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PATIENTLY AWAITING TRANSPLANT CANCER SEXUAL HEALTH HEART OBESITY STRESS DEMENTIA... HEALTH MATTERS MAY 21-27, 2012 The Voice supplement page 25 /26/31/32 INSIDE: WOMAN’S WAIT FOR KIDNEY The story of undeterred hope PROSTATE CANCER REVISITED A doctor's guide to prostate health Fizzy makes fat Are high sugar drinks increasing obesity?
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Health Matters: Transplants

Mar 27, 2016

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Marlene Davis

In this edition the Voices speaks to a woman awaiting a kidney. Revisits prostrate cancer and takes a tough look at fizzy drinks.
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Page 1: Health Matters: Transplants

PATIENTLY AWAITING

TRANSPLANT

CANCER › SEXUAL HEALTH › HEART › OBESITY › STRESS › DEMENTIA...

HEALTH MATTERS

MA

Y 21-27, 2012

The Voice supplement › page 25 /26/31/32

INSIDE: › WOMAN’S WAIT

FOR KIDNEYThe story of undeterred hope

› PROSTATE CANCER REVISITED

A doctor's guide to prostate health

› Fizzy makes fat Are high sugar drinks

increasing obesity?

Page 2: Health Matters: Transplants

26 � THE VOICE JUNE 21 - 27, 2012

By Bart Chan

THE MACHINE thatkeeps ConnieSimmons alive humslike it has a life of its

own. From time to time enig-matic beeps pierce the hushedatmosphere of the St PancrasHospital ward, where a dozenor so patients are undergoingdialysis treatment.

Simmons lies on her hospi-tal bed watching television ona mini-portable device. Whenthere is nothing worth watch-ing she leafs through a news-paper or reads a book. It canget boring, she admits, how-ever it is the reason she isalive.

“What the machine is doingfor me is taking the place ofmy kidneys, so this is my kid-ney.” The dialysis machinebegins beeping again,Simmons makes an effort tolean out of her bed and press abutton to silence it. “It is tak-ing the poisons and toxins outof my body, because as I’vegone into kidney failure I’mnot able to do that on my ownanymore. So the machinetakes over.”

ROUTINESimmons has known for the

last 21 years that her kidneyswould fail. It was only inNovember of last year that shehad to receive dialysis, whenher kidney function droppedbelow 10 percent. Dialysis hasbecome a significant part ofher routine; she must undergo12 hours a week, whichrequires that she comes intohospital three days a week,and having to lie in bed forfour hours each time while themachine does its job. “Forordinary people, their kidneyis constantly working for them24 hours,” she says, knowingthat it has been much too longa time since she could take herkidneys for granted.

The treatment does wondersthough. “I feel well and I amable to carry on my day asnormal,” Simmons says, and itallows her to keep working aswell. She works in a bank as aCustomer Accounts Manager,and on Tuesdays andThursdays, after her early startat the hospital (she arrives at6:30am), she goes back to thecareer she has had for the last34 years. She says being atwork is a good thing, her col-leagues are supportive and theordinary aspects, like talkingto her customers, help. “Ittakes my mind of my prob-lems.”

The bank manager becameaware of her kidney problemduring the early stages of herpregnancy 21 years ago. Three

weeks into her pregnancy itwas discovered that she had ahigh amount of protein in herurine, indicating that “there isa problem with the kidney, Ihad high blood pressure whichis another sign of a bad kid-ney.” She believes her kidneyfailure is a result of an infec-tion she may have contractedin that area. Nonetheless, theearly diagnosis of her condi-tion has enabled her to beclosely monitored, greatlydecreasing further risks.

DIFFICULTIn addition, having gone 21

years knowing that her kid-neys would eventually failgave Simmons all the time sheneeded to learn about her con-dition. “It was very difficult,but I realised I used that timeto become very knowledgeableabout kidney failure, learnabout all the importance offood, the ones that are goodfor your kidney, the ones thatare not good.” She carefully

adjusts her body position inbed, tubes dark red with herblood like a spaghetti junctionspiral from her right arm tothe machine. “I just really readup everything about the dis-ease and was well preparedwhen I did go into kidney fail-ure.”

Dialysis has meant her lifemust be interrupted, yetSimmons strives for normalcy.“It has changed my life dra-matically, but the way I goabout the dialysis is that I justhave to be positive, and I justthink positively that one daysomething will happen for me,one day I’ll get some helpsomewhere and I’ll be able tolive normally.” The emotion isevident in her voice. “At theend of the day it’s a treatmentthat‘s helping me, and that iswhat keeps me going. It letsme lead a normal life, andthat’s what I’m grateful for.”

But the point is that there issomeone out there who couldreturn Simmons’ life to what itonce was. She has a brotherand he could be a match. Butthe sad thing is that he is notwilling. “He’s decided that hecan’t help me, which meansthat now I have to wait forsomeone on the outside, eithersomeone that’s died or some-one coming forward to helpme.”

TRANSFORMThere is no one else on this

planet who is as close agenetic match as her sibling,so it is most likely one of hiskidneys could transform hissister’s life. Simmons appears

to have accepted and movedon from her brother’s refusal.She can take heart from her 21year-old son though, who hasalready offered his own kidneyto his mother. However, that iscurrently not an option.Simmons says the medicalprofession deems her son tooyoung to donate, for boys donot reach full maturity untilthe age of 25. “They are wait-ing until he is a bit older to seeif he’s a match.”

It is not only her own plightshe is concerned with.Simmons desperately wantsmore to be done so others like

her do not wait in limbo,unsure if they will get theorgan they need. In her opin-ion, not enough people whocould make a difference are inthe know. “I think if there wasmore awareness they wouldfind it in their hearts to comeforward. There’s over 7000people waiting for a kidneytransplant, it would help somany people.”

Simmons stops mid-sentenceand winces in pain; her legs aresuffering from cramp. “Crampscan be quite painful, it’s one ofthe drawbacks of dialysis, butyou kind of get used to it. It’s

just one of those things whichis part of the parcel.”

MODERATIONAfter the pain receded,

Simmons talks of the future, afuture with a new kidney. Sheknows what she will do: “I’dstart to be able to eat anddrink all things I’m restrictedfrom. And I’d have a bigparty, but all in moderation.”It is fair to say moderation isnot a word she utters with fullconviction. “The first thing Iwill do is eat steak and kidneypie, I will have a steak andkidney pie party.”

A broad smile radiatesacross her face as Simmonspictures this happy future. Yetthe realisation of its uncer-tainty is upsetting. “I wouldbe just overjoyed to knowthat I could get a kidney andhopefully that kidney wouldwork for me, and I’d be ableto function normally againand do the normal things inlife.”

This future where every-thing works out is what shecherishes; “The dream for meis to be able to be fit and well,and see my son graduate andget married one day.”Simmons fights back thetears, her artificial kidneyhums and whirs, oblivious toits vital function.

The mother and bankworker wants back her oldlife: “Just to be able to get upin the mornings, do my dailythings and not be thinkingabout dialysis that is justreally what I want.” She restsher head back on the hospitalpillow, her voice soundingmelancholy: “I just wish Icould get a kidney.”

Connie dreams of a normal lifeas she waits for a kidney match

LIFE SAVER: The dialysis machine.

Just to beable to getup in the

mornings,do my daily

things and notbe thinking

about dialysisthat is justreally what

I want

TREATMENT: Connie Simmons gets treatment on dialysis machine.

Page 3: Health Matters: Transplants

By Dr Frank Chinegwundoh

PROSTATE CANCER isthe most commoncancer in men in theUK, accounting for a

quarter of all male cancers.Approximately 37, 000 newcases are diagnosed eachyear, which is approximately100 new cases per day. Itaffects mainly men in latemiddle age and old age.

In the UK a man has a 1-in-9 chance of being diagnosedwith prostate cancer. About10, 000 men a year will suc-cumb to prostate cancer. Theoutlook for a man withprostate cancer is good, if thedisease is caught early before ithas spread. Unfortunately, inthe UK approximately 25% ofprostate cancer is diagnosedwhen the illness cannot becured, although there are treat-ments that will prolong life.

In 2006, I published a paper,which has subsequently beenconfirmed in larger studies,showing that black men in theUK had a three-fold greaterrisk of being diagnosed withprostate cancer than theirwhite counterparts. Thisechoed data from the USA.The reason for the racial dis-parity which holds true allover the world is currentlyunknown. Research is concen-trating on genetic factors.Whether higher rates ofprostate cancer translate into ahigher death rate is the subjectof debate. American datawould suggest that black menare more likely to die ofprostate cancer than whitemen, but preliminary UK datadoes not support this. Ofcourse the health systems aredifferent.

SYMPTOMSIt is important to appreciate

that prostate cancer may bepresent even if there are nourinary symptoms. Or it canbe linked with urinary trou-bles, such as a poor urinaryflow, passing urine frequentlyor at night, or having to reacha toilet in a hurry. Recentonset of erection difficultiesmay also herald prostate can-cer. Most men with urinarysymptoms will not haveprostate cancer, but it is onlyby seeking expert medicaladvice that prostate cancer canbe excluded.

Crucial to the diagnosis isthe blood test PSA, whichstands for prostate specificantigen. This is a chemicalmade by the prostate glandand extruded into the blood-stream. The normal PSAshould be below 4 ug/l. Alevel above this suggests thatprostate cancer may be pres-ent. Prostate cancer is alsosuggested by the prostate feel-ing “hard” on digital rectalexamination as opposed to thenormal “rubbery” feel. Manyblack men are reluctant tohave a rectal examination.The author in talking to

groups of men, on behalf ofCancer Black Care, reassuresthem that such a quick exami-nation is nothing to fear andindeed can save their lives.

ADVISABLEEvery man over the age of

50 is entitled to a blood test onrequest to their GP. The earlierprostate cancer is diagnosedthe more the treatment optionsand the greater the likelihoodof cure. Waiting for symptomsmay be too late. As black mengenerally develop prostatecancer at a younger age thanwhite men, it would be advis-able to start PSA testing at age45. Prostate cancer can be“hereditary,” therefore prostatecancer in the family shouldlead to a request for PSA test-ing from the GP.

If the PSA is raised or theprostate feels abnormal, the

GP will refer the man to anurologist, who is a specialist inurinary system disorders.There is an obligation on theNHS to be seen by the special-ist within two weeks.

The urologist will organise abiopsy of the prostate. That iscalled a transrectal ultrasoundguided biopsy (or trus biopsyfor short). Commonly 12 sam-ples (cores) of prostate tissueobtained are sent to thepathologist for analysis. Ifprostate cancer is confirmed,further tests are done to gauge

the extent of the disease. Thetests may include a MRI scanor CT scan or bone scan.These will determine if the dis-ease is confined to the prostateor not. Each case is discussedby a multidisciplinary team,comprising urologists, nursespecialists, oncologists (cancerexperts), radiologists (imagingspecialists) and pathologists,in order to recommend a treat-ment plan for the patient.

Not all prostate cancers needtreating. Especially where thecancer is small and the PSArelatively low, there is a goodchance that the cancer may liedormant and never cause aproblem. Thus some cancerscan be kept under surveillance.However, where the decision isto treat the prostate cancer,there are various options whenthe disease is confined to theprostate. Such options include

radical prostatectomy surgeryto remove the prostate glandaltogether. This removal canbe effected through a tradi-tional open operation throughthe lower abdomen or by “key-hole” surgery or by the newtechnique of using a robot toassist the surgeon (robotic rad-ical prostatectomy).

DOSESAn alternative to surgery is

the use of external radiother-apy in small doses daily forseven weeks. For somepatients it is possible to offerbrachytherapy, which is a daycase procedure implanting tinyradioactive pellets into theprostate, where they lie perma-nently and give off radiationto destroy the cancer. Theradioactivity lasts for a fewmonths but by then the canceris destroyed.

Other techniques of eradi-cating the cancer are lesswidely available but nonethe-less sound treatments, such ashigh intensity focused ultra-sound (utilising heat energy todestroy the cancer) andcryotherapy (utilising extremecold to target the cancer). Thepatient is advised to discussavailabilities of treatments andthe advantages and disadvan-tages of each. Side effects doneed to be considered. Thesemay include sexual problemsand urinary leakage issues.The clinical nurse specialist isin a position to further advisethe man, over and above theurologist. There are also char-ity help lines that can assist.

For those men whose cancerhas already spread by the timeof diagnosis (metastatic can-cer) the mainstay of treatmentis hormonal. This is by way of

drugs (or surgical removal ofthe testes) to reduce the testos-terone levels. This is becausetestosterone fuels the growthof prostate cancer; thereforelowering it stops the cancer inits tracks. There are sideeffects of such treatment, butthese are tolerable. While hor-mone therapy is effective iteventually fails.

DRUGSWhere first line hormonal

therapy fails, which can beseveral years down the line,the oncologists have severalnew drugs in the locker. Suchpowerful drugs, such as doc-etaxel, abiraterone, cabazi-taxel and others, prolong sur-vival but are unable to cureprostate cancer.

Voluntary organisationssuch as Cancer Black Care(CBC) provide a valuablesource of information andsupport. Such groups are anadjunct to the statutory serv-ices and are worthy of supportfrom the community.Awareness needs to be raisedin the black community aboutprostate cancer. Men shouldbe encouraged to get them-selves tested annually.

Dr Frank Chinegwundoh is aConsultant Urologist in HarleyStreet, London and Chairmanof Cancer Black Care.

JUNE 21 - 27, 2012 THE VOICE � 31

We are looking for motivated individuals to join our board of trustees or to volunteer experience and skills in fundraising, grant writing, welfare rights, cancer awareness raising, newsletter production, administration.

If you have some time to commit to four board meetings a year and would like to be part of a well respected, London based, forward thinking organisation, why not give us a ring.

Speak to Natalie on: 020 8961 4151or contact by email: [email protected]

Cancer Black Care is a registered charity since 1996, supporting predominantly black and ethnic minority cancer sufferers and their families.

Prostate Cancer – An expert tells why testing can save your life

Further information on prostate cancerand how to combat it is available from

Donations to Cancer Black Care to aid in the work of thisblack led charity, via the website or by post, will be gratefullyreceived.

Cancer Black Care http://www.cancerblackcare.org.uk/

Prostate Action http://www.prostateaction.org.uk/

Dr Chinegwundoh http://www.urologyconsultant.co.uk

Prostate cancer charity http://www.prostate-cancer.org.uk/

Dr Frank Chinegwundoh

Page 4: Health Matters: Transplants

32 � THE VOICE JUNE 21 - 27, 2012

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By Jules Jack

OVER THE last fewweeks, a debate hasbeen raging in theUS, whose origins

are in New York. MayorMichael Bloomberg hasbravely proposed a ban onthe sale of sodas and othersweetened drinks in contain-ers over 16 ounces (about500ml in new money or apint in old).

He has set himself on thepath for a head on battle witha very powerful food anddrinks lobby, retailers such ascinemas and consumers whoview his proposal as a ‘fascist’attack on their American free-doms.

Are we attached to our sug-ary drinks because of the greattaste, habit, or perhaps themore insidious reason, addic-tion? Whatever the reason,there are many like MayorBloomberg who believe theyare a primary source of manyof our recent health problems.

A few months ago, whilstdiscussing their daily con-

sumption of up to five cans ofa popular fizzy drink, a clientbecame extremely emotionalto the point of tears. They wereadamant about working hardtowards agreed goals and thatthere was no problem withhaving a ‘treat’ after all the

effort; surely this wasdeserved?

This particular client is mor-bidly obese, a type II diabeticon insulin and a cacophony ofother aural medication forother ailments.

During his appearance onJon Stewart’s Daily Show,London Mayor Boris Johnsonstated: “The reality is we areall getting fatter. It is a prob-lem in a city like London andit is a problem in New York. Ifyou can stop kids getting fat-ter by restricting the size of thecoke they drink then whynot?” Could we soon see thesame proposal for areas in theUK and would you, the generalpublic, welcome it?

Mayor Bloomberg has aheadwind of academic opinionon his side. There’s a growingbelief that we are becomingfatter not because we are lessactive than 50 years ago, orbecause we are consumingfoods containing more fat, butsimply because of the sheeramount of sugar in the foodwe now eat.

Furthermore, a growing

school of thought believessugar is as addictive as sub-stances such as cocaine!Although table sugar con-sumption is down since the1970s, that of high fructosecorn syrup consumption isdramatically up. Other clientsof mine, friends and familymembers, who are otherwisefit and apparently healthy,admit to consuming more sug-ary liquids in a day than water.

I for one would welcome asimilar ban in London andwould ideally like it applied tothe whole country. Not for methe argument of an infringe-ment on civil liberties; nomore so than any of the vari-ous bans instigated on ciga-rettes.

For me, there’s no doubt weunderestimate the amount ofsugar in drinks. I’m interestedto hear your views on the pro-posed ban in New York; wouldyou object to the same beingintroduced in your city? Dropus a line at The Voice or tweetme.

And what of my clientabove? No more fizzy drinks,

more herbal tea, a change ofbehaviour and well on his wayto developing a new andhealthy lifestyle.

Jules Jack, is founder of a40rty Weight Management,

specialist in the managementof weight and weight relatedchronic illnesses, specificallyobesity and diabetes:w w w . 4 0 r t y . c o . u kT:@healthat40rty

Mayor Bloomberg – FoodFascist or Health Hero?

LARGE SIZE: A man leaves a7-Eleven store with a DoubleGulp fizzy drink.

DOWN SIZE: New York Mayor Michael Bloomberg is proposing aban on the sale of large sodas and other sugary drinks in thecity’s restaurants, delis and movie theaters in the hope of com-bating obesity.