HEALTH MATTERS: Your health questions answeredQ. On a recent television show, the celebrity Dr. Mehmet Oz indicated that thyroid cancer is increasing dramatically in frequency, especially in women.
By: Dr. Joshua Wynne , Grand Forks Herald
Q. On a recent television show, the celebrity Dr. Mehmet Oz indicated that thyroid cancer is increasing dramatically in frequency, especially in women.
I understand that thyroid cancer can be related to radiation exposure, so should I be concerned, especially given the prevalence of dental X-rays and the recent nuclear reactor accident in Japan?
A: While it is true that the diagnosis of thyroid cancer has about tripled in the past 30 years or so and has doubled in women in less than a decade, these statistics are somewhat misleading for a number of reasons.
First of all, while the relative frequency of thyroid cancer has increased, the total number of cases is still quite low, because thyroid cancer is actually uncommon overall. Second, the death rate from thyroid cancer has not increased, suggesting that many of the cancers diagnosed more recently did not pose a major health risk even if untreated. Thus, we suspect that many of the “new” cancers are the result of better diagnostic techniques and not necessarily the result of a true increase in the frequency with which thyroid cancer occurs.
Finally, thyroid cancer is, in general, eminently treatable, with more than 97 percent of patients surviving. While thyroid cancer can be serious — and even fatal, the good news is that you should not be overly concerned. If you are having needed dental X-rays, I recommend that you insist on a lead thyroid shield, but this is something that dentists typically provide. If you do notice a lump in your throat, by all means have your health care provider take a look at it.
Q. I understand that there have been changes in the recommendations regarding cardiopulmonary resuscitation. How have the recommendations changed?
A. CPR is used when the heart is unable to pump an adequate quantity of blood to the vital organs of the body, a condition termed “cardiac arrest.” Usually the result of an abnormal heart rhythm (either too fast or too slow), patients with cardiac arrest typically succumb if not supported by CPR until definitive medical care is available.
Unfortunately, even with CPR, the long-term survival of patients suffering out-of-hospital cardiac arrest is not good; probably no more than 10 percent or so recover to a reasonable level of functioning.
However, 10 percent is better than zero percent, and in some cases — especially in children and young adults—the results can be amazing and dramatic. Two new developments have been suggested that may improve the results even more. First, we have learned that of the two things we do during CPR (compress the chest to pump blood to the body and do mouth-to-mouth breathing to get oxygen into the patient’s lungs), the more important by far is chest compression.
Thus, it now is recommended to emphasize chest compression, rather than the breathing part. Second, we have learned that because most cases of cardiac arrest are the result of fast heart rhythms, shocking the heart back to regular rhythm can be even more effective than CPR. This has led to the increased deployment of automatic external defibrillators around the community. These devices are easy-to-use even for novices, inexpensive and effective.
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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