Month: September 2022

September is Prostate Cancer Awareness Month, and there is no better time to remind men that screening is important for early detection and treatment of all cancers, particularly cancer of the prostate. If you know me, you know I’m all about preventative care.

Prostate cancer—what is it?

The prostate is a gland that surrounds the posterior part of the urethra in the male, just under the bladder. It helps by producing fluid that carries sperm during ejaculation. As men get older, it is common for the prostate to enlarge in a way that isn’t cancerous. However, prostate cancer is the second leading cause of cancer death in men, so it is important to have the discussion about screening with your physician when it is time and for many men to opt into screening.

About 1 in 8 men will be diagnosed with prostate cancer in his lifetime; for Black men, this number is 1 in 6. About 1 in 41 men will die of prostate cancer; that means every 15 minutes, an American man dies of prostate cancer. The latest data for Black men indicate these numbers are 1 in 26.

Risk factors: What are they?

Data shows that you are at increased risk if you have a family history of prostate cancer.  This is generally a first degree relative (father or brother), or multiple relatives with the diagnosis. Certain chemical exposures are also thought to be risk factors. Race is also a factor; as previously discussed, Black men are of significantly increased risk.

The American Cancer Society also recommends that in general, you live an active lifestyle, not smoke, dip, or vape tobacco products, try to maintain a healthy weight, and limit alcohol to healthy limits to decrease your risk of cancer.

Own your health: Know the Recommendations

The American Cancer Society recommends all men aged 50 and over who have a greater than 10-year life expectancy have an individualized conversation with their health care provider about screening for prostate cancer with a prostate specific antigen blood test (PSA) with or without a digital rectal exam (DRE) during the complete physical exam. For men who are at increased risk, such as men of African descent and with the other risk factors discussed above, this discussion should begin at age 45.

No organizations offer recommendations for all men who are of average risk for prostate cancer to be screened due to concern of risk of harm due to overdiagnosis and treatment. However, recent data modeling suggests that screening African American men aged 45-69 could reduce mortality up to 29% while not increasing overdiagnosis in this population. Even with current recommendations, in recent years, we are seeing that about one-third of the men who should be screened are being screened, which has resulted in an increase in higher grade cancers, and a reduction in the decrease in mortality from prostate cancer seen in previous years.

PSA normals vary by lab, age and man, although generally less than 3 is considered normal. Based on what we see clinically, if you opt to screen, it is best to do so yearly. This is because it is best to have a baseline, and track what is known as a PSA velocity. This is how quickly your PSA is changing over time. Some men will have a PSA in normal range but have had much lower PSA values which suddenly begin to jump, and this can be a sign of something that needs to be evaluated.

Other reasons for elevated PSA include enlarged prostate, infection, or inflammation, so having a high PSA does not mean that you have cancer. Repeat testing and further evaluation by a urologist is indicated.

Signs and Symptoms:

Prostate cancer is normally without symptoms when caught. However, prostate cancer that has become far advanced can cause symptoms. Some include:

• Changes in urination, including a slow or weak urinary stream, trouble emptying the bladder, or urinating more often, particularly in the evenings or overnight.
• Blood in the urine or semen, or painful ejaculation.
• Problems getting an erection
• Pain in the hips, back (spine), chest (ribs), or other areas
• Weakness or numbness in the legs or feet, or loss of bladder or bowel control

While any of these symptoms could be from several causes such as normal aging, infection or arthritis, you should be evaluated by your physician, and a PSA should be a part of that evaluation, particularly if there is not another good explanation for them, and they are new symptoms.

Treatment

Even if you find you have an abnormal evaluation with a urologist, sometimes, it is reasonable to watch and wait, since prostate cancer is often very slow growing, and won’t cause many problems. Of note, African American men are more at risk to have aggressive cancers that require treatment, and more likely to have poor outcomes. Black men are over twice as likely to die of prostate cancer.

Active treatment options usually include surgery, hormonal suppression, chemotherapy, and radiation. These modalities can be used alone, or in combinations depending on the presentation of the cancer. It is important that men know the right information about their bodies, to ensure they get the proper recommendations. Survival rate is up to 96% if caught early enough, so again, early detection is key.

Age is important

Prostate cancer tends to affect men later in life. While some younger men develop prostate cancer, the median age for diagnosis is 66.

Talk to your doctor

Don’t be afraid to discuss your questions and concerns with your doctor. Your health is important, so it is important that you understand your options and make an informed decision that is best for you.

Educate a friend

Do not keep your knowledge about the impact of prostate cancer screening to yourself. This is so important, you should want your loved ones to be aware as well, so make sure you spread the news about what you have learned. Online resources are available at www.cancer.org/cancer/prostate-cancer.html, www.pcf.org, https://www.cdc.gov/cancer/prostate, www.zerocancer.org.

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Resources:

https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21718

https://www.cancer.org/cancer/prostate-cancer.html

www.cdc.gov/cancer/prostate

www.zerocancer.org

I’ll be honest. This week, I found myself having one of those perfectionism moments. You know, the ones where even though you have all this great stuff, you’re hyper-focused on the one thing that could or could not be. So hyper-focused that you’re getting anxious and stressed and forgetting that what you have is already SUFFICIENT. It’s enough. It’s more than enough, in fact.

So, I sat myself down, and said, “It’s time for a gratitude moment.” I listed ALL those things that I already had that I was really ignoring because of that one thing I hadn’t heard about yet. That moment helped calm my unfounded worries, helped bring me to the present, and helped ground me.

That’s why I practice gratitude. Because sometimes, we forget just how much we already have. Sometimes, we really are going through a mess, and it reminds us that we have an anchor to hold on to. No matter what’s going on, through loss (there has been so much lately), through trials, through pain, I practice gratitude. It’s my anchor.

8/31/2022

This week, I’m grateful for time with family, safe travels, great Indian food, my thoughtful husband, a good start to the new school year, new connections, growth, and the opportunity to touch lives—and the gift of receiving flowers while I’m here.

9/1/2022

This week I’m thankful for getting the books in the hands of the people who are supporting me, finally getting some books in the mail, seeing a friend I haven’t seen in close to a decade over amazing, relatively healthy food, an amazing panel on health and beauty and working with the lovely @thekimroxie, CEO of @lamikbeauty (if you don’t know, her makeup is IT—catch her on Friday Night Live for special deals), fellowship and celebrating at my book signing and all the people who helped make that a success, and how my kids literally wait for me to tell me all about their day. I’m grateful for unexpected blessings and favor.

9/8/2022

This week, I’m grateful for a long weekend and time with family, a beautiful memorial service for a very special person, singing with a chorus again—masked up and quadruple vaxxed , my smiling Dobe having fun with my kid, youngest K’s creativity, and the time to create this school project with him.

What are you grateful for? I’d love for you to leave a comment or send me a message letting me know!

******#ThankfulThursdays Note******

Gratitude is important for wellness–it can improve mood, tolerance to pain, improve blood pressure, improve sleep, reduce inflammation, and the benefits go on. I have devoted Thursdays to publicly showing gratitude, because no matter what is going on in life, if you’re alive, there is something you can give thanks for.

Having high cholesterol or cholesterol that isn’t in the right ratio is a risk factor for cardiovascular disease, the number one cause of death in the United States. High cholesterol affects 38.1% of Americans, that’s more than 1 in 3! If you missed the post that really explains the importance of addressing your cholesterol, make sure you check out this post!

What Changes to Make

If you follow me, you know that I’m a huge proponent of Healthy Plate eating. If you’re doing this, you’re already on the right track. However, there are some specific recommendations if you need to take one thing at a time:

• Decrease your intake of foods that contain saturated fats
• Increase your intake of foods that contain omega 3 fatty acids
• Consume more foods that contain soluble fibers
• Eat more foods that contain whey protein

Saturated Fats

Saturated fats contain a high proportion of fatty acid molecules without double bonds. Practically speaking, they are oils/fats that are typically solid at room temperature–and make foods taste rich and delicious…lol. I know, I know. But we should have them in extreme moderation, because they when we have too many, our bodies don’t like it.

Foods containing lots of saturated fats:

• Red meat: beef, pork, lamb, etc
• Full fat dairy
• Butter
• Coconut oil
• Ice cream
• Chocolate
• Cheesecake

Limiting our whole fat dairy, red meat, and desserts drastically decreases our saturated fat intake. You can replace butter with oils such as olive or avocado oil.

Omega 3 Fatty Acids

The Council of Nutrition and Dietetics recommends that healthy adults consume between 250-500mg of EPA and DHA omega 3 fatty acids weekly. This is pretty easy to accomplish if you enjoy fish, since two servings of fatty fish weekly will typically get you there. These two types are superior to ALA omega 3 fatty acids, because ALA is a precursor for EPA and DHA omega 3s that is not efficiently converted to the other two types in humans.

Sources of EPA and DHA Omega 3 fatty acids:

• Fatty fish such as salmon, mackerel, and herring
• Oysters
• Caviar
• Algae
• Grass-fed animals (beef, eggs from cage free chickens)–but much less so

Sources of ALA Omega 3 Fatty Acids:

• Walnuts
• Flaxseed
• Chia seed
• Soybeens
• Spinach

There are many foods that contain Omega 3 fatty acids, so you should be able to get them in, but if you can, go for the DHA, EPA sources. This article goes into much more detail about the levels of Omega 3 fatty acids found in certain foods.

Soluble Fiber

Soluble fiber is fiber that does what it sounds like–dissolves in water. You should be getting 25-30g of fiber daily, and roughly half of that should come from soluble fiber. Getting overly concerned with which fibers are soluble and which aren’t isn’t the point. Both are beneficial in their own way, so if you focus on eating the fruits and veggies on that healthy plate at every (or most) meals, you’ll be fine.

Foods high in soluble fibers:

• Black beans, lentils, edamame, chickpeas
• Chia seeds, flax seeds, sunflower seeds
• Oats and barley
• Hazelnuts
• Broccoli, Brussel sprouts, artichoke hearts
• Avocado, apples, pears, berries

Again, you don’t have to focus on these foods, but if you see something you like, know that it’s a great source.

Whey Protein

Whey protein is actually a milk protein that contains lots of branched-chain amino acids (building blocks for proteins/muscle in our bodies), functional peptides, and antioxidants. Hence it is mostly found in dairy. However, it is added to a few other foods, such as certain baked goods and salad dressings, some medical nutritional formulas and infant formulas, and in emulsifiers.

Trans Fat

Trans Fats are bad business. So bad, in fact, that the FDA banned them from foods in 2018. Any foods produced after 2018 do not contain trans-fat. However, you may still have some products produced prior to 2018, like vegetable shortening. Additionally, some processed baked goods and fried foods may still contain trans fats due to the way they are processed. You will want to check the label for partially hydrogenated vegetable oil–this will be your clue that a trans-fat is included.

What about foods containing cholesterol?

Studies have shown that eating cholesterol in your diet doesn’t necessarily correlate with high cholesterol in your blood. However, it is still recommended that certain populations, such as those with diabetes, continue to monitor the levels of cholesterol in their diets.

What about Eggs?

Yes, I have given eggs their own special category, because they are always causing problems in conversations about health. Eggs, specifically from cage free chickens, turn out to be okay. However, you should not consume eggs with yolks daily, as it is a source of saturated fat, and you want to be careful about that intake. Moderation is key–as with anything, you don’t want to overdo a good thing.

Remember, you do not have to do everything at once. One small change at a time will eventually get you there. I like to say that food can be medicine or poison–you get to decide one change at a time.

September is National Cholesterol Education Month, so here I am, taking the opportunity to spread some awareness about your cholesterol. So many of my patients, when told they have high cholesterol, are a little clueless as to how it affects them. Rightfully so! It’s not that straight-forward. Well, sit tight–I’m about to explain some things!!

What is high cholesterol?

We define high cholesterol (hyperlipidemia/hypercholesterolemia) as a cholesterol greater than 200 mg/dl. We previously defined optimal levels of LDL, but now, we use the levels to calculate risk and decide about benefits of treatment that way. However, generally, an LDL of >160mg/dL is high for anyone, and an LDL of >190 mg/dL would generally indicate a need for some type of treatment. In addition, we worry about what we call dyslipidemia. This is an imbalance in the types of cholesterol. We generally want to see an LDL to HDL ratio of 3.5 to 1, with an optimal ration of 0.5 (1 to 2) to 3 (3 to 1).

Why is it important?

Hypercholesterolemia and dyslipidemia are major risk factors for cardiovascular disease, which is the building up of plaques in the arteries of the heart and the main cause of heart attack and stroke. High cholesterol affects 38.1% of Americans and was estimated to cause 4.51 million deaths in 2020. High cholesterol is believed to increase the risk of cardiovascular disease by contributing to atherosclerosis.

Atherosclerosis is the hardening and narrowing of arteries from plaque build-up. Heart attacks and strokes are caused by atherosclerosis. These plaques eventually become unstable and break off. Clots form on the uneven surface, suddenly blocking the vessel and causing ischemia (lack of blood flow) to the tissue beyond the clot.

Coronary artery disease is the most common type of cardiovascular disease. It causes heart attacks most frequently. Coronary artery disease causes 1 in 5 deaths in the US—that’s one death ever 34 seconds. Strokes are another leading cause of death. In fact, if separated from other cardiovascular causes of death, it is the 5^th leading cause of death in the United States. It causes 1 in 19 deaths in the United States—that’s one death every 3 minutes and 30 seconds.

What can we do?

It’s important to go to your primary care appointments so that you can have your routine bloodwork and know your cholesterol values. If they are elevated, there are ways you can try to change your lifestyle to lower your cholesterol.

Additionally, your doctor may suggest you begin medication to help lower your cholesterol if you have one of the following:

• You are at high risk for heart attack and stroke
• If you’ve had a previous heart attack or stroke
• You have certain health problems, like diabetes

Physicians use statins most commonly to address high cholesterol requiring medical intervention. These are medications that not only lower cholesterol, but stabilize plaques, making them harder, and less likely to break. This means that the clot formation that causes heart attack and stroke is much less likely to occur.

So, what about lifestyle?

So glad you asked!

Healthy diet

You can begin by eating a heart healthy diet. There are several different things that constitute a heart healthy diet, but typically, you want to

• reduce saturated fats
• eliminate trans fats
• increase omega 3 fatty acids
• include more soluble fibers in your diet
• increase whey proteins

Of note, cholesterol in your diet doesn’t tend to affect the numbers as much as you might think, but some people, especially people with diabetes, should still watch the amount of cholesterol in their foods. You can find more detail about these interventions HERE.

Exercise/Activity

Experts recommend getting 30 minutes, 5 days weekly or 150 minutes weekly of moderate intensity cardiovascular exercise, or 20 minutes, 3 days weekly, or 75 minutes of high intensity cardiovascular exercise. Moderate intensity exercise is defined as 50-70% of your maximum heart rate. High intensity is 70-85% of your maximum heart rate. Your maximum heart rate changes as you age. (General guide is 220-your age).

You should also incorporate strength training twice weekly. Additionally, experts recommend a stretching and flexibility regimen. Cardiovascular exercise is the most important for targeting the cholesterol. For more on this intervention, see a blog post later this month.

Stop Smoking

Smoking is one of the single greatest ways you can take years off your life. It independently increases your risk for heart attack and stroke, raises blood pressure, increases your risk of cancer, causes lung disease, delays wound healing, and so much more.

When you stop smoking, it is one of the best things you can do for your health. For more information on this lifestyle intervention, see a blog post later this month.

Maintain/Approach a Healthy Weight

No one really likes to talk about weight, but here we are. Let me say this—you should love your body and yourself no matter what the number on the scale says. That being said, that love for yourself is also the reason you should want to be the healthiest you can be.

Evidence shows that high body mass indexes are correlated with worse health, and people who lose weight and have high cholesterol tend to see these numbers improve. With weight, a little goes a long way, so you don’t have to feel like you must do the impossible. Losing 5% of your body weight can change your health status dramatically. For more information on this intervention, see a blog post later this month.

Use Alcohol Within Healthy Limits

Those limits are 7 servings of alcohol weekly for women and 14 servings of alcohol for men.

These are ways YOU can take control of your health and decrease your risk. Change can seem like a lot, but everything is one step at a time. Pick one thing and make a SMART goal. Once that is achieved, add on to it.

You’ve got this!!

I was going back through some of my old posts and came upon Rainbows. It almost brought me to tears. Sometimes you get so used to telling a story that you have become detached from the trauma of going through what you went through. Sometimes, even though you are able to remember the lessons, you have forgotten parts of the journey.

I had forgotten this moment. I had forgotten these words I wrote to myself. I said, “…because I’m almost certain He’s just told me to be quiet and trust Him more. To hush, and stop thinking so hard, and do what He says, and that even if He’s got to destroy some things I think I need, He’s got me. Peace, be still.”

Even if He’s got to destroy some things.

Fast forward three years later. I still haven’t told you guys everything I went through in those three years. What I will say, is the Lord had to get VERY loud about the things He meant for me to walk away from. I can be hard-headed. I realize this as I begin to comb through my sparse journals and notes from about three years ago. So, He had to get really loud.

But here I am, with so much that was destroyed, to find a peace so complete I can’t explain it. God truly intends to produce the purest, strongest form of you. And He continues to apply heat when necessary, prune when necessary, so that the work He has begun will eventually be completed–if you listen, follow, and surrender.

I wrote a chapter about the beginning of this journey, but this blog–this blog in its disjointed way really captures my spiritual walk over the past 3 years. It shows how God has been speaking to me and preparing me for this year of LEAP.

What does that mean for you?

One of my favorite things has always been to look back and see how God brought everything together. I wrote another post, Moving in Faith, that talks about waiting for your 41. Getting through those hard times knowing that the Lord has something great on the other side for you, and that you in Him with Him in you are powerful beyond measure to live His will–that is to glorify Him through your unique gifts in the fullest way possible. It means that even if you can’t see it right now, God is moving, shifting, breaking and pruning things for your good. You will be more than okay as long as you are trusting Him. We will be okay as long as we are trusting Him.

I can’t wait to see what He has in store. Because you know–it’s beyond our imagination!