Health Connection - March 2022

Colon Cancer Rates Increasing Among the Young

By Ripple Sharma, MD, FACG

While nobody looks forward to a colonoscopy, this critical screening test is a life saver. That’s because when cancer is caught early, one has the highest chance of cure. 85 percent of colon cancers start off as colon polyps, and any polyps found during a colonoscopy are removed and sent to pathology. About 30 percent of men and 25 percent of women over the age of 45 have precancerous polyps, making the benefits of a colonoscopy abundantly clear.

According to the American Cancer Society, regular colonoscopy procedures are responsible for a decrease in cancer deaths in people aged 50 and older.

Unfortunately, the colorectal cancer rate is increasing in people younger than 50 over the past several years. A study in The Journal of Medical Screening found that for people in their 40s, the incidence of colon cancer has increased by 1.3 percent and rectal cancer by 2.3 percent each year from the mid-1990s through 2013. Multiple other studies had the same findings and the U.S. Preventive Services Task Force and the American Cancer Society are now recommending that colon cancer screening begin at age 45 in average-risk patients. Patients who may have a family history of colon cancer or personal history of inflammatory bowel disease or certain genetic syndromes may need to get their first colonoscopy at an even younger age.

Symptoms of Colon Cancer

In the early stage of the disease, colon cancer rarely causes symptoms. When symptoms do appear, they may vary, depending on the tumor’s size and location. Talk to your healthcare provider if you have any of the symptoms below:

• A change in bowel habits, including diarrhea or constipation, or a change in stool consistency that lasts longer than four weeks
• Rectal bleeding or blood in your stool
• Persistent abdominal pain
• Unexplained weight loss

Following the Guidelines

MarinHealth gastroenterologists recommend that their patients follow the U.S. Preventive Services Task Force guidelines:

• People at average risk for colorectal cancer should be screened every 10 years, starting at age 45. If polyps are found, your doctor may recommend more frequent screenings.
• People with the following risk factors should be screened more frequently, as recommended by their physician:
• Medical history of ulcerative colitis or Crohn’s disease
• Family history of colorectal cancer
• Confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)

Reduce Your Risk

Getting timely, regular colonoscopies is the most important thing you can do to protect yourself from colon cancer. However, these lifestyle measures can help reduce your risk for colon and many other cancers:

1. Maintain a healthy body weight and exercise regularly. Obesity and a sedentary lifestyle increase your risk for colon cancer.

2. Eat a variety of fruits and vegetables, especially raw.

3. Don’t smoke. Smoking has been linked to cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia.

4. Limit your alcohol consumption. The recommended maximum is no more than one drink a day for women and two for men.

MarinHealth® gastroenterologists perform colonoscopies using the latest technology, with superior imaging capabilities. Our specialists have excellent colon cancer detection rates that surpass the national average. Make an appointment with a MarinHealth gastroenterologist.

Daylight Saving Time and Your Circadian Rhythm

“Fall back, spring forward.” That’s the phrase we use to remind ourselves to reset our clocks twice a year, from standard time to daylight savings time in March and back again in November. The idea of daylight saving time (DST) is to get the most out of natural light during warm weather. That extra hour comes in handy for beach days and neighborhood barbecues. However, sleep deprivation can be a problem in the weeks following the transition to DST, as the change makes it difficult for many to fall asleep. What’s more, the effects of sleep deprivation can linger for weeks. In addition to sleep issues, researchers have noted other negative effects:

• Mood disturbances
• Increase in traffic accidents
• Uptick in heart problems

A bill that proposes to make daylight saving time the standard year around is now working its way through Congress. If passed, it would go into effect in November 2023 and would permanently eliminate the need to change clocks twice a year. But the bill is not without controversy, and many healthcare professionals and other experts believe a permanent change to standard time (with more sunlight in the early hours of the day) would be the better change, as it more naturally aligns with our circadian rhythm.

What is circadian rhythm?

Circadian rhythm is the body’s 24-hour clock. It regulates your sleep-wake cycle and influences appetite and mood. To ensure deep, healthy sleep, your circadian rhythm needs to be aligned with the natural cycle of light and darkness. Transitions in and out of DST alter the times when we are exposed to natural light. The March time change brings darker mornings and later sunsets. This can affect your sleep-wake cycle, making you feel tired in the morning and alert in the evening.

No matter what standard the government eventually sets for our clocks, maintaining good sleep hygiene and habits will help ensure that you are more likely to get good quality and consistent rest.

Tips for better sleep

1. Watch what and when you eat: Don’t eat too close to bedtime and avoid fatty, fried, or spicy food that can cause heartburn. Stop drinking liquids 1-2 hours before bed so you won’t have to take a 3 am bathroom break. Skip the alcoholic beverages. Alcohol reduces production of the sleep hormone melatonin, so you may fall asleep quickly only to wake up at 4 am. Try not to consume caffeine within 8 hours of bedtime.
2. Exercise regularly, but not too close to bedtime: Regular exercise helps ensure a good night’s sleep. However, it’s best not to work out too close to bedtime because exercise stimulates the production of epinephrine and adrenaline and increases alertness.
3. Develop a sleep schedule and stick to it: Adhering to a schedule reinforces your sleep/wake cycle. Try to go to bed and get up at the same time every day, even on weekends. Limit day-time naps to 30 minutes.
4. Turn bright lights and devices off 2 hours before bed: Nighttime exposure to light, especially blue light, can trick your brain into thinking it’s daytime and disrupt your body’s production of melatonin. Turn off smartphones, computers, and the TV two hours before bed. Instead of LED or compact fluorescent bulbs, use incandescent or red bulbs to light your bedroom. Align your circadian rhythm with the time change by getting plenty of bright light, especially sunlight, during the day.
5. Set the stage for sleep: Manage temperature, light, and sound. Keep the temperature between 60 and 67 degrees. Consider black out curtains and eyeshades. If noise is a problem, try ear plugs and/or white noise machines. Invest in quality bedding–sheets that breathe and a comfy pillow and change your mattress every 5-7 years. Also... Chillax! Use a diffuser to perfume your room with the relaxing scent of lavender. Meditate, do breathing exercises, take a warm bath, have a cup of herbal tea, or tuck in with a good book. You know what relaxes you best.
6. Use your bed only for sleep and sex: This strengthens the association between your bedroom and sleeping.
7. If you haven’t fallen asleep after 20 minutes, get up: Staring at the clock only makes it harder to get to sleep. Instead, get out of bed and do something distracting but calming like reading, listening to music, or meditating.
8. Try melatonin and other supplements: Melatonin is a key sleep hormone that helps stabilize the circadian rhythm. Other natural supplements said to aid sleep include ginkgo biloba and valerian root, the amino acids glycine and L-theanine, and the mineral magnesium. While you don’t need a prescription for natural sleep aids, talk to your healthcare provider before trying any of them.
9. Don’t smoke: Exposure to smoke–including secondhand smoke– has been associated with difficulty falling asleep and fragmented sleep.

Preparing for Pregnancy

Whether you’re planning your first baby or your third, there’s a lot to think about. Is the timing right? How will your job be affected? Are you financially ready?

Once you resolve those big-picture issues, it’s a good idea to schedule a pre-pregnancy appointment with a midwife or OB/GYN. You may need advice on transitioning off of birth control. You’ll also want to review your current medications and make sure your vaccinations are up to date.

Share your concerns regarding fertility, medical issues, or family health history with your doctor. From there, depending on your situation, you may be referred to a fertility specialist, endocrinologist, or other specialist. Your provider may recommend that you meet with a genetic counselor before proceeding if you or your partner have a family history of a particular genetic disorder.

If you have a preexisting condition such as endometriosis, diabetes, or lupus, your pregnancy may require additional monitoring. Thanks to MarinHealth®’s relationship with UCSF Health, you can receive specialized care right here in Marin. That includes state-of-the-art ultrasound examinations, consultations, prematurity prevention efforts, management of unexpected pregnancy complications, and oversight by UCSF Health maternal-fetal medicine specialists.

Get Your Body in Gear!

A healthy pregnancy starts with a healthy body. Here are some lifestyle adjustments to get your body baby-ready:

• If you don’t already have a workout routine, this is a good time to start. Get at least 30 minutes a day of moderate exercise. Choose something you are more likely to continue once you’re pregnant, such as walking, cycling, or swimming. Yoga is a good option to improve strength and help manage stress.
• Eating a balanced diet is especially important for mothers-to-be. Cut out junk food and empty calories now. Eat a variety of fruits, vegetables, whole grains, nuts, low-fat dairy, and lean protein.
• Take a good multivitamin that includes 400-800 micrograms of folic acid. Folic acid helps prevent serious neural tube birth defects such as spina bifida that can develop even before you know you are pregnant.
• Aim to maintain a healthy weight. Being underweight or overweight can make it harder to get pregnant or have a healthy pregnancy. Talk to your healthcare provider to determine what a healthy weight is for you.
• Floss daily. The risk of gum disease increases when you’re pregnant, so make daily flossing a habit now.
• Moderate your caffeine intake. While high levels of caffeine may affect fertility, most experts agree than up to 200 milligrams (about one 12-ounce cup of coffee) is safe.
• Eliminate alcohol and marijuana. An occasional glass of wine probably won’t affect your ability to get pregnant―but no amount of alcohol is safe to consume once you are pregnant. No amount of marijuana is known to be safe in pregnancy, and it can damage your baby’s brain development. Marijuana is not a good remedy for nausea and vomiting in pregnancy and can even make those symptoms worse.
• Stop smoking. Smoking is unhealthy for everyone, and it can lower your chances of getting pregnant and even increase your chances for miscarriage. Need help? Learn about MarinHealth’s Smoking Cessation program.
• Lower your stress levels. Stress adversely impacts fertility. Consider whether there’s anything you can take off your plate, or try yoga or guided meditation.

Are you ready to take the next step in planning for pregnancy? Make an appointment with a midwife, nurse practitioner, or OB/GYN today. MarinHealth OB/GYN | A UCSF Health Clinic has offices in Greenbrae and Novato with a team of experts to help you prepare for and oversee your pregnancy and birth. Find a provider or call 1-415-461-7800 to schedule an appointment.

For more useful tips on pregnancy planning and conception, visit MyMarinHealth.org/Maternity to sign up for a free email series!

A Healthier Immune System for a Healthier You

The job of your immune system is to recognize and address internal threats to your body, such as a viral or bacterial infection or cellular damage caused by sunburn or cancer. This complex network includes organs (spleen, thymus, bone marrow, and lymph nodes), as well as specialized white blood cells (T cells) that travel through your blood stream or lymphatic system looking for potential threats. When an infectious agent enters the body, your immune system creates antibodies. These antibodies trigger the creation of immune cells specific to that particular pathogen.

As winter comes to an end, we must still guard against COVID-19 and flu, and a healthy immune system is more important than ever. Individuals with compromised or weakened immune systems are more susceptible to infection. Seniors are at increased risk because the immune system’s response capability weakens with age. Even if you don’t fall into a high-risk group, it makes sense to do all you can to boost your immune system to help keep illnesses and infections at bay. A few tweaks to your lifestyle can help you strengthen your immune system and boost your overall health.

Eat Right

If you are mindful about what you eat, you already know that a healthy diet is rich in fresh fruits and vegetables, whole grains, lean protein, and legumes, and low in sugar, red meat, and processed foods. Hopefully, you are already eating this way to help ward off heart disease and diabetes. But did you know that this diet is also good for your immune system? That’s because a high-fiber, plant-rich diet supports the growth of beneficial microbes in your gut. Conversely, the typical Western diet, high in sugar, fat, and processed foods, can harm “good” bacteria and suppress their growth. This leads to chronic inflammation of the gut, which is associated with suppressed immunity.

Lower Your Stress Level

Modern medicine’s increasing focus on the mind/body connection has inspired a lot of research into the impact of emotional stress on health. A variety of illnesses, from hives to heartburn to heart disease, have been linked to stress, and studies are being conducted on the effect stress may have on the immune system. If you are experiencing stress (and who isn’t these days?), try to address both the symptoms and the causes:

• The symptoms: Engage in activities that relax or inspire you. This could be anything from yoga or walking in nature to indulging in your favorite hobby or even taking up a new one. Close your eyes and listen to music. Laugh more–watch a funny movie or Zoom with friends. Turn off the news. Take a break from worrying with mindful meditation or guided imagery.
• The causes: Learn to say no. Be willing to delegate chores even if you feel like you could accomplish them more effectively yourself. You can’t help others if you’re exhausted and emotionally depleted. Saying yes all the time can leave you feeling resentful and angry, leading to more stress. Try journaling–putting your innermost thoughts on paper can be cathartic. Talk to a spiritual adviser or a counselor to gain perspective into your situation. Get more tips with this podcast.

Exercise Regularly

Exercise is good for your cardiovascular health. It helps control your weight and lower your blood pressure. And it gets your blood flowing–literally. By promoting good circulation, exercise helps immune cells and antibodies move more efficiently through your body. Another thing you can do to enhance your circulation is to take a cold shower. It’s not the most relaxing activity, but taking a cold shower or jumping into a cold pool has been shown to stimulate circulation.

Watch Your Weight

Fat tissue produces substances called adipocytokines that promote chronic low-grade inflammation and impair T-cell function. It’s never too late to start good nutrition and exercise habits that can help you achieve and maintain a healthy weight.

Sleep Better

Sleep has a restorative impact on your body and brain. During sleep, your body releases immune cells and proteins called cytokines. These proteins are signaling molecules that stimulate and regulate your body’s immune response to inflammation and infection. Inadequate sleep reduces your body’s production of cytokines and other immune cells, leaving you more vulnerable to infection.

Try Vitamins

No prescription drug or food supplement can keep you healthy on its own or prevent disease. However, some studies have shown that vitamin C and zinc can help reduce the duration of the common cold. Vitamin D deficiency may make you more vulnerable to infection. However, vitamin D supplements are not recommended if you already have adequate levels of vitamin D. Talk to your doctor before starting a new supplement.

Try Essential Oils

In addition to having a pleasant, soothing scent, eucalyptus and tea tree oils are known to have antiviral properties. Try inhaling them through an oil diffuser. You can also experiment with lavender, which has a calming affect that can help with sleep. Promote relaxation with a few drops of lavender in a warm bath.

Avoid Environmental Toxins

Environmental toxins such as smoke and air pollution can have a negative effect on your immune system. Stay indoors on bad air quality days and avoid polluting your own lungs by smoking or vaping. In addition to the impact on your immune system, vaping or smoking may increase your risk of severe illness if you contract COVID-19.