Why Thyroid disease Matters to your Cardiologist

Why Thyroid Disease Matters to your Cardiologist

The thyroid gland regulates the body’s metabolism through the production of the hormones thyroxine (T4) and triiodothyronine (T3). While often associated with weight management and energy levels, thyroid health also has a significant impact on cardiovascular health. Thyroid function can easily be assessed with simple blood tests.

Thyroid hormones influence heart rate, cardiac output, and vascular resistance. When thyroid function is disrupted—either by hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)—it can lead to complications that increase the risk of heart disease.

In hypothyroidism, low levels of thyroid hormones slow the heart rate and reduce cardiac output. It also raises levels of LDL cholesterol (“bad cholesterol”), which contributes to atherosclerosis, the disease process that results in coronary arteries becoming narrowed, thereby increasing the risk of heart attacks. Additionally, hypothyroidism may lead to diastolic dysfunction, where the heart has difficulty relaxing between beats.

Conversely, hyperthyroidism accelerates the heart rate and increases cardiac workload. This can result in conditions like atrial fibrillation, an irregular heartbeat that heightens the risk of blood clots and stroke. Persistent hyperthyroidism can also cause cardiomyopathy, weakening the heart muscle over time.

Recognizing the link between thyroid health and heart disease is essential for early detection and prevention. Symptoms such as fatigue, unexplained weight changes, palpitations, or swelling should prompt a discussion with your doctor. Early detection of thyroid imbalance and proper management whether through medication, lifestyle changes, or surgery, can significantly reduce cardiovascular risks. 

Contributed by
Dr Rohit Khurana
Consultant Cardiologist

Harley Street Heart and Vascular Centre
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A Healthier You This Festive Season

A Healthier You This Festive Season

The festive season is a time for indulgent feasts and heartfelt connections. However, it’s also a time when calorie-dense foods and a sedentary lifestyle can take a toll on our health. Studies show adults can gain between 0.4 to 0.9 kg during the holidays, primarily due to increased food intake and reduced physical activity (1).

While the festive season is a time for enjoyment, making mindful choices can help you stay healthy and feel your best.

Tips for Healthy Eating

Here are some tips to maintain a balanced approach to eating during the festive season:

  1. Mindful Portion Control: Using smaller plates can help manage portion sizes, and starting meals with high-fibre foods like salads can promote satiety.
  2. Healthier Cooking Methods: Opt for baking, steaming, or grilling over deep-frying. For example, baking or air-frying snacks can reduce fat content.
  3. Limit Sugary Beverages: Alcoholic and sugary drinks can add unnecessary calories. Consider water or sugar-free options to maintain calorie balance.

Staying Active

Physical activity often takes a backseat during the festive season. To counteract this:

  • Incorporate Movement: Engage in family activities like walking tours of festive light-ups, shopping to keep up with steps or playing games.
  • Set Realistic Goals: Aim for at least 150 mins of moderate-intensity aerobic activity weekly, as recommended by the Health Promotion Board (HPB) (2).

Managing Stress

Sometimes the hustle and bustle of festivities such as financial pressure or last minute preparations can lead to stress. Here are some tips to help manage it more effectively:

  • Prioritise Sleep: Ensure you get 7-9 hours of quality sleep to help manage stress and maintain energy levels (3).
  • Practice Mindfulness: Techniques such as deep breathing or meditation can help reduce anxiety (4).
  • Plan Ahead: Organise your schedule to balance social commitments with personal downtime.

While indulging in the festivities, don’t forget to keep an eye on your overall health. By making mindful choices in eating, staying active, and managing stress, you can enjoy the festivities without compromising your health. Let’s embrace a balanced approach to ensure a joyful and healthy holiday season.

Thank you for your time. 

Sincerely,
MHC Asia Group

References

  1. Díaz-Zavala, R.G., Castro-Cantú, M.F., Valencia, M.E., Álvarez-Hernández, G., Haby, M.M. and Esparza-Romero, J. (2017). Effect of the Holiday Season on Weight Gain: A Narrative Review. Journal of Obesity, [online] 2017, p.2085136. doi:https://doi.org/10.1155/2017/2085136.
  2. Lee, Y.S., Biddle, S., Chan, M.F., Cheng, A., Cheong, M., Chong, Y.S., Foo, L.L., Lee, C.H., Lim, S.C., Ong, W.S., Pang, J., Pasupathy, S., Sloan, R., Seow, M., Soon, G., Tan, B., Tan, T.C., Teo, S.L., Tham, K.W. and van Dam, R.M. (2016). Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Obesity. Singapore Medical Journal, [online] 57(6), pp.292–300. PubMed: https://pubmed.ncbi.nlm.nih.gov/27353244/.
  3. Baranwal, N., Yu, P.K. and Siegel, N.S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in Cardiovascular Diseases, [online] 77(77), pp.59–69. doi:https://doi.org/10.1016/j.pcad.2023.02.005.
  4. Shattell, M. and Johnson, A. (2017). Three Simple Mindfulness Practices to Manage Holiday Stress. Journal of Psychosocial Nursing and Mental Health Services, 55(12), pp.2–4. doi:https://doi.org/10.3928/02793695-20171117-01.

Red Face After Drinking Alcohol – Is My Liver “Stronger”?

Red Face After Drinking Alcohol – Is My Liver “Stronger”?

Having a red face after drinking alcohol is commonly believed to be a sign of strong qi (energy flow) or good blood circulation. The truth is that this is an indication that one’s body is not breaking down alcohol efficiently.

This condition is known as “Asian Flush Syndrome” which is commonly observed in East Asian descent (Chinese, Japanese, Korean, etc). It can manifest as facial flushing and increased heart rate, amongst other symptoms.

Causes of Asian Flush Syndrome

How well the body metabolises or breaks down alcohol is dependent on 2 enzymes: alcohol dehydrogenase (converts alcohol into acetaldehyde), and acetaldehyde dehydrogenase (ALDH2) which breaks down acetaldehyde into harmless substances (1).

About 80% of Asians have an overactive alcohol dehydrogenase, this causes alcohol to break down to acetaldehyde faster – up to 100 times faster. As alcohol is broken down faster, there may be little or no alcohol “buzz”.

Making matters worse, most Asians have an inactive variant of the liver enzyme ALDH2. This means that acetaldehyde takes much longer to clear from the blood. This is the primary cause of Asian Flush Syndrome. Acetaldehyde accumulates in the body, causing the characteristic flushing when blood vessels dilate. The flushing is also associated with nausea, headache and increased heart rate.

Risk of cancer

The build-up of acetaldehyde causes the facial flushing as blood vessels dilate. This problem is not just aesthetic, as acetaldehyde is more toxic than alcohol, and is a known cancer-causing agent (2).

Acetaldehyde can cause inflammation of the upper gastrointestinal tract, and cause DNA damage. As such, individuals with ALDH2 deficiency who regularly consume alcohol have an increased risk of developing oesophageal cancers, stomach cancers and peptic ulcers.

Tips to manage Asian Flush Syndrome

1) Drink moderately, or don’t drink 

Drink moderately if you must drink. Men should limit themselves to 2 standard alcoholic drinks per day, and women should limit to 1standard drink per day. One standard alcoholic drink is equivalent to 1 glass of wine (150 ml/12.5% alcohol), or 1 can of beer (350 ml/5% alcohol)

2) No binge drinking

Binge drinking overloads the body’s ability to breakdown alcohol. With the Asian Flush Syndrome, one should wait till the redness subside before taking another drink. This is because the liver can only metabolise 1 ounce of alcohol per hour, which is equivalent to 1 standard drink (1 can of beer or 1 glass of wine).

3) Choose drinks with lower alcohol content

Be mindful of the bottle labels. As a rule, beers, or wines have a lower alcohol content than spirits.

Contributed by:
Dr Victor Lee Tswen Wen
Senior Consultant,
Hepatobiliary/General Surgeon
HMI Medical Centre (Farrer Park)
12 Farrer Park Station Road, Singapore 217565
Other locations: https://www.liversurgery.com/contact-us.html

References

  1. Edenberg HJ. The genetics of alcohol metabolism: role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Res Health. 2007;30(1):5-13.
  2. Sim W, Pan JT, Chua CWX, Fong KY, Wong SH, Lee B, Oon HH. Association between alcohol flushing syndrome and cancer: A systematic review and meta-analysis. Ann Acad Med Singap. 2024 Jul 30;53(7):420-434.

Understanding the Effects of Blue Light Effects on the Skin

Understanding the Effects of Blue Light Effects on the Skin

Did you know that your smartphone, laptops, and TV screens actually give off blue light? In the last decade, dermatologists and researchers have uncovered that blue light is emitted from digital devices, which is commonplace in our daily lives, particularly at the workplace. This has led to increased attention on the effects of blue light and our skin.

Blue light is part of the visible light spectrum, which is naturally emitted by the sun. However, with the proliferation of artificial sources like smartphones and mobile devices, this has greatly increased our exposure to blue light. At the workplace, the regular professional working in an office-based setting, spends an average of 7 hours a day in front of screens.

What blue light does to our skin

It is vital to understand that blue light penetrates the skin more than ultraviolet (UV) light, which allows it to reach the deeper layers where collagen and elastin are found, which will manifest with the following in the skin:

  1. Skin aging – This leads to damage of important structures of our skin that leads to damage of DNA and important structures. This causes the skin to lose its firmness and elasticity, leading to wrinkles and sagging.
  2. Hyperpigmentation – Research has shown that blue light worsens existing pigmentation conditions, i.e melasma. This is more accentuated in individuals with darker skin tones.
  3. Skin inflammation – Prolonged exposure blue light has been shown in studies to lead to increased inflammation, which leads to worsening of conditions such as acne and dermatitis.

On the other hand, it is also necessary to understand that dermatologists have also harnessed the effects of blue light in the medical setting to treat the skin. For example, blue light in licensed medical devices has been shown to have anti-bacterial effects and used to treat conditions like acne and reduce inflammation in psoriasis skin. However, it is rarely used in isolation, and combination treatment with topical creams and oral medications, is required to effectively treat the aforementioned conditions.

How can I protect myself in the workplace?

In the workplace, we are constantly exposed to digital devices, computer screens and LED lighting. It then becomes essential to integrate these simple steps to reduce the ill-effects and protect our skin:

  1. Broad-Spectrum Sunscreens: Look for sunscreen that offers wide protection from UV light and include ingredients that protect against visible light (which will include blue light).
  2. Device management: Install a blue light filter on your laptop screens to reduce exposure. It is also advisable to take regular screen breaks, which can be achieved by taking a 20-second break every 20 minutes to look at something 20 feet away. Many computer operating systems also have adjustable screen settings to reduce blue light emission during evening hours.
  3. Build a healthy lifestyle regime: Incorporate a diet rich in anti-oxidants like fruits and vegetables to support against the oxidative stress you are subjected to from blue light, which goes a long way to supporting the healthy renewal of your skin.

When do I need to seek help? 

As blue light exposure in the workplace becomes increasingly unavoidable, learning more about skin protection becomes important. If you notice any effects on blue light showing on your skin, it is advisable to pay a visit to your dermatologist before starting yourself on skincare products. You might read that products containing vitamin C, vitamin E, and niacinamide, may be useful to help with your skin. However, it is important to ascertain if these are suitable for your skin and skin type. Your dermatologist will evaluate your skin type, understand your concerns, and evaluate if any existing conditions are present that may conflict with treatment options available. The most suitable plan can then be formulated to address your needs.

Conclusion 

Many professionals have to spend long hours in front of screens, whether at their desk in front of a laptop or in meetings with digital presentations. The cumulative effect of blue light exposure can contribute to premature skin aging, hyperpigmentation, and increased inflammation, particularly in those with sensitive skin.

While more research is still required to fully comprehend the full impact of blue light and our skin, current evidence suggests that it plays a role in many skin conditions. It is therefore important to understand the effects of blue light, and to proactively seek medical help from a dermatologist to help protect your skin early, so as to keep up with the demands of a digital work environment.

Schedule an appointment with Dr Kok today at the clinic most convenient for you and get personalised advice on prevention and skincare tips to protect your skin from the effects of blue light:

Contributed by:

Dr Kok Wai Leong

Senior Consultant Dermatologist,

HMI Medical Centre Farrer Park & MHC Medical Centre (Amara)

References

  1. Clement M, Daniel G, Trelles M. Optimising the design of a broad-band light source for the treatment of skin. J Cosmet Laser Ther. 2005 Dec;7(3-4):177-89.
  2. Regazzetti C, Sormani L, Debayle D, Bernerd F, Tulic MK, De Donatis GM, Chignon-Sicard B, Rocchi S, Passeron T. Melanocytes Sense Blue Light and Regulate Pigmentation through Opsin-3. J Invest Dermatol. 2018 Jan;138(1):171-178.
  3. Mahmoud BH, Ruvolo E, Hexsel CL, Liu Y, Owen MR, Kollias N, Lim HW, Hamzavi IH. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Invest Dermatol. 2010 Aug;130(8):2092-7.

How Cold Weather Affects Heart Health

How Cold Weather Affects Heart Health

For people residing in Singapore, the cool breeze that comes with visiting cold countries can be both refreshing and exhilarating. Whether you’re flying for a winter holiday or visiting Christmas markets, experiencing freezing temperatures can be a delightful change from Singapore’s warm and humid climate. However, while cold weather may seem harmless, it can pose risks to heart health. Do be cautious when travelling overseas, especially during winter, especially if you have an underlying heart condition (1).

In this article, we will explore how cold weather impacts your heart and circulatory system, how you can protect yourself, and why it’s essential to take heart health seriously when travelling to colder regions.

Increased Blood Pressure and Heart Rate

In colder weather, several physiological changes occur that can strain the heart. Even a slight drop in temperature can lead to changes in blood pressure, heart rate, and overall cardiovascular health (2).

When temperatures drop, the body responds by narrowing blood vessels, a process known as vasoconstriction. This helps to preserve core body heat but also increases the resistance the heart has to overcome to pump blood. Consequently, blood pressure rises. For individuals with pre-existing heart conditions, this added strain can lead to an increased risk of heart attack and stroke.  

Impact of Seasonal Behaviour Changes

When travelling overseas in the cooler months, lifestyle changes can also affect heart health. Singaporeans may tend to stay indoors more, which can reduce physical activity levels. Additionally, the holiday season often brings dietary indulgences and increased alcohol consumption, both of which can negatively impact heart health.

1. Reduced Physical Activity

Staying indoors more often may lead to a decrease in physical activity, which is vital for maintaining cardiovascular health. Regular exercise helps to manage weight, lower blood pressure, and reduce cholesterol levels. The cooler months can be a challenge for maintaining an active lifestyle, but it’s important to find ways to stay moving (4).

2. Diet and Alcohol Consumption

The festive period may lead to increased consumption of rich foods and alcohol. Excessive intake of these can contribute to weight gain, high cholesterol, and hypertension (5).

Protecting Your Heart During Cooler Months

Fortunately, there are several strategies that we can use to safeguard their heart health during the cooler seasons.

1. Stay Active

Even if it’s cooler outside, maintaining an exercise routine is essential. Activities such as brisk walking, indoor workouts, or joining a local gym can help keep your heart in good shape. Consider activities that can be done indoors or during the warmer parts of the day.

2. Dress Appropriately

If you do go outside, make sure to dress in layers to stay warm. This helps to avoid sudden changes in body temperature, which can strain the heart. Layering also allows you to adjust your clothing as needed to stay comfortable during physical activity (6).

3. Monitor Your Diet

Be mindful of your dietary choices. Opt for heart-healthy foods such as fruits, vegetables, whole grains, and lean proteins. Limit intake of saturated fats, sugars, and alcohol.

4. Stay Hydrated

Dehydration can increase the risk of heart problems by affecting blood viscosity. Ensure you drink plenty of water throughout the day, even if you’re not engaging in intense physical activity.

5. Regular Check-Ups

Regular medical check-ups can help monitor blood pressure, cholesterol levels, and overall heart health. For men, who are at a higher risk for heart disease, it’s especially important to stay on top of these health metrics.

Understanding the Statistics

While heart disease is a global issue, Singapore has seen an increasing prevalence of heart-related illnesses in recent years. According to the Singapore Heart Foundation, heart disease accounts for 30.9% of all deaths in the country in 2023. The rising trend is attributed to factors such as ageing, lifestyle choices, and the increasing prevalence of conditions like high blood pressure, high cholesterol, and diabetes (7).

Conclusion

Travelling to colder countries is exciting and enriching, but it’s essential to be mindful of the impact that cold weather can have on your heart. As a Singaporean, your body may not be accustomed to extreme cold, so taking precautions can prevent serious heart problems. Dress warmly, stay active but avoid overexertion, maintain a healthy diet, and always listen to your body. With proper care and planning, you can enjoy your winter holidays while keeping your heart safe.

References:

  1. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/cold-weather-and-cardiovascular-disease
  2. https://pubmed.ncbi.nlm.nih.gov/20036896/
  3. https://pubmed.ncbi.nlm.nih.gov/6437575/
  4. https://pubmed.ncbi.nlm.nih.gov/26907579/
  5. https://jofem.org/index.php/jofem/article/view/150/177
  6. https://apps.dtic.mil/sti/pdfs/ADA445604.pdf
  7. https://www.myheart.org.sg/health/heart-disease-statistics/

Prevention of Cardiovascular Disease

Prevention of Cardiovascular Disease

Heart health often takes a backseat in the hustle and bustle of everyday life. But here’s a friendly reminder: prioritising your well-being isn’t just an option—it’s a necessity. Let’s dive into key preventive measures for cardiovascular disease that every Singaporean should know about.

1. Adopt a Heart-Healthy Diet

A balanced diet is your first line of defence against heart disease (1). Include a variety of fruits, vegetables, whole grains, and lean proteins into your diet. Avoid foods rich in saturated fats, trans fats, cholesterol, and sodium. Choose heart-healthy fats such as those present in avocados, nuts, and olive oil.

2. Stay Active

Regular physical activity is crucial. Aim for at least 150 minutes of moderate-intensity exercise, such as brisk walking, each week (2). Exercise helps maintain a healthy weight, lowers blood pressure, and reduces stress.

3. Maintain a Healthy Weight

Excess weight, particularly around the abdomen, increases the risk of heart disease (3).  A balanced diet and consistent exercise will help to achieve and maintain a healthy weight.

4. Quit Smoking

Smoking is a significant risk factor for cardiovascular disease. Seek support from smoking cessation programmes or counselling to help you quit since it will significantly reduce the risk of cardiovascular problems (4).

5. Limit Alcohol Consumption

Excessive alcohol intake can lead to high blood pressure and other heart-related issues (5). Enjoy alcohol responsibly by consuming it in moderation.

6. Control Blood Sugar and Cholesterol Levels

Regular screenings can help you keep track of your blood sugar and cholesterol levels. Manage these through diet, exercise, and medications if necessary.

7. Manage Stress

Chronic stress can harm your heart. Use stress management practices such as mindfulness, meditation, and regular physical activity.

Common Questions About Heart Disease Risk

What are the main risk factors for heart disease?

The primary risk factors include smoking, diabetes, high cholesterol, physical inactivity, obesity, excessive alcohol consumption, and genetic predisposition (6).

Can heart disease be prevented if it runs in my family?

While genetic predisposition increases your risk, many lifestyle changes can significantly reduce your risk. A healthy diet, regular exercise, and avoiding smoking are key preventive measures (7).

How often should I get screened for heart disease?

It is recommended to have regular health screenings. Speak with your healthcare provider about the appropriate frequency based on your personal and family medical history (8).

Preventing cardiovascular disease involves adopting a healthy lifestyle, staying informed, and seeking regular medical advice. By making these changes, you can significantly reduce your risk and enjoy a healthier, longer life.

References

  1. Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now? Vascular Health and Risk Management, 19(19), 237–253. https://doi.org/10.2147/VHRM.S379874
  2. American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
  3. Obesity. (n.d.). British Heart Foundation. https://www.bhf.org.uk/informationsupport/risk-factors/obesity#:~:text=Excess%20weight%2C%20especially%20round%20your
  4. Joseph, A. M., & Fu, S. S. (2003). Smoking Cessation for Patients with Cardiovascular Disease. American Journal of Cardiovascular Drugs, 3(5), 339–349. https://doi.org/10.2165/00129784-200303050-00005
  5. Johns Hopkins Medicine. (n.d.). Alcohol and Heart Health: Separating Fact from Fiction. Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-heart-health-separating-fact-from-fiction#:~:text=Excessive%20alcohol%20intake%20can%20lead
  6. CDC. (2024, April 24). Heart Disease Risk Factors. Heart Disease. https://www.cdc.gov/heart-disease/risk-factors/index.html
  7. Buttar, H. S., Li, T., & Ravi, N. (2005). Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Experimental and Clinical Cardiology, 10(4), 229–249. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716237/
  8. American Heart Association. (2019, March 22). Heart-Health Screenings. Www.heart.org. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings

Ways to Reduce Risk for Lung Cancer

Ways to Reduce Risk for Lung Cancer

Lung cancer remains one of the leading causes of cancer-related deaths globally (1). Despite its prevalence, lung cancer can be largely preventable. By understanding the risk factors and adopting preventive measures, individuals can significantly reduce their chances of developing this chronic disease.

Overview of the Risk for Lung Cancer

Lung cancer primarily affects the respiratory system, starting in the lungs and potentially spreading to other parts of the body. While smoking remains the most significant risk factor, non-smokers are not entirely immune. Other factors such as exposure to second-hand smoke, radon gas, asbestos, air pollution, and genetic predispositions also contribute to the risk.

Ways to Prevent Lung Cancer

1. Avoid Smoking

The most effective way to reduce the risk of lung cancer is to avoid smoking altogether (2). Cigarette smoke contains carcinogens that damage lung tissue, leading to cancer. For smokers, quitting can drastically reduce the risk. According to the World Health Organisation (WHO), the relative risk of lung cancer decreases steadily after smoking cessation, dropping to half after 10 to 15 years of cessation (3).

2. Minimise Exposure to Second-hand Smoke

Non-smokers exposed to second-hand smoke have a significantly higher chance of developing lung cancer. Second-hand smoke, or passive smoke, is a major risk factor for lung cancer among non-smokers, increasing the risk by about 20-30% (4). No amount of exposure to second-hand smoke is safe. Ensuring homes and vehicles are smoke-free can protect non-smokers from the harmful effects of tobacco smoke.

4. Avoid Exposure to Carcinogens at Work

Certain occupations expose workers to carcinogens such as asbestos, arsenic, and diesel exhaust (5). Ensuring proper safety measures, using protective equipment, and following safety protocols can significantly reduce the risk of lung cancer associated with occupational exposure. Employers are also mandated by law to provide a safe working environment, and employees should be proactive in adhering to safety guidelines.

5. Maintain a Healthy Diet

A diet rich in fruits and vegetables can help lower the risk of lung cancer. These foods contain antioxidants and phytochemicals that protect cells from damage. Studies have shown that a high intake of vegetables and fruits, particularly cruciferous vegetables like broccoli and cabbage, is associated with a reduced risk of lung cancer (6).

6. Reduce Air Pollution Exposure

Prolonged exposure to polluted air can increase the risk of lung cancer. Air pollution, particularly in highly polluted cities, has been identified as a significant risk factor for lung cancer. During periods of poor air quality, staying indoors, using air purifiers, and wearing masks can help reduce exposure to harmful pollutants. According to estimates from the World Health Organisation, air pollution causes over 4 million unnecessary deaths globally each year and Lung cancer is one of the primary causes (7).

Conclusion

Reducing the risk of lung cancer involves a combination of lifestyle changes, environmental awareness, and proactive health measures. By avoiding smoking, minimizing exposure to second-hand smoke and other carcinogens, maintaining a healthy diet and exercise routine, and being mindful of air quality, individuals can significantly lower their chances of developing lung cancer.

References

  1. Barta, J. A., Powell, C. A., & Wisnivesky, J. P. (2019). Global Epidemiology of Lung Cancer. Annals of Global Health, 85(1). https://doi.org/10.5334/aogh.2419
  2. Benefits of Reduced Smoking on Lung Cancer. (2024, February 9). Cancer.gov; Cancer.gov. https://dceg.cancer.gov/news-events/news/2024/reducing-smoking-lung-cancer#:~:text=A%20new%20analysis%20quantifies%20the
  3. Faselis, C., Nations, J. A., Morgan, C. J., Antevil, J., Roseman, J. M., Zhang, S., … & Ahmed, A. (2022). Assessment of lung cancer risk among smokers for whom annual screening is not recommended. JAMA oncology, 8(10), 1428-1437. https://jamanetwork.com/journals/jamaoncology/fullarticle/2794805
  4. CDC. (2022, November 28). Health problems caused by secondhand smoke. Www.cdc.gov; CDC. https://www.cdc.gov/tobacco/secondhand-smoke/health.html
  5. Cani, M., Turco, F., Butticè, S., Vogl, U. M., Buttigliero, C., Novello, S., & Capelletto, E. (2023). How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers? Cancers, 15(10), 2836. https://doi.org/10.3390/cancers15102836
  6. Ağagündüz, D., Şahin, T. Ö., Yılmaz, B., Ekenci, K. D., Duyar Özer, Ş., & Capasso, R. (2022). Cruciferous Vegetables and Their Bioactive Metabolites: from Prevention to Novel Therapies of Colorectal Cancer. Evidence-Based Complementary and Alternative Medicine, 2022, 1–20. https://doi.org/10.1155/2022/1534083
  7. Lung Cancer. (n.d.). www.singaporecancersociety.org.sg. https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/lung-cancer.html#risk-factors

Understanding Lung Cancer: What Every Singaporean Should Know

Understanding Lung Cancer: What Every Singaporean Should Know

Lung cancer is a prevalent health concern in Singapore. Understanding its nature, types, and symptoms can empower you to take proactive steps for your health. This article provides a comprehensive overview of lung cancer, helping you stay informed and vigilant. 

Overview of Lung Cancer

Lung cancer often begins in the cell lining of the lung’s air passage. It is one of the most common cancers worldwide.

In Singapore, lung cancer has the highest mortality rate among males and the third highest among females. According to the Singapore Cancer Registry 2019 Annual Report, lung cancer made up 25.6% of cancer deaths in males and 15.5% of deaths in females in Singapore between 2015-2019(1)

Lung cancer had the second poorest survival rate for males 25.5% and the lowest survival rate for females 29.3%.(2)

While anyone can develop lung cancer, it is more prevalent among:

  • Smokers 🚬: Smokers are 15-30 times more likely to get lung cancer.
  • Individuals exposed to secondhand smoke: Secondhand smoke increases the risk by 20-30%.
  • People exposed to pollutants and certain chemicals.

Types of Lung Cancer

Lung cancer is broadly classified into two main types:

  1. Non-Small Cell Lung Cancer (NSCLC): This is the most common type, accounting for about 85% of cases. It includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
  2. Small Cell Lung Cancer (SCLC): Less common but more aggressive, SCLC accounts for about 15% of cases. It tends to spread quickly and is often found in heavy smokers.(3)

There are also other types of cancer that may affect the lung.

Signs and Symptoms

Early detection of lung cancer can significantly improve treatment outcomes. Here are the common signs and symptoms to watch out for:

  • Persistent Cough: A cough that doesn’t go away or gets worse over time.
  • Chest Pain: Discomfort or pain in the chest that may worsen with deep breathing, coughing, or laughing.
  • Shortness of Breath: Difficulty breathing or feeling winded with minimal exertion.
  • Hoarseness: A change in voice or hoarse sound.
  • Weight Loss: Unexplained loss of appetite and weight.
  • Coughing Up Blood: Even a small amount of blood in the cough can be a sign of lung cancer.
  • Fatigue: Persistent tiredness and lack of energy.

If you experience any of these symptoms, it is important to consult a healthcare professional promptly.

Stay informed and proactive about your health. Early detection and treatment can make a significant difference in managing lung cancer effectively. Seek medical advice without delay If you have any concerns.

Remember, your health is in your hands. Stay vigilant and take charge of your well-being!

References:

Understanding Liver Cancer: How It Differs from Liver Disease

Understanding Liver Cancer

Liver cancer is a significant health concern worldwide, with a particularly high incidence in Asia, including Singapore. As the primary filtration system for our blood, the liver plays a crucial role in maintaining overall health. Understanding the differences between liver cancer and liver disease is essential for early detection, effective treatment, and prevention.

Overview of Liver Cancer

Liver cancer, also called hepatic cancer, begins in the liver cells. The most common type is hepatocellular carcinoma (HCC), accounting for about 75% of all liver cancers. (1) Less common types include intrahepatic cholangiocarcinoma and hepatoblastoma.

According to the Singapore Cancer Registry, there were over 1,500 new cases of liver cancer diagnosed between 2015 and 2019.

Signs and Symptoms of Liver Cancer

Early detection of liver cancer can be challenging as the symptoms often do not appear until the disease is in an advanced stage. However, recognising the early signs is crucial for timely medical intervention. Common symptoms include:

  • Unexplained Weight Loss: Sudden and unexplained weight loss is a common symptom. (2)
  • Loss of Appetite: A noticeable decrease in appetite and feeling full after eating small amounts.
  • Abdominal Pain and Swelling: Persistent pain or discomfort in the upper right side of the abdomen, which can sometimes spread to the back or shoulder.
  • Nausea and Vomiting: Frequent episodes of nausea and vomiting.
  • General Weakness and Fatigue: Persistent tiredness and weakness that does not improve with rest.
  • Jaundice: Yellowing of the skin and eyes, indicating a liver problem.
  • White, Chalky Stools: Changes in stool color can also be a sign. (3)

Risk Factors for Liver Cancer

Several behaviors and conditions increase the risk of developing liver cancer:

  • Obesity: Being overweight or having obesity increases the risk.
  • Diabetes: Having diabetes can increase the risk of liver cancer.
  • Smoking: Cigarette smoking is linked to a higher risk of liver cancer.
  • Alcohol Consumption: Drinking alcohol excessively can lead to liver damage and increase cancer risk.
  • Hemochromatosis: This condition, where the body stores more iron than needed, can increase risk. (4)
  • Chronic Hepatitis Infections: Long-term hepatitis B or hepatitis C virus infections are significant risk factors.
  • Cirrhosis: This scarring of the liver, often caused by hepatitis or alcohol use, significantly raises cancer risk.
  • Nonalcoholic Fatty Liver Disease (NAFLD): The presence of extra fat in the liver not caused by alcohol is a risk factor.
  • Aflatoxin Exposure: Consuming foods contaminated with aflatoxins, a type of fungus that grows on improperly stored grains and nuts, is a risk factor. (5)

How Liver Cancer Differs from Liver Disease

Liver cancer is a specific malignancy within the broader category of liver diseases. While both can cause liver dysfunction, they differ in cause, progression, symptoms, diagnosis, and treatment. Liver cancer often arises from chronic infections (hepatitis B/C), cirrhosis, or excessive alcohol intake, and progresses rapidly, with symptoms like weight loss and jaundice appearing later. Conversely, liver disease encompasses a wider range of conditions like hepatitis, fatty liver disease, and genetic disorders, with variable progression and symptoms depending on the type. Diagnosing both may involve blood tests, imaging scans, and biopsies, but treatment differs significantly. Liver cancer treatment focuses on removing or destroying cancerous tissue (surgery, ablation), while liver disease treatment depends on the cause, ranging from antiviral medications (hepatitis) to lifestyle changes and potentially liver transplant (cirrhosis).

While liver cancer is a specific type of cancer affecting the liver cells, liver disease is a broader term encompassing various conditions that impair liver function. The primary differences between liver cancer and liver disease include their causes, progression, and treatment.

Prevention and Early Detection

Preventing liver cancer involves addressing the risk factors associated with liver disease. Key preventive measures include:

  • Regular Screening: Individuals at high risk, such as those with chronic hepatitis or cirrhosis, should undergo regular screening for early detection of liver cancer.
  • Healthy Lifestyle: Maintaining a healthy weight, limiting alcohol consumption, and avoiding exposure to aflatoxins can reduce the risk of liver disease and cancer.
  • Safe Practices: Using clean needles, practicing safe sex, and ensuring blood products are tested can prevent hepatitis B and C infections.
  • Vaccination: Hepatitis B vaccination helps protect against preventable chronic liver disease. (6)

References

  1. Types of Liver Cancer: Common, Rare and More Varieties. (2018, October 5). Cancer Treatment Centers of America. https://www.cancercenter.com/cancer-types/liver-cancer/types  
  2. Bhattacharya, R., Hwang, J. H., & Ko, C. (2020). The Patient with Unexplained Weight Loss. Yamada’s Handbook of Gastroenterology, 37.
  3. Mayer, L., & Bhikha, R. (2014). Changes in Colours of the Body–the Determinants of Disease. skin, 1, 270.
  4. Elmberg, M., Hultcrantz, R., Ekbom, A., Brandt, L., Olsson, S., Olsson, R., … & Askling, J. (2003). Cancer risk in patients with hereditary hemochromatosis and in their first-degree relatives. Gastroenterology, 125(6), 1733-1741.
  5. Jackson, P. E., & Groopman, J. D. (1999). Aflatoxin and liver cancer. Best Practice & Research Clinical Gastroenterology, 13(4), 545-555.
  6. Hepatitis B Foundation: Hepatitis B Vaccination. (n.d.). Www.hepb.org. https://www.hepb.org/prevention-and-diagnosis/vaccination/

What is Hepatitis A?

What is Hepatitis A?

Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV) (1), typically spreads through contaminated food or water, or close contact with someone infected with the virus. (2)

In Singapore, historically, most reported cases of Hepatitis A stemmed from consuming contaminated raw or undercooked shellfish (3).

Due to improved sanitation and food safety measures, the incidence of Hepatitis A in Singapore has significantly declined. However, it’s still crucial to be aware of the risks, especially for travelers visiting regions with high HAV prevalence (4).

Symptoms of Hepatitis A

Hepatitis A symptoms may not always appear, especially in children. However, when present, they can include (5):

  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Abdominal pain or discomfort
  • Fever
  • Dark-colored urine
  • Pale stools
  • Jaundice (yellowing of the skin and whites of the eyes)

Preventing Hepatitis A with Immunisation

The best defense against Hepatitis A infection is vaccination. There are two main types of hepatitis A vaccines:

  • Single-antigen vaccine: Protects solely against hepatitis A.
  • Combination vaccine: Protects against both hepatitis A and hepatitis B, typically recommended for adults 18 years and older (6).

Protecting Yourself

Beyond vaccination, practicing good hygiene is essential to prevent Hepatitis A infection. This includes (7):

  • Thorough hand washing with soap and water after using the toilet and before preparing food
  • Drinking only treated or boiled water, particularly when traveling to regions with high HAV prevalence
  • Consuming thoroughly cooked food, especially shellfish
  • Avoiding close contact with individuals infected with Hepatitis A

By understanding the symptoms and importance of vaccination and good hygiene practices, you can effectively protect yourself from Hepatitis A. Talk to your doctor about getting vaccinated and discuss any concerns you might have.

References

  1. NCI Thesaurus. (n.d.). Ncit.nci.nih.gov. Retrieved June 18, 2024, from https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C3096
  2. Fiore, Anthony E. (2004). Hepatitis A Transmitted by Food. Clinical Infectious Diseases, 38(5), 705–715. https://doi.org/10.1086/381671
  3. Goh, K. T., Doraisingham, S., Monteiro, E. H., & Ling, A. E. (1987). Acute hepatitis A in Singapore: importance of shellfish ingestion in a non-epidemic period. Annals of the Academy of Medicine, Singapore, 16(4), 591–594.
  4. Cao, G., Jing, W., Liu, J., & Liu, M. (2021). The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatology International, 15(5), 1068–1082. https://doi.org/10.1007/s12072-021-10232-4
  5. World Health Organization. (2023, July 20). Hepatitis A. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
  6. (2024, May 6). Hepatitis A Vaccine. Hepatitis A. https://www.cdc.gov/hepatitis-a/vaccination/index.html
  7. Services, D. of H. & H. (n.d.). Hepatitis A. Www.betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/node/1313