorectal cancer risk. But how do we screen 15:19 for colorectal cancer? We screen 15:23 by doing a process called colonoscopy. 15:27 Some people say I don't have any problems, 15:31 I don't feel any abdominal pain, 15:33 I don't have a change in bowel habit, 15:35 I don't have blood in my stool. 15:37 So I don't need to get a colonoscopy done. 15:41 Wrong, that is the very time that 15:44 you need to have a colonoscopy done 15:46 because that's when they will find the cancer 15:49 in its earliest stages as a tiny polyp. 15:52 They find that tiny polyp that's an 15:54 early cancer they snip it off, 15:57 100 percent cure. On the other hand, 16:01 if you wait until you have symptoms of 16:04 weight loss, abdominal pain, 16:07 blood in the stool by that time you may have 16:10 a large cancer that is actually spread 16:14 into the lymph nodes and on into the liver 16:16 and to other vital organs of the body 16:18 in which case there is not 100 percent cure. 16:24 When do we screen for colon cancer? 16:28 The current guidelines recommend that persons 16:32 50 years or older with no other risk facts for 16:36 colorectal cancer should be screened for 16:40 colon cancer. And the best screening would be 16:44 if a colonoscopy done by a trained specialist, 16:49 a gastroenterologist or a colorectal surgeon. 16:54 On the other hand if your mother, 16:58 father, brother or sister had colon cancer 17:02 when they were 40 years old then you would 17:07 need to be screened 10 years prior to that 17:10 because it takes about 5 to 7 years 17:13 for a colon cancer to grow. 17:15 So if your first degree relative had 17:19 colon cancer 40, you should get screened 17:22 at 30. But if there is no family history 17:27 or no other underlying medical condition 17:30 such as ulcerative colitis that would 17:33 increase your risk for colon cancer 17:35 then the only screening time would began 17:38 at age 50. Please don't put it off, 17:41 in the hands of a well trained specialist 17:46 the procedure can be done quickly 17:49 and uneventfully. And then it would not 17:51 have to be done for another 10 years 17:55 and of course during those 10 years 17:57 you are gonna be doing all those things that 17:59 we know decreases the risk for colon cancer 18:02 as far as diet is concerned. 18:04 Fruits, vegetables, whole grains, 18:07 foods that are rich in calcium. 18:11 Exercise that decreases inflammation 18:15 because the current thought is that 18:17 the colon cancers actually a part of an 18:20 inflammatory process that is going on. 18:25 Certainly fiber is important 18:27 when it comes to colon health, 18:31 but more so then fiber red meat has been linked 18:36 quite strongly with colorectal cancer 18:40 and so if you want to prevent colon cancer 18:43 you will avoid red meats, you will 18:46 exercise, you will avoid the regular use of 18:51 cakes, pastries, ice creams, sodas. 18:54 Instead you will eat fruits, vegetables, 18:57 whole grains and foods that are rich in calcium 19:02 such as green leafy vegetables. 19:06 So colon cancer that can be screened for, 19:09 it can be prevented. What is some of the 19:12 other cancers in woman? Breast cancer. 19:16 In woman between ages 40 and 50, 19:19 the number one cause of death is an 19:21 heart disease, it's in fact breast cancer 19:24 and so breast health is very important 19:28 that should be a strong focus in those years. 19:31 What are some of the things that we know 19:34 that help prevent breast cancer? 19:38 You have got it. Exercise a plant based 19:43 diet these will decrease the risk of 19:46 breast cancer, but if you have a 19:49 family history you are clearly at higher risk, 19:52 if your mother or sister or maternal aunt 19:56 had breast cancer you will clearly 19:59 at a higher risk. That doesn't mean it is 20:02 inevitable, it means that you have to more 20:05 aggressive to do those things to protect 20:08 your breast. Fiber in fact a special kind of 20:13 fiber that we find in flax is very important 20:16 for breast health, lignans very important 20:21 ground flax seed sprinkled on whole grain 20:24 cereal will go a long way to protect 20:28 your breasts from breast cancer as we exercise, 20:32 as we eating the cruciferous vegetables 20:35 broccoli, cauliflower, Brussels sprouts, kale. 20:40 There is nothing new under the sun 20:42 as song of Solomon says still a diet 20:49 that is healthy coupled with physical activity 20:52 is what promotes cellular health whether 20:57 it's health of the breast tissue, 20:58 whether it's health of the colon tissue, 21:00 whether it's health of the testicular tissue, 21:03 cellular health and integrity is governed 21:08 by the lifestyle and activity that is 21:10 occurring in ones body. What other kind of 21:14 cancers can be screenful easily? 21:16 Cervical cancer, Pap smears, 21:20 well woman exams. Woman you need to see 21:24 your gynecologist or your family physician 21:26 who also does gynecology to get a 21:29 Pap smear done. It's easily done not painful; 21:33 we can quickly take a sample, 21:35 send it off to the lab and look for early 21:38 science of cancer before it becomes invasive 21:40 at which point it is very difficult to treat. 21:43 No woman in 2004 or 2005 should die of 21:49 cervical cancer because it is so 21:51 easily screenful. If you have not had a 21:56 Pap smear done in the last year, 21:58 although last two or three years, 22:01 please see your doctor right away. 22:05 Regarding breast cancer what can we do to 22:07 screen for it? Mammograms, 22:11 there is some controversy about 22:13 the use of mammograms but there is an overall 22:19 idea that the older women is the more 22:22 useful the mammogram is. The more older she is, 22:25 woman more then 55 who have less dense breasts, 22:31 a positive mammogram is more likely to be 22:35 a true positive. But if you are younger 22:38 and have dense breasts then a negative 22:43 mammogram if it says that oh! Nothing 22:45 is found may not be that useful because 22:47 it may miss a cancer lesion 20, 30 percent 22:53 of the time. So a negative mammogram 22:57 when you are younger with dense breasts 22:59 should not put you at ease, it should still, 23:02 you should still be in a frame of mind that 23:05 prevention is the key. Diet and lifestyle 23:10 and even your state of mind is important 23:13 for breast health and general immune health 23:17 because is the immune system that access 23:21 surveillance to mop-up those cancer cells, 23:25 we will always expose to cancer cells. 23:27 The immune system mops them up; 23:30 if they are antioxidants it takes care of them. 23:33 Phytonutrients takes care of them sometimes 23:37 prevent even the cancer cells forming. 23:41 So, a simple screening test should not 23:45 necessary put you at ease, it should simple 23:47 be part of the alimentarium for you 23:51 to do prevention also. So we have talk about 23:55 colon cancer, breast cancer, cervical cancer 23:59 and testicular cancer. We have also talk about 24:03 lung cancer. It is rather difficult to 24:06 screen for lung cancer, the best thing to do 24:08 for lung cancer is not to smoke, 24:11 it's not to smoke to avoid it completely. 24:14 But clearly if you have, if you are a smoker 24:17 and you have a persistent cough 24:19 or you are coughing up blood then you need 24:22 to have a chest x-ray done to make sure 24:25 that there isn't some obvious lesion 24:27 in your lungs. And so as we continue 24:32 through the lifespan on into the late years 24:37 then the number killer changes from cancer 24:41 to heart disease. And how do we screen 24:45 for heart disease, you get your 24:48 cholesterol checked, which is the blood test, 24:51 you get a physical exam done so that 24:54 they can access for your body mass index 24:56 for a abdominal obesity. You get your 25:00 blood pressure checked to make sure 25:01 you do not have high blood pressure, 25:05 you get a fasting blood sugar done to make sure 25:08 you don't have diabetes that's the screening. 25:12 But in the meantime, you are going to live 25:14 the lifestyle the same lifestyle 25:17 that we said prevented colorectal cancer. 25:20 A diet that is composed of fruits, vegetables, 25:25 whole grains, low fat dairy, lean meats 25:29 if you eat meat better to avoid it especially 25:33 the red meats and exercise and those who 25:38 combine together will promote weight loss. 25:43 Even if you are eating a healthy diet, 25:46 we want you to eat your diet in moderation. 25:50 Even though whole grains are good for us, 25:54 we do not want you to pack your plate 25:56 and stuff yourself with these good food because 26:01 that will also promote obesity. 26:05 It's a biblical principle that 26:07 we should be temperate in all things 26:09 that includes way that we eat. 26:15 It also includes how much we exercise, 26:19 not enough exercise is not good, 26:21 but too much exercise isn't good either. 26:25 When you think about exercise 26:27 we want to think about the frequency, 26:30 the duration, and the intensity. 26:34 The frequency, the duration, 26:36 and the intensity would like you to exercise 26:39 on most days of the week that's the frequency. 26:42 What about the intensity? We want you 26:45 to exercise between 65 and 85 percent 26:49 of your maximum heart rate. 26:52 We don't want you to exercising at your 26:54 maximum heart rate that would just ware out 26:56 at your heart. We don't want that to happen 26:58 so we want you to stay in your target 27:02 training range and you can talk to 27:04 your physician about that. Your physician 27:06 will be able to based on your age calculate 27:08 what your target training ranges. 27:10 So the frequency, the intensity, 27:14 and the duration the institute of medicine 27:16 recommends between 30 and 60 minutes 27:20 of exercise. Moderate intensity exercise 27:24 within your target training range. 27:26 So as you can see across the lifespan 27:29 there are several things that you can do 27:33 to screen for the major killers 27:36 and there are lots of things that you can do 27:39 to prevent these major killers. 27:43 Being safe, being wise, choosing were you go, 27:48 choosing to wear a helmet, choosing to 27:51 avoid alcohol and driving, 27:53 choosing to get a Pap smear done, 27:57 choosing to do regular testicular exams, 28:00 choosing to get a colonoscopy done, 28:03 choosing to eat fruits, vegetables, 28:06 whole grains, and regular exercise. |
Revised 2014-12-17