Search for tag: "prevention"

Interviewer: It is time for "ER or Not," the game where we come up with a scenario and give it to emergency room physician, Dr. Troy Madsen, and you get to play along at home and decide whether or not that scenario is something you'd go to the ER or not and Dr. Madsen will tell us the definitive answer. Dr. Madsen, are you ready to play?

Dr. Madsen: I am ready.

Interviewer: So the weather has been getting quite hot lately, especially for us here in the Southwest, and we've been getting a lot of questions coming from people that are really concerned about overheating, so everything from heat exhaustion to heatstroke. So the question is, heatstroke, we know it's pretty serious, but is it serious enough for the emergency room? Troy Madsen, ER or not?

Dr. Madsen: It is, Mitch. Yeah, heatstroke, you need to go to the ER. And that's an important distinction. You mentioned there, heat exhaustion and heatstroke. So heat exhaustion is just when you start to get very overheated. So this is when you start to feel very hot, maybe you feel lightheaded, a little bit nauseous, maybe a headache. This is when your body is overheating, your body temperature is rising.

But then heatstroke is the next step beyond that. And heatstroke, we're talking about people who are really experiencing severe effects, very high body temperatures, and then they start to even experience some damage to the organs in their body, maybe their kidneys, even their brain. It can affect the brain. It can affect the heart. These are cases where people become confused. They're just not responding as well, maybe passing out. These are very serious cases. So if someone is truly experiencing severe symptoms, where they have been in an environment, say in a house without air conditioning or they've been outside exposed to the heat for a long period and they seem confused, they're passing out, they're just not responding to you well, absolutely get them to the ER. And I would say even in these cases, don't hesitate to call 911 to get them to the ER, just because it's essential that we get them in a situation where we can make sure everything is okay and then get their body cooled down rapidly.

Interviewer: Wow. So what are like the top signs, I guess? Because it sounds like heatstroke could be a real problem for your organs, for your brain, like almost as serious as maybe even a stroke.

Dr. Madsen: The biggest signs I would say to look out for are people who are not responding, who seemed confused, or just not responding altogether. You try to get them to respond, they're not answering questions. People who are passing out. Those would be the biggest things I see in people who have moved just beyond heat exhaustion to heatstroke, where you're seeing very serious effects on their body from this.

Interviewer: Is there anything that people can do at home while they're, say, waiting for help to arrive or to get to the ER?

Dr. Madsen: Absolutely. If you can get a fan going on the person, get a spray bottle with cool water in it, spray that on the person, that evaporative cooling can really help, especially in a dry environment like Utah, where evaporative cooling can decrease your body temperature. So spraying down with a cool mist, getting a fan going, circulating air, that can definitely help get that cooling process started. And if someone is in a situation where they're not to heatstroke, but they just say, "Hey, I just don't feel great. I feel a little bit nauseous. I'm just feeling hot." Those are things you can do at home as well to avoid having to go to the ER.

Interviewer: So heatstroke, it's serious. Time is of the essence. Get help as soon as possible?

Dr. Madsen: That's exactly right. If someone is hot, they're confused, they're not responding well, get help, get to the ER.

Announcer: "Health Hacks" with Dr. Troy Madsen, on The Scope.

Dr. Madsen: Today's health hack is having an antibiotic in your bag when you travel. The antibiotic I really have in mind here is Ciprofloxacin. And the reason for it is urinary tract infections. So if you're female and you're traveling, you may have experienced this before. I mean anyone could experience it, but urinary tract infections are more likely in females. And if you're traveling and you experience a urinary tract infection, you know how miserable this can be.

If you're in a foreign country or just even another city, just trying to get in to find health care, interrupt your plans, getting the help you need to get a prescription for exactly what you know you need can be an incredible headache. So I think it's not at all unreasonable if you're going on a big trip or, you know, if you meet with your doctor just to ask them, "Can I get a prescription for an antibiotic to have on hand for this kind of situation?"

I think it's a reasonable thing to have. Typically you know when you have a urinary tract infection, and studies that have been done have shown that if a person feels like they're having a urinary tract infection, they're probably right.

So the health hack here is have an antibiotic on hand. Ciprofloxacin is one that I recommend that works very well for urinary tract infections. Take it with you when you travel. If you have symptoms of urinary tract infection, you can take this, avoid a trip to an ER or to some health care facility in a foreign country.

Announcer: For more health hacks, check out thescoperadio.com. Produced by University of Utah Health.

Announcer: "Health Hacks" with Dr. Troy Madsen on The Scope.

Dr. Madsen: Well, today's health hack is a trick to try and get a raisin or any other sort of foreign body out of your child's nose. Now, this health hack is a little bit gross, but it works, and it could save you a trip to the ER.

So if your child sticks something up their nose, a raisin or anything else they find around the house, you can't see it to pull it out and you're thinking to yourself, "There's no way I'm going to get this out." One trick is to have your child lie down on a couch or on a bed. You place your mouth on your child's mouth. You blow into their mouth forcefully, quickly, only maybe a second or two of forceful air into their mouth. That air then gets forced up through the nose and that is going to ideally force this raisin or whatever else is in there out of their nose.

Now, it's a little bit gross because you've got to put your mouth on your child's mouth, you have to blow in there, and most likely that raisin or whatever else is in there is going to get blown out onto your face with some mucus. But the good news is you avoid the trip to the ER. If you were to come to the ER with the same problem, I would probably ask you in the ER, "Are you willing to try this here? Because it can avoid a whole a lot of trauma to your child, a whole lot of probing around in their nose." So, if this happens at home, give it a try. There's good evidence that this works well. It can save you a trip to the ER.

Announcer: For more health hacks, check out thescoperadio.com. Produced by University of Utah Health.

Announcer: "Health Hacks" with Dr. Troy Madsen on The Scope.

Dr. Madsen: Today's health hack is a simple thing you can do to drop calories from your diet and lose weight. So let's say you're cruising along, you want to lose weight, but you just cannot seem to drop the pounds. Simple trick is look at your diet. If you're having a soda every day for lunch, particularly a large soda, or maybe breakfast, maybe dinner, whenever you might have a soda or several sodas, if you can cut a large soda, one of these gas station soda-sized things from your diet every day, you will lose a pound per week.

This is based on the fact that these large sodas probably have 500 calories. If you're just maintaining that drop right there, 500 calories for a man or a woman, is enough that you should be dropping about a pound of weight per week as long as you're keeping things steady with the rest of your diet. It's a simple thing you can do, just a matter of trying to replace it. Just drink more water, avoid the calories from that soda, and over several weeks, you're going to see the weight start to come off.

Announcer: For more health hacks, check out thescoperadio.com, produced by University of Utah Health.

Announcer: Health Hacks with Dr. Troy Madsen on The Scope.

Dr. Madsen: Today's health hack is treating an ingrown toenail to prevent it from getting worse. So if you've ever had an ingrown toenail, you know they're pretty miserable. They get inflamed. Sometimes you need to have a piece of the toenail cut off, you need to have the infection opened up and drained, and you need to go on antibiotics. So if you can catch this early, you can save yourself a whole lot of pain and headache.

An ingrown toenail essentially happens when one side of the toe or one side of the toenail digs into the toe and it grows out. It causes that area to just get inflamed. So if you can get that corner of the toenail and somehow lift it up so it's not pushing into the skin, you can prevent it from getting worse.

The hack here is to use a cotton swab. You take that cotton swab, you pull the cotton off the end of it, throw the stick away, and then take that cotton and roll it up so it's kind of a little bit longer and thin, and then you lift the edge of the toenail up, slide that cotton up under it, and then leave it there. Do that every morning after you take a shower when the skin's a little bit softer. What that does is it lifts the toenail up away from that edge of the skin. It prevents the toenail from growing into the skin and getting worse. If you do that for about a week, you're going to be good. The toenail will grow far enough you're not going to have an ingrown toenail. You'll save yourself from having to have any sort of procedure done or having that drained.

Announcer: For more health hacks, check out thescoperadio.com, produced by University of Utah Health.

Announcer: "Health Hacks" with Dr. Troy Madsen on The Scope.

Dr. Madsen: Today's health hack is using a combination of ibuprofen and acetaminophen instead of an opioid for injuries and pain from those injuries. This is all based on a study. Came out in the Journal of the American Medical Association a few months ago. It was eye-opening for me, for a lot of people I work with because we've always assumed that opioids worked better.

So this study, patients got a combination of ibuprofen 400 milligrams and acetaminophen, also known as Tylenol, 1,000 milligrams. These are standard over-the-counter medications, and they compared it to patients who got opioids. Those who got this combination of ibuprofen and acetaminophen did just as well with their pain. So I think the take home from this would be if you're in the ER and you're offered opioids, ask for some Tylenol, ask for ibuprofen. Avoid the opioids and avoid that addiction potential.

Announcer: For more health hacks, check out thescoperadio.com. Produced by University of Utah Health.

Announcer: "Health Hacks" with Dr. Troy Madsen on The Scope.

Dr. Madsen: Today's health hack is an easy to do, homemade splint. So all of us have cardboard boxes around the house. So let's say you have something where you fall or a child falls, you look at their arm, and it looks like it's broken. It's obviously deformed, it's swollen, they're having lots of pain. You want to get them in to get some x-rays and get this checked out. But every time they're moving that arm, it hurts.

So if you take a cardboard box, you break it down, do a couple layers the length of their arm, you can then put one piece of that cardboard box on each side of their arm, so you've got two pieces total. And then wrap it around with something that's not too tight, maybe just use like a shirt, a couple shirts to tie it around there. This can stabilize their arm and help them to feel a lot more comfortable while they get into the ER to get an x-ray.

So you're wondering, "Well, why cardboard?" Well, it's easy to use. And a lot of EMTs, so if you call an ambulance, a lot of them have cardboard splints. They're just using the same thing. It's really a great tool to have. The advantage of it is if this arm's moving around while they're in the car, they're just going to hurt a lot. There's potential that the fracture could move out of place even further. And again, it's something you probably have around. It's simple enough to do. You can grab it, quickly put this in place, get them in to get some treatment.

Announcer: For more health hacks, check out thescoperadio.com. Produced by University of Utah Health.

Dr. Madsen: E-scooters and the emergency room, are more people going as a result? We'll find out next on The Scope.

Announcer: This is From the Frontlines with emergency room physician Dr. Troy Madsen on The Scope.

Interviewer: Dr. Troy Madsen is an emergency room physician at University of Utah Health. And in Salt Lake City and a lot of communities, you'll see these e-scooters now. I bet you there's more people going to the ER, because sometimes it looks like maybe the people aren't riding them as safely as they should. Wanted to find out for sure though. Are you seeing more injuries as a result of e-scooters? What's going on in the ER here in Salt Lake?

Dr. Madsen: So in our Emergency Department, we are absolutely seeing more injuries related to e-scooters. I would say now we're seeing an injury related to scooters at least once every other day if not every day in the ER.

We looked at our numbers. We pulled all the records from our Emergency Department from this last summer, and we compared it to the summer before, because e-scooters have become very popular in Salt Lake City this year with a couple of rental companies coming in, and our number of e-scooter related injuries has significantly gone up.

Interviewer: Is it the people that are riding them that are getting hurt, or is it people that are walking and getting hit by somebody that's riding an e-scooter?

Dr. Madsen: You know, interestingly, I didn't see any cases of anyone who reported getting hit who came to the ER.

Interviewer: Hmm.

Dr. Madsen: I thought we would.

Interviewer: Yeah, I would too.

Dr. Madsen: But every one of these injuries we saw this year were people who were getting hurt riding the scooter. Most of these were orthopedic injuries, people injuring their arms, their legs. I suspect what's happening is people are running into trouble on the scooter. Maybe they hit a rock or a curb. They jump off. They're going 15 miles an hour. They try and stop themselves, but you just cannot run fast enough to keep up at that speed, so you're going to fall. And these were broken ankles, dislocated ankles, dislocated/broken wrists, elbows, shoulders, all sorts of orthopedic injuries. Some of these were very serious, where they had to go to the operating room.

We even saw some very serious head injuries as well. Interestingly, when people were asked, "Were you wearing a helmet," I didn't see any cases where anyone said yes. And several people said they were intoxicated while they were on the scooter.

Interviewer: Yeah. That's what I was wondering too. So how many of the accidents are actually intoxicated related versus just somebody who maybe was riding faster than their ability? Because these are new, right?

Dr. Madsen: Yes.

Interviewer: And they do go fast. It would be easy to outride your skill level at this point.

Dr. Madsen: Oh, it absolutely would. So of these, I would say about 20% said they were intoxicated.

Interviewer: Okay.

Dr. Madsen: So a decent number, but, you know, not the majority.

Interviewer: Yeah.

Dr. Madsen: But you're exactly right. I think of someone like myself, because most of these injuries were people between the ages of 20 and 50. And for someone like myself, I haven't personally been on a scooter in probably 20 years, and it didn't have a motor on it. So you figure I'm just going to jump on the scooter. It can go 15 miles an hour. You can imagine how you could run into trouble, try and swerve around someone or hit a curb or a rock, and you could run into trouble pretty quickly at that speed.

Interviewer: Yeah. So it sounds like that the solution maybe to this is slow down a little bit. It is good to know that it's not people getting hit, because that would be my fear as a pedestrian.

Dr. Madsen: Exactly.

Interviewer: I would, yeah. So if you're riding the scooter, slow it down. Make sure you're not riding above your skill level, and then also look out. Realize you've got, you know, there's other people there.

Dr. Madsen: Yeah. That's exactly right. My recommendation is take a few minutes just to get comfortable with the scooter. Practice turning on it, getting on and off. These things go 15 ...

Interviewer: Braking.

Dr. Madsen: Braking. Yeah, exactly. I mean they go 15 miles an hour. That's as fast as you ride on a bike.

Interviewer: Yeah.

Dr. Madsen: And wear a helmet.

Interviewer: Yeah.

Dr. Madsen: That's the other thing too. If this is part of your daily commute, you ride tracks, you catch a scooter, you go to work a mile away, bring a helmet in your backpack. Put the helmet on. It can make a big difference if you do fall off and hit your head. You'd wear a helmet on a bike. You should wear one on a scooter as well.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.

Interviewer: You may have heard there's a new shingles vaccination, and your doctor might have recommended that you get it. Should you? Well, we'll talk about that next on The Scope.

Announcer: Access to our experts with in-depth information about the biggest health issues facing us today. The Specialists, with Dr. Tom Miller is on The Scope.

Interviewer: Let's talk about shingles. First of all, let's just set the stage. What is shingles?

Dr. Miller: Let's talk about that. So shingles is what we call recurrent chicken pox. Now, before the chickenpox vaccine was given routinely to children, most of us, probably greater than 95% of us, have had chicken pox and may not even remember it as kids. Now, once you've had it, it never goes away. The virus goes into your nerves in your spine and hides, and for reasons that are not entirely clear, probably because our immune system sort of forgets that the virus is hidden over time, chicken pox comes out again as shingles or herpes zoster. So it doesn't present as a fulminant, itchy rash like we get when we're kids, but it comes out in specific areas where the nerves innervate parts of the skin.

Interviewer: Meaning it's painful.

Dr. Miller: Well, it's painful, and what's even more concerning and more damaging, probably 10% to 20% developed what we call postherpetic neuralgia, which is a pain that continues after 90 days. And it's very severe and very hard to treat. Some people when they have postherpetic neuralgia can't even wear a shirt because it's painful.

Interviewer: Sounds miserable.

Dr. Miller: Treatments are not very good either. So the best you can do is prevent shingles.

Interviewer: And there is a shingles vaccine. And a lot of people have already gotten it, and now I'm hearing about a new shingles vaccine. So help me kind of reconcile if I should get it or not.

Dr. Miller: Well, that's right. So we say there's about a 30% lifetime chance that you'll develop shingles, and shingles rises in incidence after the age of 50, and by the time you're 80 years old, probably about 20% of people who develop shingles will have postherpetic neuralgia, which is this chronic pain that goes on and on and on.

If you vaccinate, it's basically waking up your immune system to watch out for that virus sneaking out of its hidden cave and coming back and bothering you. So the first vaccine was a live vaccine that was developed in the middle of the last decade. And it was pretty darn effective. But there's a new vaccine that is recommended even if you've had the older vaccine, that is not a live vaccine. And the advantage to that is we can now give this newer vaccine to patients who are immunocompromised. That is to say that their immune system is not quite up to par. It would have been dangerous to give them even a weakened live vaccine because they could develop full chicken pox. So we didn't we didn't give that older vaccine to folks who are immunocompromised.

Interviewer: So if you've been told you couldn't get the shingles vaccine before, now you can?

Dr. Miller: Now you can.

Interviewer: Okay.

Dr. Miller: If you have a history of being immunocompromised.

Interviewer: So that person for sure should get it. Who else should think about getting it?

Dr. Miller: Well, anyone who's over the age of 50 and certainly over the age of 60, the advantage to the newer vaccine is it is a more potent and efficacious vaccine. It works better than the older vaccine. So, in time it will become probably the sole vaccine available.

The issue with the newer vaccine is, one, it has more side effects. And two, it's costly and the older vaccine was costly, but this is a little more costly. So side effects, and what I mean by that is about 10% of the time people after getting the vaccine will develop a flu-like illness that's bad enough that they may not want to go to work.

Interviewer: So symptoms like chills, body aches . . .

Dr. Miller: Chills, aches, malaise, you just don't feel quite right. It lasts for 24 hours to 48 hours and then it's gone. This is not a reason to not get the vaccine. It's self-limited. It doesn't mean that it's going to go on. It was also a sign that this is a very immune genetic vaccine, that it is revving up the immune system and making the immune system remember that it has to go after the zoster or go after the shingles virus if it comes out of the nerves in the spine. And we know that this new vaccine is more effective in the sense that it lasts longer.

Interviewer: So if I got a shingles shot a couple years ago, and I'm 65, if I'm over 50, should I really consider turning around and getting this one?

Dr. Miller: The recommendation is to receive the new vaccination, even if you had Zostavax, the first vaccination, the live vaccination that was out.

Interviewer: At any point?

Dr. Miller: At any point.

Interviewer: Okay.

Dr. Miller: Well, I probably say, if you've had Zostavax, you would wait a year, maybe two or three years before getting the new one.

Interviewer: You can talk to your physician about that if that's the case, yeah.

Dr. Miller: You can talk to your physician. And then I think the second thing is some people assume that this particular vaccine is covered under Medicare. Certain vaccines are covered under visits during for people who have Medicare insurance, such as the flu shot and a couple of other vaccines, pneumococcal vaccine for instance. This one is not. It's covered under Part D. So you really need to find out from your insurance what the cost of this vaccine will be. The other slight disadvantage with the newer vaccine is it's a two-shot vaccine. You take the first shot and then come back in three months for the second shot.

The total course of therapy on average or treatment on average is about $340 if you were just to pay out of pocket, and for many people who don't have insurance, that's a big inhibitor. But since most of us over 65 will have Medicare and some coverage, it'll be cheaper. But again, check with your private insurance or check with Medicare to know what it's going to cost you so you don't get hit with sticker shock.

Interviewer: Yeah, and then take a look at I mean, it sounds like if it develops into the long-term chronic pain, not being able to put on a shirt, I mean, that sounds like it might be worth figuring out how you could come up with a little extra money if you're not able to.

Dr. Miller: Well, that's true. I think one of the problems that we see folks experience, they come in and they hear about it, and then they get the vaccine, but they experience the sticker shock. And either they decide not to get the vaccine or they wait.

And just as long as you know what the cost is, you can make an informed decision. And I certainly recommend it in all of my patients over the age of 50 and certainly over the age of 60.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.

Interviewer: Diet and exercise can help reduce cancer risk. Talk about that next on The Scope.

Announcer: Health tips, medical views, research and more, for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Cancer can be caused by many different factors, but some of them like diet and exercise is actually something a lot of us can control. Dr. John Sweetenham is a medical oncologist from Huntsman Cancer Institute. And how much of cancer risk is related to diet?

Dr. Sweetenham: Well, overall in the U.S., the current estimates are that about 20% to 30% of all cancers are related in some way to either excess body weight, to poor nutrition, or to inactivity and lack of exercise.

Interviewer: So to round up, maybe around a third. That's pretty substantial. Give me an idea of how that fits in context with maybe some of the other risk factors that are out there like genetics or smoking or stuff like that.

Dr. Sweetenham: Sure. I mean, if you look overall at risk factors for kind of cancers globally, we know for example, that tobacco and smoking is a very significant cause for lung cancers. And we can kind of rest the blame for certain types of cancer on certain types of lifestyle changes and behaviors.

For excess weight and for inactivity, it seems like it affects a whole breadth of different types of cancers. So there are many cancers which are more common in folks who are maybe overweight and folks who are inactive and who have deficiencies of whatever type in the diet or excesses of diet in the diet like high fat and so on.

Interviewer: Yeah. I'd like to delve into some of those details here. But before we kind of get into the how's and why's of some of those details, let's just lay out what a good diet and exercise plan for cancer prevention would look like, and then we'll go from there.

Dr. Sweetenham: Sure. So we don't know the absolute details of that, but some general rules are to eat plant based foods as much as you can, plenty of vegetables, beans, any other plant-based foods, they're helpful in that regard. They seem to reduce cancer risk. And stay away particularly from cured and processed meats and red meats. They seem to be particularly risky. And then finally, the other components of the diet that's well known about is high fat foods. So it's difficult to eliminate those from diet, but if you can reduce the amount of high fat food that you have, that can be a big help.

Interviewer: So this might be a bit of a technicality, but is it plant-based foods are good just because they're not the bad foods? Or are there actually some positive health benefits to those?

Dr. Sweetenham: Yeah. That's a great question. There are very definite health benefits from those. For example, the fiber content of your diet, we know that that can reduce your risk of certain cancers like colon cancer. So it isn't just about not eating bad foods, there are positive benefits from a lot of vegetables and fruits and so on.

Interviewer: Yeah. So the bad foods, what's going on there? How are they causing damage?

Dr. Sweetenham: So we don't really know in detail. We know for sure that if you are for example, overweight, that can affect the way that your body reacts to levels of insulin, and that is thought to be one reason why some folks develop cancer as a result of the way the body handles insulin.

Some of the hormone levels are affected by excess weight. Estrogen levels are thought to be affected by how heavy somebody is, and that may be responsible for certain types of cancer such as breast cancer. But exactly why it is that excess weight causes cancer is still something that a lot of people are researching.

Interviewer: Yeah. So we have pretty good research to show that the diet that you laid out, plant-based diet, avoiding a lot of red meats and processed foods, we just don't know the why's kind of that.

Dr. Sweetenham: Absolutely, yeah. The evidence for that is very good. The cause is still a little unclear.

Interviewer: Got you. So what about a lack of activity? We started out by talking about food and exercise. So you're talking about how people that have excess body fat could be at more risk of cancer. Is the activity just about keeping a lean physique so that doesn't happen, or are there actually benefits to activity?

Dr. Sweetenham: There are clear benefits to activity, and we see that at several levels. Partly in cancer prevention it seems to reduce the risk. But also there's increasing information around how someone who already has cancer, how they may respond to their treatments and what their likely outcome is going to be, if they're able to exercise during the treatment after the diagnosis. So now, some really interesting evidence that exercising during and after your treatment can reduce your risk of a cancer coming back.

Interviewer: Yeah. So is it generally thought that it's chemical reasons? Again, for the exercise and for the food it's the chemical changes that are going on in the body that might be affecting the cell division?

Dr. Sweetenham: Yes, it probably is. Again, a number of large research programs addressing that and we have some big research programs at Huntsman Cancer Institute which are specifically looking at why that is and how it is that exercise can reduce your cancer risk, and improve your cancer outcome if you do develop the condition.

Interviewer: Yeah. Here's what I think I know. I want you to tell me if this is right, and then fit it into the context of this conversation. So cancer is an uncontrolled division of cells which is caused by genetic mutation. So every time your cell divides there's a chance of a genetic mutation happening. Some are . . . it doesn't matter, some could be bad, some could be good.

Dr. Sweetenham: Correct.

Interviewer: Over time, you get enough of these genetic mutations, then the cancer or the cell loses its ability to control its division speed.

Dr. Sweetenham: Yeah. The brakes come off.

Interviewer: Okay, the brakes come off, and that's when you start to get cancer.

Dr. Sweetenham: Exactly.

Interviewer: So eating red meats, we don't know why that's causing that genetic breakdown.

Dr. Sweetenham: There are clues. It may be that there are substances within the red meats, or within the processed meats that actually kind of accelerate that mutation, that genetic change within the cells. But again, we don't know in great detail why that is.

Interviewer: Got it. Are some people more susceptible to one trigger than others? Meaning, for one person it might be the foods they eat or don't eat, but for them smoking isn't quite as much of a risk. I guess what I'm trying to ask here, is there a cumulative protection in all of it? Like the more right things I do, the better chance I'm going to have of not developing cancer.

Dr. Sweetenham: At the moment, all the evidence would suggest that's the case. Yeah. The more healthy behaviors that you're able to follow, the lower your risk of cancer. So that as you eliminate one of these risk factors from your life, your risk of cancer goes down in proportion. So if you stop smoking, you reduce your risk of certain types of cancer. If you lose weight, you're reducing your risk of additional types of cancer. So absolutely. It all adds up.

Interviewer: Yeah. And all 30% of it you can control.

Dr. Sweetenham: Absolutely.

Interviewer: With just diet and nutrition.

Dr. Sweetenham: That seems to be the case. Yeah. Absolutely.

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