Acupuncture for Drug-Induced Joint Pain - Aromatase Inhibitors & Breast Cancer

Acupuncture may help treat some of the common side effects of hormonal drugs called aromatase inhibitors.

Aromatase inhibitors, such as anastrozole (Arimidex), exemestane (Aromasin) and letrozole (Femara), are used to treat hormone-receptor-positive breast cancer in postmenopausal women. The drugs lower blood levels of estrogen, a hormone that stimulates the growth of these cancer cells. Although aromatase inhibitors are considered effective for early-stage cancer, nearly half of people taking them experience pain and stiffness in the joints and muscles.

The researchers studied 43 women with breast cancer who reported joint pain associated with aromatase inhibitors. The participants were randomly assigned to either true acupuncture or sham acupuncture twice a week for six weeks. During the sham acupuncture, a superficial needle was inserted into non-acupoints. All of the participants continued taking aromatase inhibitors.

At the beginning of the study and three and six weeks after treatment, pain was assessed using the Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH).

According to the results, published in theJournal of Clinical Oncology, true acupuncture significantly improved joint pain and stiffness after six weeks. In addition, 20 percent of the patients who reported taking pain-relieving medications no longer needed them after acupuncture treatment. No significant improvements were reported in the sham group.

The authors concluded that "acupuncture is an effective and well-tolerated strategy for managing this common treatment-related side effect."

Scientific evidence supports the use of acupuncture for several other indications, including osteoarthritis, chronic pain, post-operative pain, dental procedures, endoscopy-related pain, fibromyalgia and several types of nausea and vomiting.

References:

1. Crew KD, Capodice JL, Greenlee H, et al. Randomized, blinded, sham-controlled trial of acupuncture for the management of aromatase inhibitor-associated joint symptoms in women with early-stage breast cancer. J Clin Oncol. 2010 Mar 1;28(7):1154-60.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

The Importance of Quality Supplements - Unsafe Fish Oils in the News!

My patients know the importance of quality supplements and it's something I've talked about. You need to know that the supplements you're buying have the concentrations that they say they have on the bottle. Some studies have shown that you may not be getting what's on the label. You should know if the supplements you're taking have been made with good manufacturing practices (GMP) and have been tested for quality and for impurities.

In the case of a commonly used supplement like fish oils, one needs to know that there is zero to low levels of heavy metals (ie. mercury), polychlorinated biphenyl compounds (PCBs) and other impurities. Here at the clinic, we did not used to sell supplements. But with increasing demand from our patients, we now carry certain reputable brands that have been vetted for their good manufacturing practices and quality. As for fish oils which is now making the news, I have personally requested for the certificate of analysis which shows third party testing on the supplements we carry. Our patients can be confident of this and next time you're in, feel free to ask to see a copy of this report.

If you caught the news last night on the CBC, you would have heard about PCBs being found in a number of fish oil supplements. PCBs are known carcinogens and a lawsuit is underway naming certain companies and pharmacies in the United States.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Humour and Health - Medical Clowns....for Real

I wrote about this 'phenomenon' in a blog back in 2008: Laughter as therapeutic medicine! There was a hospital down in Mexico that was implementing laughter therapy and was seeing tremendous results. Unfortunately that clip of the work they were doing is no longer available.

In any case, I'm delighted to see that Toronto will be host to a medical clown conference. Who knew it was such big business? See The Star's article for more info. It's great that laughter therapy/medicine has made its way to Sick Kids. I would like to see it implemented in palliative care settings as well as seniors homes and oncology wards. This would be money well spent.

Ask yourself this, are you having fun in life? Are you enjoying life? You'd be surprised how many people respond 'no' or 'not sure'. Usually, I just pause and repeat "So you're NOT SURE if you're enjoying life?"

[SILENCE]

It's like a light bulb turning on. Some patients make changes and others will rationalize or make excuses. The truth is, if you want to see change in your life, you NEED to make a concerted effort to change this status quo. Whether your goal is to lose weight or to be happier, it takes effort. Sometimes it takes a lot of planning and other times you may require the help of a coach or third party than can be objective and truthful with you.

I leave you with this quote from the Bible "A cheerful heart is good medicine."

Whether you're religious or not, I think we can all agree that's some good advice!

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Prescription Drug Abuse & Addiction - A report from the US National Institutes of Health

This is a great article from the U.S National Institutes of Health and it describes the most commonly abused medications and how they can affect you. I have seen patients who have become dependent and I am always reminded by the patients I observed & the stories I heard while preceptoring with a rheumatologist during my training days.

You can access this article here.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Marijuana - What's the harm you ask?

I've gotten this question a number of times, what's the harm of smoking pot? Many people say that it's not addictive and it can't be any worse than cigarettes, so why is it illegal. I'm not a politician or a judge so I'm not going there.

But I will talk about the health implications. We know for a fact now that when we breath in noxious fumes or smoke, this causes damage to our lungs. Not only that, but the toxins in the smoke is carried into our body through various organs including the kidneys & liver. These are more commonly known consequences associated with smoking marijuana.

Few people know of the other potential consequences, namely that marijuana increases the risk of developing schizophrenia & psychosis. Schizophrenia is a condition where by one experiences hallucinations and delusions. Cannabis use nearly doubles the risk of psychosis especially if one starts early. Heavy use before 16 years of age can quadruple ones risk.

There is a misperception that marijuana, the drug of choice of the "flower-power" generation in the ninety-sixties is a harmless drug. What people don't realize is that modern marijuana does not resemble the pot of the 1960s. Tetrahydrocannabinol (THC) the active ingredient in marijuana that produces the psychedelic effects was in the 1-3% range in the 1960s. Now, plants seized from illegal grow-ops have staggering amounts of THC in the range of 18-25%. THC increases dopamine levels in the brain which heightens awareness. This extra awareness can lead some to perceive things that aren't happening, hence the hallucinations.

Marijuana plants naturally contain a compound called cannabidiol (CBD) that buffers the actions of THC - much like green tea has theanine, which buffers caffeine's actions - but this too is being bred out making today's pot that much more potent.

Now, most people who smoke marijuana don't end up with psycosis, but there are segments of the population for reasons not yet known are more susceptible. What researchers do agree on is that there are certain risk factors marijuana smokers need to be aware of.

Risk Factors
- Family History of psychosis & schizophrenia
- Use of other drugs like cocaine or crystal meth.
- Living in an urban area.

This last risk factor is a strange one. I'm guessing that urban folks have more access to these drugs so that may be the reason, though I'm not sure if researchers accounted for this in there statistical analyses. Those who have a family history of mental disorders may want to think twice before lighting up next time.

Teens are the most prevalent users of marijuana and a teenager's brain is still actively trying to sort itself out. This may be why psychosis risks are greater for early users of marijuana.

There are medicinal benefits to marijuana and many years ago when I worked in a clinic that treated HIV/AIDs patients, I saw tremendous improvements in appetite, weight gain and pain management in some of my patients. But I would just like to caution those who are under the impression that this drug is without any negative side effects.


Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Colouring & Food Labelling - Health Canada wants your Opinion

I've preached to patients the importance of reading labels and sometimes we will read on the labels "colour". For most of us, we are not affected by this, but for some people who are sensitive to certain types of colouring, the term "colour" doesn't say much.

Health Canada wants your input on this topic. From Feb. 8 - May 4, 2010, Canadians will have the opportunity to comment on this topic.

You can voice your opinions on Health Canada's website, by mail to:

Bureau of Chemical Safety
251 Sir Frederick Banting Drive, Health Canada, Tunney’s Pasture, Address Locator: 2203B, Ottawa, Ontario K1A 0L2.

Comments by email can be sent to bcs-bipc@hc-sc.gc.ca, using the words “Food Colour Labelling” in the subject box.


Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

A link between soft drinks & pancreatic cancer?

News of Coca Cola's strong growth overseas sent its share prices higher. That's the news from the business pages. On another front, there's a large Singaporean study showing that sugary soft drinks are now linked to pancreatic cancer, one of the more deadlier cancers out there.

Analysis of 60,000+ adults showed that those who drank two or more sugary soft drinks per week were at greater risk of developing pancreatic cancer. Notice that amount, two per week! Many people drink that much per day!

However, this link does not prove cause and effect. Rather it should be noted that many people who consume generous amounts of pop tend to also live an unhealthier lifestyle, be it from lack of activity, poor diets, smoking and drinking alcohol.

This is why I often tell patients that they need to make wholesale changes to their lifestyle to achieve good health. In fact, there's a study out there showing that it is often easier for patients to make wholesale changes than cutting out little things here and there. When patients have the proper motivation and someone that can guide them, better longer lasting results are seen with those that make big changes. I can definitely attest to that fact.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

Acupuncture vs. Drug Therapy (Hot Flashes & Sex Drive)

In a study published in the Dec. 2009 Journal of Oncology comparing the benefits of acupuncture vs. Effexor, the number one choice for the treatment of hot flashes - something that affects the majority of breast cancer survivors - the randomized control trial showed that acupuncture had a longer-lasting effect on the reduction of hot flashes and night sweats for women receiving hormone therapy for breast cancer. The women also reported additional energy, improved sex drive and clarity of thought with the acupuncture treatments.

A good article summarizing the findings can be found here.

Journal Reference:

1. Walker et al. Acupuncture Versus Venlafaxine for the Management of Vasomotor Symptoms in Patients With Hormone Receptor-Positive Breast Cancer: A Randomized Controlled Trial. Journal of Clinical Oncology, 2009; DOI: 10.1200/JCO.2009.23.5150

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

H1N1 vaccine makers & The WHO are being Investigated

I heard recently from the news that the second wave of H1N1 has been declared over in Canada. To be honest, we haven't seen too many concerned patients clamouring for H1N1 treatments or for information regarding the vaccine since the initial scare. The Canadian government had ordered enough vaccines for every single Canadian. As a result of the low vaccination rates, I believe we ended up donating much of the vaccines to other countries.

I haven't had to answer an H1N1 question for so long, but two interesting notes came to my attention this week.

1) A patient here at the clinic (who reads European & Russian newspapers) informed us that there were big investigations getting started in Europe regarding the involvement of the pharmaceutical industry's reach and their ability to influence the World Health Organization. That sounded far-fetched to me (as I'm not one to believe in conspiracy theories). But it appears that an inquiry is being launched. This is news that has yet to appear here in North America. You can read more about this here.

2) Apparently pregnant women in Hong Kong have stopped getting the H1N1 vaccine. This has happened as news of 3 fetal deaths occurring in the last month after women received the H1N1 shot. I believe that at least one of these women had an underlying complication.

Frankly, I don't know enough about what's happening in Asian or Europe to make a well-informed commentary, but for those of you who would like to do further research, send me an email or links for what you find and I'll try to post relevant information for our readers.

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

New Year's Resolutions! Weight Loss & Quitting Smoking

Happy 2010 everyone!

Like every other year, many of you have set New Year's Resolutions for yourself. Two common ones seen here at the clinic is to 1) Lose Weight and 2) Quit Smoking.

First off, if you've tried to do this in the past and were unsuccessful, don't despair! If at first you don't succeed, try, try, try again.......and believe me, you will eventually get it right. Sometimes though, people just need a helping hand: support from friends and family members, advice from a professional or health care practitioner who is knowledgeable in these areas and can guide you through tough times is a must.

Failures should be looked upon as learning opportunities. It's what I tell all my patients. Don't beat yourself up about past failures. LEARN from them! Why were you unsuccessful in previous attempts? Make a list and work on solutions to those obstacles because these obstacles will be present this time around as well.

Obesity in a recently published report in the American Journal of Preventive Medicine now ranks as the biggest health risk in North America, ahead of smoking! Who would have thought? It appears that the anti-smoking campaign this past decade has been making a considerable impact. Smoking rates have declined 18.5% in the U.S. between 1993 to 2008, however we've seen obesity rates increase by 85% over the same time frame. It should be noted that approximately 20,500 Canadians died of lung cancer in 2009 and 85% of that was due to smoking. I often tell smokers that they need to be aware that smoking increases the risks of ALL cancers - the smoke and the toxins pass through your entire body - the liver, kidneys, bowels - not just your lungs.

Diabetes, high cholesterol, hypertension and even things like low libido and erectile dysfunction can be attributed to one being overweight. My patients know that I'm not a fan of fad diets. I don't even like that word - 'diet'. It sends the wrong message. Diets too often implies that we'll be eating a certain way for a set period of time. But what happens when you go off the diet? Can you sustain this way of eating? The end goal isn't all about losing weight, it's about what kind of weight you've lost (ie. fat instead of muscle) and how you feel (ie. more energy). Often times, people find other health concerns are diminished when they lose weight (ie. back pain).

So make 2010 a good year.....the year you finally quit smoking and get your weight under control. Do this for yourself and for your loved ones!

Yours in health,

Ian Koo, ND
Doctor of Naturopathic Medicine

Naturopathic Essentials Health Centre
"The care you want, the health you need"

FYI: 2010 is the year of the nurse. To all my friends and colleagues who are nurses, have an especially good year. We appreciate the job you're doing!