Palliative care

Palliate means to relieve.

Palliative care means a relief of suffering for people with serious medical diseases. Cancer is probably the best example.


Palliative care includes

*Pain relief
*Symptoms management: treating nausea, weakness, confusion, bladder and bowel problems, shortness of breathes
*Spiritual support
*Emotional support

The goal is to provide comfort care and increase quality of life for terminally ill person.

Addressing mental health and spiritual needs, palliative care focuses on compassionate care and love.

Home, hospice, or hospitals may be used in specialized palliative care programs for cancer.

Family may need to develop a plan for managing financial expenses, loss of income, transport, shopping, cooking needs Medical professionals can provide valuable advice for suffering families.

High-quality palliative care makes the difference between a death with dignity and one in which suffering is terrible and prolonged.


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Cancer prevention

Aleksandr Kavokin MD, PhD


How to prevent cancer?

Cancer cells are mutated cells.

Those mutations could be inherited from parents. There is little you can do to change your family history. However knowing your family history of cancer and performing genetic testing can help in early detection of tumors and better, more focused treatments.

Other Factors leading to cancer can actually be altered - lifestyles, environment, bad habits.

There are usually two events are prominent in the development of cancer cells - Initiation and promotion .

So, there are two factors - initiator and promoter. Let's explain simply. Let's say you have a new car. It 's shiny. You love it. It goes fast. Zoom. It smells so good, so new.

Now, go and scratch the paint until you see bare metal. This is initiation. Your nail is an initiator.

Now go drive in humid climate, near the salty ocean. Or go north, where they use salt to rid off snow. The salt and water are promoters.

Now you have a rusty car.

The same happens with normal cells - they should be first damaged, and then this damage get help of other factors. Then you get the tumor.


What are initiators and promoters? Initiators are:

*Viruses (for example EBV- virus that cause kissing disease; or HPV - usually very harmless but eventually may cause cervical cancer - recently they develop vaccine against HPV for women protection)
*Chemicals
*Ultraviolet radiation - this is why they ask you to avoid sun X-ray and Gamma radiation. Leukemia hit Japanese hard after Hiroshima and Nagasaki.
*Genes inherited from parents

Promoters are:
*Hormones
*Chemicals
*Different types of irritation and inflammation form other diseases and so on

There is a theory of multiple hits. That suggests that a cell needs at least 6-7 different hits before it goes really nuts. There are also several protective mechanism known and unknown - inside cells and outside.


So you need to break many of them as well to get cancer cells growing and spreading. Generally speaking there are still plenty unknowns in the picture of cancer development. However, knowing the risk factors and avoiding them may significantly reduce your chances for cancer. So what should you do or do not?
-Don't smoke. Smoking leads to one third of cancer deaths (this is because lung cancer is the most aggressive killer). Lighted cigarette produces more than 40 chemicals causing cancer. Pipes or cigars produce less smoke that goes into lungs, but more into mouth. So, you will have increased chances of mouth cancer.
-Diet. Everybody talks about diet. Diet this - diet that. Swinging back and forth. Current recommendations - eat fruits and vegetables. A lot. Decrease saturated fat (this mostly animal fat, processed food) Include high-fiber - whole-grain bread, cereals, vegetables, fruits.
Charred, over-fried foods increase chances for getting cancer. Fried food is often rich in carcinogens.
-Decrease alcohol drinks. Abuse of alcohol increases chances for oral and esophageal cancer
-Obesity and overweight were linked to breast, colon, and uterine cancers.
-Avoid ultraviolet-rich sunlight (from 11 am to 4 pm)
-Use sunscreens. Protect skin with clothes, eyes with sunglasses
Total luck of sun exposure was recently reported linked to higher incidence of prostate cancer. This item is still controversial
-Avoid excessive tanning, especially artificial sunlight
-Exercise.
Lack of physical activity helps in development of breast and colon cancer.
Do even small exercise - use stairs and walk. Walk a lot.
-Check if you have hazards at your working place or home. Majority of chemicals and equipment have safety data sheets. The sheets tell you what could be carcinogenic.
-Avoid exposure to known carcinogen s- x-ray, arsenic, asbestos, nickel, etc. Use protective devices and clothes.
-Have periodic check by a doctor
-Have a mammogram starting at 40, colonoscopy around 40-50, PAP smear - starting at 20.
-Perform self-exams of your skin and breast
-Monogamous relationships are a sure bet to prevent many cancer-related problems.

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What causes cancer?

What are initiators and promoters?


* Viruses (for example EBV- virus that cause kissing disease; or HPV - usually very harmless but eventually may cause cervical cancer - recently they develop vaccine against HPV for women protection)

* Chemicals

* Ultraviolet radiation - this is why they ask you to avoid sun X-ray and Gamma radiation. Leukemia hit Japanese hard after Hiroshima and Nagasaki.

* Inherited form parents


Promoters are:

* Hormones
* Chemicals
* Different types of irritation and inflammation form other diseases and so on

There is a theory of multiple hits. This suggests that a cell needs at least 6-7 different hits before it goes really nuts.

There are also several protective mechanism known and unknown - inside cells and outside.

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What is cancer?

Cancer types include hundred diseases with excessive, uncontrolled growth of abnormal cells that invade and destroy other tissues.

* There are several definitions of malignancy.

Any description of Malignant tumors (and cancer fist off all) should include at lest 2 important features:

* Invasion

* Metastases.

* There are also other elements that characterize malignancy: anaplasia (loss of distinctive cell features, loss of normal features, regression) heteroplasia (overgrowth of another cell type), neoplasia (tumor formation), metaplasia (transformation of some cell type to another, tranformation of tissue) Loss of contact inhibition, metalloproteases (that help cancer to dissolve membranes and go where it shouldn't go normally) And so on.

* However eventually it all leads to the same 2 scary cancer features. Invasion and metastases are the 2 main things that make cancer so formidable and so feared for physicians. You can cut tumor, but you cannot cut out every metastases in body and if tumor grow into another life-important organ, you cannot get it out too.



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Heart failure prevention

To avoid heart failure or at lest to slow down the progression you should:

* Follow recommendations of your doctor and use heart and blood pressure medication responsibly

* Follow healthy diet

* Decrease salt consumption

* Watch your weight and cholesterol consumption

* Avoid stress in your life

* Avoid alcohol

* Avoid tobacco

* Avoiding tobacco, decreasing fat in your food, exercising would help to prevent one of the main reason of heart failure - Coronary Artery Disease. However if you already have heart failure, consult your doctor about exercises, because later stages of heart failure require special treatment.

For treating heart failure your doctor may prescribe certain medications, that increase function of your heart, change heart rate. Management of those medications is a sort of art (though obviously strict recommendations exist).
In the worst cases you may need surgery - valve repair. Very late stages may need heart transplant.
In any case to prevent is easier than to treat.




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What happens when you have the heart failure?

What happens when you have the heart failure?


Your hear t becomes big and weak, or the valves of your heart start to leak. Or Both.
That leads to all kinds of troubles.

Main thing is the decrease of blood and oxygen supply to all of your organs. Weak pump can not pump well. Everything leaks backward. Also, because everything leaks back, the blood and fluid overall tends to stay in tissues and organs.

The fluid accumulates in lungs and cause your wheezing. You have coughing and difficulties breathing, especially when lying flat.

The fluid also stays in lower part of your body. You ankles, feet, abdomen, liver swell. The conduction of electric impulses in a big, stretched heart becomes disrupted. That causes irregular and rapid heart beats. Luck of blood and oxygen in the upper part of body causes bluish color of lips, fingers and face. The brain deprived of oxygen makes you feel tired, decreases concentration and attention, causes troubles with sleeping.

To treat heart failure is difficult.

As with majority diseases it is easier to prevent the condition.

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How to avoid heart failure? Intro

Aleksandr Kavokin MD, PhD

Just the name "heart failure" sounds terrible. Doesn’t it? Your main pump goes down. Really scary. If you hear it form you doctor, it's not good. However if you watch yourself carefully you may prevent heart failure. In the least you can really slow down the process.

What is the heart failure? The term means exactly this: your heart does not work well. Usually the symptoms develop slowly over the many years. Though sometime the condition may happen suddenly. You may start to pay closer attention to your health if you:

* Had heart defects since you were born

* Had problems with blood supply to the heart due to narrowing of blood vessels (usually it happens because of atherosclerosis). Atherosclerosis is a condition where there are plaques on blood vessels. The plaques may contain cholesterol, calcium, some special cells and other material. Whole spectrum of diseases has a name of Coronary Artery Disease. Cutting of blood supply causes damage of the heart.

* Had a damage to heart form using some medications, drugs or abusing alcohol

* Had a damage to the heart valves from Rheumatism, Endocarditis or other heat diseases

* Had high blood pressure damaging your heart.


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