What’s the best imaging technique to detect cancer?

A patient recently approached me to know which medical imaging modality was the best to detect cancer, if any, within her.

March 13, 2019 Health, Wellness

By dr alex khoo cheen hoe

Imaging modalities are important to allow doctors to see what’s going on inside our bodies. — Photos.com

This question has always been asked and will continue to boggle the minds of many.

First and foremost, there is no universal imaging modality that can detect everything.

It is also important to know what are the underlying health issues (if any), which organ is involved, what needs to be assessed and why is the imaging needed.

There are many medical imaging modalities available, including ultrasound, echocardiography, conventional x-rays, computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine imaging (gamma imaging and positron emission tomography, or PET).

Each of these imaging modalities has their own strengths and weaknesses.

For example, ultrasound, which basically uses attenuation and deflection of sound waves for tissue mapping, is very useful in assessing superficial soft tissue organs.

Women who undergo antenatal follow-up are quite familiar with the use of this imaging modality to evaluate their baby in the womb.

However, it is difficult to get good quality images of organs in certain areas and in obese patients with an ultrasound.

The widely available conventional radiography (or more commonly known as x-ray) has been used since its first discovery by Wilhelm Roentgen in 1895.

Most people will remember undergoing chest x-rays for their pre-employment screening test.

On the other hand, CT scans, which also use x-rays , are able to visualise the body in three dimensions (3D).

This imaging modality is available in most hospitals and has become an important tool in clinical practice.

It has been used to detect cerebrovascular accidents (strokes), lung diseases, cancers and fractures.

However, this scan is limited when it comes to visualising soft tissue lesions, particularly in the brain, spinal cord and pelvic organs.

The good news is that the days where radiation from the CT machines was an issue are gone, as newer CT machines are able to produce better quality images with much lower radiation.

MRI, which uses magnetic resonance of the protons within the body, is basically free of ionising radiation.

It is able to visualise soft tissues within the body with better resolution compared to a CT scan.

Unfortunately, the lungs and bone structures are not well visualised on MRI.

Patients with non-MRI compatible implants, like a non-compatible pacemaker or implantable cardioverter defibrillator (ICD), are also not allowed to undergo the scan.

Fortunately, the newer generation of such implants are now MRI-compatible.

Though uncommon, the side effects related to the use of gadolinium-based contrasts – used in x-rays, CT scans and MRIs to help visualise the targeted area – are real and the search for better alternative contrast agents is underway.

A PET scan of a head. This nuclear medicine imaging has a high sensitivity in detecting cancers. — Photos: AFP

Nuclear medicine imaging

Being in the field of nuclear medicine, I am frequently asked to comment if nuclear medicine imaging is still relevant when we already have other good imaging modalities.

The answer is simple: Nuclear medicine imaging has its strength in functional imaging.

In nuclear medicine imaging, small doses of radioactive substances are used either independently or paired with special pharmaceuticals to visualise the organ of interest.

If doctors need to evaluate the skeletal system, a radioactive bone scan using Technetium-99m methylenediphosphonate (Tc-99m MDP) can be done.

This radiopharmaceutical will be distributed within the bones in such a way that any abnormalities will cause either an increase or decrease in its levels, which can be detected.

In fact, Tc-99m MDP is so sensitive that a 5% change in bone turnover can be detected, compared to 40%-50% on conventional radiograph or even a CT scan.

And early detection means early intervention.

Nuclear medicine is also unique as some radioactive substances not only treat diseases, but are also able to provide images at the same time – hence the word “theranostic”, a portmanteau of “therapy” and “diagnostic”.

For example, not only can radioactive iodine-131 be used for the treatment of well-differentiated thyroid cancer, but imaging of the cancer distribution can also be done – literally “killing two birds with a stone”.

PET pros and cons

PET imaging is currently the “in-thing” in cancer management.

Whether used with CT or MRI (PET/CT or PET/MRI), the high sensitivity in detection of cancers, and most uniquely, the determination of the level of metabolic activity within the cancer is very useful to clinicians.

Though some cancers are already dead after treatment, the physical aspect of the cancer may still be seen on conventional radiographs and CT for a period of time, analogous to a dead tree stump.

When dealing with cancers, time is essential and any residual metabolically-active disease should be dealt with swiftly.

Hence, information of the metabolic activity of the tumour is very useful – no metabolic activity means dead tissue.

Furthermore, the radioactive substance can be used safely in patients with renal (kidney) impairment without causing further deterioration.

Then again, PET/CT or PET/MRI is not the ultimate imaging modality.

There are limitations to using PET as not all tumours take up the radioactive substance and there might be masking by physiological uptake by normal cells.

The fear of having radioactive substances within the body is also a major deterrent in many patients.

However, with proper counselling, they will realise that the radioactive substance used will basically decay exponentially and wash out from the body, similar to any other medical imaging contrasts.

Imaging is necessary

The ultrasound is one of the more commonly experienced imaging modalities as pregnant women are required to undergo them as part of their regular check-ups.

Once again, I highlight that no imaging modality is perfect.

Not all clinical information can be gathered from non-ionising medical imaging such as ultrasounds and MRI, and neither are all patients suitable to undergo them.

Patients undergoing x-rays, CT and nuclear medicine imaging, including PET/CT and PET/MRI, are exposed to certain levels of radiation.

Technological advancement has significantly reduced the radiation exposure to the least possible, compared to many years ago.

Even though the radiation exposure is minimal, many people still harbour the unfounded fear of it possibly triggering or exacerbating cancer.

In actual fact, the radiation exposure from medical imaging is negligible in the course of medical treatment.

Cost is no doubt an issue in this day and age. It goes without saying, that the more expensive the imaging is, the more likely that patients will try to avoid it.

Better equipment and technology comes with a price.

One needs to consider the investment, equipment costs, research and clinical trials involved before an imaging modality is approved, similar to how smartphones are being improved and made.

The better the specifications of the phone, the pricier it is. But with time, prices will fall due to increasing demand and availability.

Nuclear medicine imaging is relatively expensive due to the scanner, as well as the radioactive substances needed for the imaging.

These substances need to be specially ordered and are not widely available.

Nonetheless, it is a small price to pay for crucial clinical information needed to manage our own health.

In short, it is important for patients to understand that doctors choose imaging modalities to help diagnose, stage, plan, evaluate and monitor their condition.

There are times when doctors will order multiple imaging modalities in the course of their management.

The risk and benefits for each imaging is always taken into account before subjecting patients to them. Each and every person is unique and every disease is different.

Whenever I hear patients sharing their medical conditions, I do sometimes wonder if they actually realise that they are unique individuals with different medical issues and their experience may not be applicable to their listeners.

In the era of precision medicine, there is no one imaging that fits all. To achieve the best treatment, it is important to tailor the treatment according to the patient and underlying condition.

If in doubt, discuss with your doctor. I end with a quote from Ralph Waldo Emerson: “Don’t waste life in doubts and fears.”

https://www.star2.com/health/2019/03/13/whats-the-best-imaging-technique-to-detect-cancer/

New imaging machines for IJN

Technological advances increasingly mean that doctors are able to see and assess the function and structure of our organs without having to cut our bodies open or insert instruments into us.

March 5, 2019 Health, Wellness

By TAN SHIOW CHIN

Imaging methods like X-rays and ultrasound are familiar to us all, with many of us having undergone at least a chest X-ray (as part of a health check-up before being hired) or an abdominal ultrasound (for pregnant women).

Some of us with medical concerns or conditions might have undergone more advanced imaging like CT (computed tomography) scans, PET (positron emission tomography) scans and MRI (magnetic resonance imaging).

According to National Heart Institute (commonly known by its Malay acronym, IJN) consultant cardiologist Datuk Dr Ahmad Khairuddin Mohamed Yusof, CT scans are actually multiple X-ray images taken from various different angles.

“From there, we reconstruct images so we can see the anatomical structures in the patient’s body,” explains the specialist in cardiovascular imaging and interventional cardiology.

The multiple X-ray images are combined into a number of cross-sectional images – also known as “slices”– of the targeted body part via a computer programme.

“On the other hand, the PET scan is the mechanism of seeing the function of the organ by introducing a radioisotope into the patient’s body. Once the radioisotope gets into the patient’s body, it will decay, and the decaying process will produce gamma-radiation,” he says.

“This radiation will be detected by special detectors, which will produce and reconstruct images via multiple complex algorithms, and from there, we can see how the organ functions as a whole.”

For example, the radioisotope fluorine-18 is commonly combined with glucose to form fluorodeoxyglucose, a common tracer for PET scans.

As a form of glucose, fluorodeoxyglucose is taken up by cells as part of their energy-producing process, thus enabling its concentration in various tissues and organs to be measured.

Cancer cells, for example, tend to use far more glucose than ordinary cells, making PET scans useful for identifying malignant tumours.

There are also PET-CT scan machines that combine both these methods into one piece of equipment. This allows for more accurate imaging as the anatomical images from the CT scan and the functional images from the PET scan, which are done consecutively in the same session, can be combined into a precise picture of the targeted organ.

IJN Imaging Centre manager Norizam Mois explains: “This advanced hybrid imaging modality or scanner has been shown to be superior to conventional imaging in terms of diagnostic accuracy, efficiency and lower dose.

“The primary purpose of using this scanner is to improve the evaluation of the functions of the heart and associated thoracic oncology.”

She adds: “IJN not only receives referrals for cardiovascular disease, but also for cases of thoracic surgery involving tumours, as well as other cancerous areas. We also offer PET-CT services to other hospitals for diagnostic evaluation.”

One of the main differences between PET scans and CT scans, she says, is that the PET scan reveals metabolic changes in an organ or tissue earlier at cellular level. “So, the use of the PET-CT scanner with the 128 slices, will help us manage these patients more effectively.”

Norizam adds: “IJN is also committed to establish an imaging centre that offers a comprehensive range of non-invasive diagnostic imaging for a wide scope of medical needs.”

Norizam notes that IJN not only receives cardiovascular cases, but also patients with lung cancer. The hospital also provides imaging services to other hospitals.

Advantages of PET-CT

“We handle a lot of patients with heart disease, so PET-CT is one way of assessing the function of the heart,” says Dr Ahmad.

“Although we do have SPECT, or single-photon emission computed tomography, which is another method of assessing the function of the heart, we consider PET-CT another newer method with advantages over the older one.”

One advantage is reduced radiation exposure for the patient, as the radioisotope dose profile for PET-CT scans are lower than those for SPECT.

Another is the ability to measure coronary flow reserve, which is the maximum increase in blood flow through the coronary arteries that supply the heart, above the normal resting volume.

This is usually done for patients suspected of having at least 50% stenosis, or narrowing, of one or more of their coronary arteries to see if they require treatment.

“By introducing a nitrogen-13–ammonia or rubidium-82 tracer, which are the special radioisotopes for this PET-CT scan, into the patient, we will be able to assess the coronary blood flow during rest and during stress.

“With these two pieces of information, we will be able to calculate the ratio and come up with the coronary flow reserve of this patient.”

Previously, the patient would have to undergo coronary angiogram, which requires inserting a catheter into a blood vessel in the groin or arm all the way up to the heart. If the cardiologist decides that there is a narrowing of 70% or more based on the angiogram, treatment will proceed.

If it is less than 70%, the patient would need to go for another test, a dopamine-stress test, to see if there is a significant disruption in coronary blood flow during stress.

“However, once we have this PET-CT scanner, this issue can be addressed by asking the patient to undergo this scan. From there, we can immediately decide whether the patient needs ballooning or angioplasty,” he says.

The third advantage is being able to assess the viability and functionality of heart muscle. Says Dr Ahmad: “Let’s say the heart muscle is weak, and we want to know if the weakness is due to poor blood supply, or damaged or dead heart muscle.”

He explains that when the heart muscle has poor blood supply, it adapts by changing its metabolic activity. “Instead of using fat as the source of energy, it will use glucose as the source of energy. But this glucose is limited in supply, so the ability of the heart to pump is reduced,” he says.

Therefore, when the tracer fluorodeoxyglucose is introduced, it would be avidly taken up by the poorly-supplied heart muscle, which can be seen on the PET-CT images. If the muscle is damaged or dead, there would be no difference in the fluorodeoxyglucose levels.

This helps the cardiologist to decide on whether or not to treat any narrowed coronary arteries – yes, if the problem is poor blood supply, and no, if the heart muscle is already dead or damaged.

Dr Ahmad explaining the features of the new PET-CT scan machine, which includes reduced radiation exposure for the patient and the ability to measure coronary flow reserve.

Upgraded CT scan

IJN recently acquired a brand new PET-CT scanner. In addition, the institute upgraded one of its CT scanners, which now provides 512 slices, compared to the 64 slices of the older machines.

“This CT scan has less radiation exposure to the patient,” says Dr Ahmad. “The detector is bigger, so we will be able to image the heart at high quality without exposing the patient to high radiation, as compared to the old CT scanner.”

Due to the faster image capture, patients need only hold their breath for one to two seconds, compared to around 12 seconds for the older one. Most anxious patients can also skip a beta-blocker drug to slow down their heart rate, as this scanner can capture high-quality images in a heartbeat.

“This CT scan also has the capability of doing fractional flow reserve, which is a special technology not available in our previous CT scanner,” says Dr Ahmad.

Fractional flow reserve is the blood flow through a specific segment of the coronary artery. It is used to determine whether or not the narrowing of the artery results in a disruption of blood flow through it, and thus, whether or not it needs to be treated.

He added that the upgraded CT scanner can also function similarly to a cardiac MRI where it can detect stress-induced ischaemia, i.e. inadequate blood supply to the heart during physical stress. It does this by taking images while the patient is at rest and under drug-induced stress.

“So, in the future, we can offer this CT scan to those patients who are not able to get into a cardiac MRI scanner because of claustrophobia – fear of a closed environment,” says Dr Ahmad.

He explains that for an MRI, the patient’s body is fully enclosed by the machine, while only half of their body is enclosed for a CT scan.

IJN aims to provide high quality, but affordable care to Malaysian, says Dr Azhari. The hospital will be charging a maximum of RM3,000 for oncology screening by PET-CT, compared to over RM4,000 in private centres.

Latest tech

“We, being the National Heart Institute, are at the forefront of technology, and cardiac imaging is the area where the advancements are,” says IJN CEO Datuk Seri Dr Mohd Azhari Yakub.

“We are investing in this technology to provide patients non-invasive cardiac imaging, which can give us a lot of information without the patient having to go for an invasive technique.”

He added that they have also invested in their people by sending two doctors and four medical technicians overseas to be trained and certified in reading the PET-CT images and handling the machine respectively. While PET-CT scans are available in Malaysia, they are focused in the area of oncology, or cancer.

“Here we are providing not only screening or investigation for oncology patients, but also sub-specialising in cardiac PET-CT,” says the senior consultant cardiothoracic surgeon.

The two new and upgraded machines were sponsored by Permodalan Nasional Bhd (PNB) as part of their corporate social responsibility (CSR) efforts. “With their contribution, we are able to provide a very competitive fee for the imaging, which will benefit the patients,” says Dr Azhari.

He adds that IJN will be charging a maximum of RM3,000 for oncology screening by PET-CT. PET-CT cardiac imaging will cost slightly more than RM3,000 due to the more expensive radioisotope they have to use, he says.

He adds that IJN will be reducing the cost of CT scans in their centre with the addition of the two new machines, as they now have three CT-capable machines in total. “This is all part of the vision of IJN: to provide high-quality care, which is affordable to the ordinary Malaysian,” he says.

https://www.star2.com/health/2019/03/05/new-imaging-machines-ijn/

Saving lives for the cost of an annual CT scan

This sounds alarmist, but the facts don’t lie. The National Cancer Registry, published in Oct 2016 for the period of 2007-2011, revealed that over 100,000 cancers were diagnosed in Malaysia during that time. Of these, 10,608 were new cases of lung cancer.

MAY 27, 2018

BY PAUL YEO

Typical appearance of an early stage lung cancer (the white object in the left black field) detected by screening with a low dose CT scan.

This means that on average, every year, 2,121 Malaysians were diagnosed with lung cancer during that time.

Overall, lung cancer is the joint number one cancer in men when it comes to incidence in Malaysia. It accounts for 15.8% of all cancers in Malaysian men, only surpassed marginally by colorectal cancer, which has an incidence of 16.3%. In women, it’s the fifth most common cancer, accounting for about 5.6% of all cases.

It is the leading cause of cancer deaths in Malaysia, as well as across the world. According to consultant cardiothoracic surgeon Dr Anand Sachithanandan, such data suggests the need for effective screening for lung cancer.

“The American College of Chest Physicians, the American Cancer Society and the American Association of Thoracic Surgery in the United States recommends screening for lung cancer,” he notes.

“What we’re dealing with is a very lethal and fairly common disease. The most common cause of cancer death in Malaysian men is lung cancer, almost one in four, which is just under 25%. In women, it’s surpassed only by breast cancer – 13% of all cancer deaths in women are due to lung cancer.

“According to the National Cancer Registry, of these 10,608 cases of cancer, they had complete data in terms of staging in 55%-60% of cases. The most alarming thing is that with lung cancer, at the time of diagnosis, only 3% were in stage 1; 7% were in stage 2; 20%-25% in stage 3; and 65%-70% in stage 4.

“Put simply, 89% of Malaysian men and 91% of Malaysian women when diagnosed, were already in stage 3 or 4.

“This is advanced disease, either locally advanced or metastatic disease. Here, automatically, the goal of treatment shifts from trying to cure the patient to palliative treatment.

“While there has been a lot of advances in chemotherapy, immunotherapy and targeted therapy, the fact remains that most of these treatments alleviate symptoms and improve quality of life, not cure.

“There are some cases where they can improve median survival, or what is called progression free survival, but unfortunately, at the end of the day, these people will still die from their lung cancer.

“And these treatments can sometimes be quite toxic and very expensive,” he says. “The only curative treatment is surgery, which is applicable in early stage disease.”

He adds: “The five-year survival for an early stage 1A lung cancer approaches 90%. Contrast that with the other end of the spectrum: stage 4B, where the five-year survival is less than 5%, and in most reported series, there’s no survival. We can see the glaring difference.”

Screening makes sense

Screening for lung cancer is not a new thing. Japan has been doing it for decades, traditionally with chest x-rays and sputum cytology. However, as time went on, they realised that such tests were not very sensitive or cost-effective.

What changed the landscape was a North American study called the NLST (National Lung Screening Trial), which was published in the New England Journal Of Medicine in 2011. This was a multi-centred prospective randomised trial involving over 30 centres in North America and Canada that looked at over 50,000 people aged between 55 and 80.

The participants were all either smokers and ex-smokers with a minimum 30-pack year history (i.e. they have smoked at least one pack of cigarettes a day for 30 years), or ex-smokers who had stopped smoking within the last 15 years.

The trial randomised these people into two groups. The participants in one group had an annual low dose CT (computed tomography) scan, while the participants in the other group had annual conventional chest x-rays. Both groups underwent their respective imaging tests for three years.

The study was able to demonstrate that death from lung cancer was reduced by 20%, while overall death from any cause was reduced by 6.7%, for those undergoing the annual CT scans.

“That became a real game-changer. It sparked an interest in screening for lung cancer around the world,” says Dr Anand. “There have been a number of trials since then; the UK Lung Screening Trial was a pilot study that has just been completed.

“Their preliminary analysis suggests that it is cost-effective, but we need to target high-risk populations. On average, all these trials and screening programmes suggest a detection rate (if you target the appropriate population) of about 2%.

“That means that out of every 100 people we screen, we pick up two lung cancer cases, of which more than 85% are early stage and amenable for curative surgery.”

According to Dr Anand, 85% of lung cancer cases picked up via regular screening of high-risk populations are potentially curable through surgery.

Targets for screening

Dr Anand notes that screening is a process and not an isolated test. Screening attempts to detect the disease at a pre-clinical stage when the person does not have any symptoms.

Unfortunately, in lung cancer, by the time a patient develops symptoms – persistent cough, coughing up blood, unexplained loss of weight, shortness of breath, chest pain – they are more than likely to already be in an advanced stage of the disease.

So the challenge is to try and pick up the disease early via screening.

“What the UK Lung Screening Trial did was, they used longstanding data from the Liverpool Lung Project and they identified people who had at least a 5% or more risk of developing lung cancer in the next five years – male gender, smoking history, chronic lung disease like COPD, family history of early onset lung cancer (and) a personal history of cancer.

“The other study was the Nelson study, where they also looked at a similar population – 50- to 75-year-olds and smokers – and tried to see if screening could detect the cancers earlier, and ultimately, save lives. Our challenge is whether we can simply extrapolate such data and apply it here.

“Obviously, if we target the wrong population, it will not be cost-effective, and there are potential hazards – it could lead to patient anxiety, unnecessary tests, and specifically with screening, false positives.

“This is when a scan or test suggests disease when in actual fact, there isn’t. This affects the specificity of the test. In the landmark study in North America, their false positive were quite high, around 23%.

“But the science and technology of screening has evolved quite a bit (since then). The European studies and subsequent ones used volumetric analysis – they looked at the nodule doubling time and were able to reduce significantly the false positive rate.

“In fact, their specificity was very high, something like 98%,” says Dr Anand.

He explains that when a person goes for a scan, there can be three potential outcomes.

“Obviously, normal is good. At the other end of the spectrum is someone who has something that is quite abnormal, very suspicious; at the very least, they will need close surveillance, a follow-up scan at an interval to be decided (three or four months), or if it is more sinister, a biopsy or surgery may be suggested.

“The difficulty is the intermediate group, which does not have a perfectly normal scan, but it is not typical of a cancer. Here we need to monitor closely, and we are mindful of things like patient anxiety whilst they wait for a follow-up scan.

“Those things are very important in terms of who we target,” he notes.

The scanning process

Dr Anand explains that low dose CT-scanning of the lung can often be done within five to 10 seconds. It only takes the time of a single breath and no imaging contrast is required.

“A CT scan is basically x-ray beams being directed at the body that are detected by an electronic x-ray detector rotating around the patient. It’s a form of ionising radiation and is linked to sophisticated software, which can reconstruct and create two-dimensional cross sectional views of the chest,” he says.

A valid concern is radiation from the CT scan. However, the low dose CT scans have been shown to have less than 90% of the ionising radiation of a conventional contrast CT scan.

“We are on the threshold of the next generation of ultra low dose CT scanners, where they can reduce the radiation dose to one-tenth of the existing low dose. It will end up almost similar to a chest x-ray,” says Dr Anand.

“The Cosmos study looked at the risk of long-term radiation by following a population being screened for lung cancer with annual low dose CT scans over 10 years. They found that the risk of cancer was overall, exceptionally low – 0.05%, which is five out of 10,000 of those screened after 10 years of cumulative exposure.

“That study showed that for every 108 cancers that were detected early, one person may get radiation-induced cancer.”

Nobody knows the optimum strategy when it comes to screening for lung cancer with low dose CT.

According to Dr Anand, “In the United States, they advocate annual screening until 75 or 80, or unless the person develops a co-morbidity that makes him or her a poor candidate for any definitive treatment. In the United Kingdom and Asia, we would probably be a bit more judicious.

“Because the scans are very sensitive, they can pick up something that’s a biologically insignificant tumour, something that will not progress to cause the patient a problem in their lifetime. As clinicians, we are mindful of all of this. But we have to start somewhere.”

https://www.star2.com/health/2018/05/27/saving-lives-annual-ct-scan/

Breakthrough: How to Detect Cancer Super Early!

This is the first of two reports about the 2015 Cancer Control Convention and Doctors’ Symposium, held over Labor Day weekend at the Sheraton Universal Hotel, Universal City, California

One of the most compelling speakers at the 2015 Cancer Control Society’s Convention and Doctors’ Symposium was Jenny Hrbacek, R.N., who worked as a neonatal nurse. She made a bold promise: “I’m going to tell you how to detect cancer the size of a pin point.”

Here’s what she had to say. . .

October 2015
Newsletter #545
Lee Euler, Editor

By Andrew Scholberg 

Jenny’s own story of cancer survival led to her quest to find ways to detect cancer years before the cancer shows up on conventional tests. When she was diagnosed with breast cancer, she was shocked to learn that it had been developing in her body for about seven or eight years. She had always had an annual medical exam, and each year the doctor had told her everything was “fine.”

She wondered how her health could be “fine” year after year, according to a doctor’s assessment of her annual exams, and then suddenly she’s diagnosed with a wicked case of cancer.

Her experience is typical. Even when conventional doctors diagnose early stage cancer, the reality is that the disease has been present for years. Before that, it’s simply too small to find – for them.

How this cancer patient “got smart”

After undergoing surgery Jenny submitted to four rounds of chemo. Her doctor also recommended the standard radiation treatments, but she decided to take a pass on radiation. Instead, she told the CCS audience that she got smart and decided to boost her immune system.

At one point, her doctor declared, “You’re cancer free. You have clean margins. Have a cupcake. Take multivitamins. Enjoy your life.” The hospital vending machine was jam-packed with cancer-feeding junk food.

A PET/CT scan did show she was clear of cancer. But she found out from a blood test that both the PET/CT scan and the doctor were wrong.

Jenny also found out later that it’s a mistake for cancer patients to submit to a PET/CT scan, because these scans zap the body with a huge amount of cancer-causing radiation. One PET/CT scan emits as much as 500 to 600 times the radiation dose of a simple chest X-ray. This excessive radiation beats down the patient’s immune cells, which are radio-sensitive, according to James Forsythe, M.D., one of America’s best cancer doctors.

Contradicting the results of the PET scan, the blood test showed that Jenny still had plenty of circulating tumor cells. In fact, she had the most circulating tumor cells the lab had ever seen!

Her doctors never specifically told her that chemo cures cancer, but they certainly led her to believe it would. They also never told her that chemo doesn’t do anything to kill circulating tumor cells, which can cause cancer to reappear just about anywhere in the body – after you’ve been told you’re “cancer free”. No wonder cancer so often comes back after patients submit to the standard cut-burn-poison treatments.

Jenny’s new book is groundbreaking. The title is Cancer Free! Are You Sure? In this book she describes ten tests that will detect cancer early — years before conventional doctors can find it. Jenny says that such super-early detection is crucial because it gives you an opportunity to make certain lifestyle changes, such as diet, stress management, and detoxification that will prevent you from ever getting an official cancer diagnosis from a conventional doctor.

Here’s a list of the tests she recommends for super early detection:

• Cancer Profile Plus
• Colon Health Screening for Occult Blood in Stool — Home Test Kit.
• EarlyCDT — Lung Test
• Human Chorionic Gonadotropin (hCG) test
• Nagalase Test
• ONCOblot Labs: ENOX2 Protein Test
• Papanicolaou (PAP) and Human Papillomavirus (HPV) Tests for Cervical Cancer
• Red Drop: Thymidine Kinase Test
• Tests from the Research Genetic Cancer Center: Circulating Tumor Count (CTC) Test, Chemo Sensitivity and Resistance Test, Natural Substance Sensitivity Test, Immunity Test Panels, Megastasis Marker Tests

 The costs of these tests vary widely. For example, the Cancer Profile Plus test by the American Metabolic Laboratories in Hollywood, Florida, costs $576.    

In sharp contrast, the Human Chorionic Gonadotropin (hCG) test costs $55 plus the cost of U.S. Post Office first class international mail. You also need about $10 worth of household items for this test. The accuracy of this test is high, and the cost is dirt cheap. That’s why Bill Henderson and I recommend it in our book How to Cure Almost Any Cancer at Home for $5.15 a Day.

No one wants to know they have cancer, right? Wrong!

Had Jenny detected the start of her cancer seven or eight years before she got the official diagnosis of full-blown cancer, she’s confident she could have avoided a mastectomy and six reconstructive surgeries, not to mention four miserable rounds of chemo. She would have had the chance to make a few adjustments in her lifestyle, and the tumor would never have grown large enough to be detectable by mainstream tests.

She believes people would rather know they have cancer so they can do something about it, instead of burying their heads in the sand and pretending everything’s “fine.”

Cancer can only become a problem in a body with an environment that welcomes, fosters, and feeds cancer. Dietary changes, detox, and immune-boosting strategies can change the environment inside the body (the bio-terrain), making it hostile to cancer cells.

The problem is this: If you don’t know you have cancer, you have no motivation to change your lifestyle.

Thanks to the tests Jenny recommends in her book, you no longer have to wait for a lump or bump. You can now find out about a potential cancer problem when the cancer is the size of a needle point — years before conventional doctors would detect it.

I do believe Jenny’s book will save lives. Those who believe they may be at risk of cancer should definitely get her book, which she wrote for the general public.

In another presentation at the conference, Dr. Emil Schandl, Ph.D. spoke on “Pre-Visual Detection by the Cancer Profile Test” (one of the tests Jenny describes in her book). It’s available from his organization, the American Metabolic Testing Laboratories in Hollywood, Florida.

The Cancer Profile Test can detect the presence of just a few dozen cancer cells. Another test, ONCOblock (also on Jenny’s list) purports to identify where the cancer is, but Dr. Schandl says ONCOblock needs a few million cancer cells in order to identify the location.

Turning up the heat on cancer

Dr. Oscar Streeter, M.D., gave a presentation on hyperthermia, a heat therapy he provides at the Center for Thermal Oncology in Santa Monica, California. He established his credibility right away by showing “before” and “after” photos of a patient with a gigantic tumor on one of his eyes. Hyperthermia and radiation made the cancerous bulge over his eyelid disappear.

Long-time readers of this newsletter know hyperthermia is one of the most effective cancer treatments on earth. The therapy involves raising the part of the body affected by cancer – or, in some cases, the whole body – to temperatures similar to those you experience if you have a high fever. Just as a natural fever is your immune system’s response to infection, so the “artificial fever” of hyperthermia is an effective response to cancer.

It’s hard to understand why it isn’t used as a standard treatment. Heat treatments are not only safe but also remarkably effective.

Dr. Streeter’s clinic can give hyperthermia with chemo at the same time. The hyperthermia weakens cancer cells, and a low dose of the right chemotherapy drug can finish them off – instead of resorting to the high doses used in conventional treatment that cause miserable side effects.

Another speaker, Dr. Sean Devlin, D.O., seconded what Dr. Streeter said about the benefits of hyperthermia. Dr. Devlin treats patients at the Institute of Integrated Oncology in Santa Monica, California. He declared that hyperthermia is “probably the safest and most innocuous therapy we use.”

Another speaker, Dr. Kazuko Tatsumura, Ph.D., O.M.D., spoke on “Far Infrared Onnetsu Therapy” — another form of hyperthermia. Instead of heating up the whole body with an artificial fever, the Onnetsu device is an inexpensive way to heat up the part of the body where the cancer is located. She said that when the device finds the cancer, the patient can actually feel the tumor heating up.

According to Dr. Tatsumura, the Onnetsu, a hand-held device, improves blood circulation, flushes the lymphatic system (which is important for detox), and promotes the free circulation of qi (which she describes as electro-magnetic energy) along the acupuncture meridians.

The device uses far infrared heat to achieve deep penetration. The benefits for cancer patients are obvious, if you understand the concept of using fever to kill cancer cells. She said the Onnetsu also works on rheumatoid arthritis and benefits a wide variety of other health problems as well.

The Onnetsu isn’t just for health practitioners. It’s inexpensive enough that many patients purchase one for home use. But some instruction is necessary in order to get the full benefit from this remarkable device. Dr. Kazuko offers classes in Onnetsu therapy.

How to pay for alternative treatment if you’re broke

It’s ironic that health insurance companies willingly pay hundreds of thousands of dollars for toxic, dangerous – and usually ineffective — cancer treatments like chemo and radiation, but they won’t pay for inexpensive treatments that safely kill millions of cancer cells.

Although holistic treatment is cheap in comparison to conventional treatment, the cost can still be steep if you have to pay for it yourself. Holistic clinics typically charge $5,000 to $10,000 per week, and the course of treatment usually lasts about three weeks.

The question is: how can you pay for $30,000 worth of alternative cancer treatment if you don’t have that much in your savings account? Alex Barba of the Life Credit Company has come up with a solution. In his presentation he pointed out these pertinent facts:

• Six out of ten bankruptcies are the result of medical bills.
• Seven out of ten adults have life insurance.
• Eight out of ten life insurance policies lapse without a payout.

 Barba’s company offers cancer patients a cash advance of up to half the value of their life insurance policy (whole or term) to pay for alternative cancer treatment, collateralized by the life insurance. This is a brilliant solution to enable financially stressed cancer patients to pay for the kind of treatments that are most likely to be successful

http://www.cancerdefeated.com/breakthrough-how-to-detect-cancer-super-early/3358/

4 Must-Have Heart Tests - MUST READ

Heart disease is tricky. Like other “silent” conditions, such as high blood pressure and kidney disease, you may not know that you have it until you’re doubled over from a heart attack.

HEALTHWISE

Published

 

June 1, 2015

 

Publication

 

Bottom Line Health

 

Source

Joel K. Kahn, MD, Wayne State University School of Medicine

THEY TRULY ARE LIFESAVING…

Heart disease is tricky. Like other “silent” conditions, such as high blood pressure and kidney disease, you may not know that you have it until you’re doubled over from a heart attack.

That’s because traditional methods of assessing patients for heart disease, such as cholesterol tests and blood pressure measurements, along with questions about smoking and other lifestyle factors, don’t always tell a patient’s whole story.

Shocking finding: In a recent study, doctors followed nearly 6,000 men and women (ages 55 to 88) who had been deemed healthy by standard heart tests for three years and then gave them basic imaging tests (see below).Result: 60% were found to have atherosclerosis. These study participants were eight times more likely to suffer a heart attack or stroke, compared with subjects without this fatty buildup (plaque) in the arteries.

THE MUST-HAVE TESTS

Below are four simple tests that can catch arterial damage at the earliest possible stage—when it can still be reversed and before it has a chance to cause a heart attack or stroke. My advice: Even though doctors don’t routinely order these tests, everyone over age 50 should have them at least once—and sometimes more often, depending on the findings. Smokers and people with diabetes, very high cholesterol levels (more than 300 mg/dL) and/or a family history of heart disease should have these tests before age 50. Having these tests can literally save your life…

For more on this topic, see our
Guide to Surprising Things 
That Help—or Harm—Your Heart

• Coronary calcium computed tomography (CT) scan. This imaging test checks for calcium deposits in the arteries—a telltale sign of atherosclerosis. People who have little or no calcium in the arteries (a score of zero) have less than a 5% risk of having a heart attack over the next three to five years. The risk is twice as high in people with a score of one to 10…andmore than nine times higher in those with scores above 400.

While the American College of Cardiology recommends this test for people who haven’t been diagnosed with heart disease but have known risk factors, such as high blood pressure and/or a family history of heart disease, I advise everyone to have this test at about age 50.* The test takes only 10 to 15 minutes and doesn’t require the injection of a contrast agent.

Cost: $99 and up, which may be covered by insurance. 

I use the calcium score as a onetime test. Unless they abandon their healthy habits, people who have a score of zero are unlikely to develop arterial calcification later in life. Those who do have deposits will know what they have to do—exercise, eat a more healthful diet, manage cholesterol and blood pressure, etc.

One drawback, however, is radiation exposure. Even though the dose is low (much less than you’d get during cardiac catheterization, for example), you should always limit your exposure.

My advice: Choose an imaging center with the fastest CT machine. A faster machine (a 256-slice CT, for example) gives less radiation exposure than, say, a 64-slice machine.

• Carotid intima-media thickness (CIMT). The intima and media are the innermost linings of blood vessels. Their combined thickness in the carotid arteries in the neck is affected by how much plaque is present. Thickening of these arteries can indicate increased risk for stroke and heart attack.

The beauty of this test is that it’s performed with ultrasound. There’s no radiation, it’s fast (10 minutes) and it’s painless. I often recommend it as a follow-up to the coronary calcium test or as an alternative for people who want to avoid the radiation of the coronary calcium CT.

The good news is that you can reduce CIMT—with a more healthful diet, more exercise and the use of statin medications. Pomegranate—the whole fruit, juice or a supplement—can reduce carotid plaque, too. In addition, research has found Kyolic “aged” garlic (the product brand studied) and vitamin K-2 to also be effective.

Cost: $250 to $350. It may not be covered by insurance.

• Advanced lipid test. Traditional cholesterol tests are less helpful than experts once thought—particularly because more than 50% of heart attacks occur in patients with normal LDL “bad” cholesterol levels.

Experts have now identified a number of cholesterol subtypes that aren’t measured by standard tests. The advanced lipid test (also known as an expanded test) still measures total cholesterol and LDL but also looks at the amounts and sizes of different types of cholesterol.

Suppose that you have a normal LDL reading of 100 mg/dL. You still might have an elevated risk for a heart attack if you happen to have a high number of small, dense LDL particles (found in an advanced LDL particle test), since they can more easily enter the arterial wall.

My advice: Get the advanced lipid test at least once after age 50. It usually costs $39 and up and may be covered by insurance.

If your readings look good, you can switch to a standard cholesterol test every few years. If the numbers are less than ideal, talk to your doctor about treatment options, which might include statins or niacin, along with lifestyle changes. Helpful supplements include omega-3 fatty acids, vitamin E and plant sterols.

• High-sensitivity C-reactive protein (hs-CRP). This simple blood test has been available for years, but it’s not used as often as it should be. Elevated C–reactive protein indicates inflammation in the body, including in the blood vessels. Data from the Physicians’ Health Study found that people with elevated CRP were about three times more likely to have a heart attack than those with normal levels.

If you test low (less than 1 mg/L) or average (1 mg/L to 3 mg/L), you can repeat the test every few years. If your CRP is high (above 3 mg/L), I recommend repeating the test at least once a year. It’s a good way to measure any progress you may be making from taking medications (such as statins, which reduce inflammation), improving your diet and getting more exercise.

Cost: About $50. It’s usually covered by insurance.

* People already diagnosed with heart disease and/or who have had a stent or bypass surgery do not need the coronary calcium CT.

Source: Joel K. Kahn, MD, a clinical professor of medicine at Wayne State University School of Medicine and director of Cardiac Wellness at Michigan Healthcare Professionals, both in Detroit. He is also a founding member of the International Society of Integrative, Metabolic and Functional Cardiovascular Medicine and the author of The Whole Heart Solution.

http://bottomlinehealth.com/4-must-have-heart-tests

Be Wary of Low-Price CT Scans

February 15, 2014

Certain hospitals and medical facilities are aggressively advertising low-cost computerized tomography (CT) scans. These scans sometimes cost just a few hundred dollars or less, a fraction of the price typically charged. Some even are free. Why? So the medical facility will get your business if any treatment is needed.

A CT scan combines a series of X-ray views of the body taken from many different angles. But it's usually not a good idea to get a CT scan unless your doctor provides a specific medical reason why you need one. Each CT scan you get during your lifetime exposes you to radiation, increasing your risk for cancer. Also, though "precautionary" (not ordered for a specific reason) CT scans often are advertised as offering "peace of mind," they are likely instead to cause unnecessary health scares. The issues they turn up frequently turn out to be false alarms.

Potential exception: A recent study suggests that there could be some benefit to precautionary chest CT scans for certain long-term heavy smokers. This applies only to people ages 55 to 74 who have smoked a pack or more a day for 30 years or more.

An advertised low-cost CT scan could be worth investigating if your doctor has a legitimate reason to recommend a CT scan and you lack health insurance or you would have to pay a significant amount out of pocket for the scan under the terms of your policy. Contact the hospital recommended by your doctor (and your insurer if you have one) to ask how much you would have to pay for the scan. If it's more than a few hundred dollars, ask your doctor if he/she knows of any way to lower that CT scan cost—many hospitals have programs to help the uninsured and underinsured pay these bills. If not, ask your doctor if he thinks highly of the facility that's been advertising low-cost CT scans. If your doctor cannot recommend the facility, don't use it—there's little point in having a CT scan done at a facility that cannot be trusted to interpret it correctly. Alternatively, call around to other hospitals and medical facilities in your area, and ask them to quote you their prices for the CT scan you need. Rates can vary dramatically.

Source: Charles B. Inlander, consumer advocate and health-care consultant based in Fogelsville, Pennsylvania. He was the founding president of the nonprofit People's Medical Society, a consumer advocacy organization. He is author or coauthor of more than 20 consumer-health books.

http://www.bottomlinepublications.com/content/article/health-a-healing/be-wary-of-low-price-ct-scans?

Reduce Your Risk Of Breast Cancer

Dr. Isaac Eliaz | Feb 18, 2014

Many experts believe we are winning the fight against breast cancer and that the more than 2.6 million breast cancer survivors in the United States testify to our progress.

But you can’t be complacent about this deadly disease. Though we may be edging forward in the anti-cancer battle, you may not be out of danger. We may never completely prevent or cure this disease even though we are increasing the survival statistics.

Reduce Your Risks

Though there is a genetic component to breast cancer, 90 percent to 95 percent of cases are not hereditary. You need to focus on the risks that you can reduce.

Always avoid ionizing radiation whenever possible. Consider that CT scans produce 500 times more radiation than standard X-rays, so never be scanned except when the scan is absolutely necessary.

You also need to minimize other potential carcinogens in your life like pesticides, heavy metals, environmental toxins and estrogen-mimicking compounds present within numerous food, household and environmental sources.

Personal habits are critically important. Lower your cancer risk by not smoking, avoiding excess drinking, getting enough sleep and keeping your weight under control.

Smart Detection

Mammography can spot problem areas in the breast, but it also misses tumors. It fails to detect 20 percent of tumors in women over 50 and as many as 40 percent in younger women. Also, mammograms produce ionizing radiation, a cancer risk. However, researchers are constantly searching for ways to improve this technology, with some interesting outcomes such as a novel, new photon-counting technique.

Other testing options include ultrasound, MRI and thermography. Unfortunately, none of these tests achieve complete accuracy. I recommend a combination of the above imaging methods in order to achieve a comprehensive baseline image, then using thermography annually to measure breast health progression.

There is also preventive detection using lab work. For example, vitamin D levels, hormone imbalances, poor estrogen metabolism, low thyroid levels and high iodine can all be problematic. Diagnosing these problems early and correcting them can head off cancer.

We are also learning more about cancer biomarkers. The Food and Drug Administration has recently approved a test for galectin-3, a protein that, at elevated levels, can indicate increased cancer risk.

Biopsy

If you have a suspicious mass, a biopsy is often used to determine whether it is cancer. There are two main types of biopsy:

• Fine needle biopsy: A hollow needle removes a small sample of tissue.

• An excisional biopsy: Removal of the entire mass.

Each of these techniques has advantages and disadvantages.

Needle biopsies produce accurate results, but they disturb the body. That can lead to increased inflammation and growth factors the body tries to use to heal the irritated area. This response, however, can actually feed cancer.

Excisional biopsy, on the other hand, removes the entire mass. It leaves behind no abnormal tissue for the body to try to heal. However, excisional biopsies are more invasive and require general anesthesia.

Treatments

The three major forms of cancer treatment include surgery, chemotherapy and radiation.

Surgery can be either lumpectomy, removal of only the cancer, or mastectomy, the removal of the entire breast. The choice depends largely on a cancer’s invasiveness.

Interestingly, breast cancer survival rates are better in premenopausal women when surgery is conducted soon after ovulation.

Chemotherapy uses toxic chemicals to poison cancers. However, new individualized approaches, based on the genomes of the cancer and the patient, are having a profound effect on chemo effectiveness. All cancers have genetic mutations, and knowing those specific variations can direct treatment. Other genetic tests can determine whether a patient will respond well to a certain drug.

New radiation therapies are also being developed. Some facilities offer a technique, called the mammotome, in which a tiny radioactive seed is inserted for a short period of time, delivering highly targeted radiation to the tumor while leaving surrounding tissue undisturbed.

Published Research On Foods And Herbs

Your lifestyle and diet can affect your breast cancer risk.

We have long known that red meat and fried foods are associated with cancer. Sugar feeds inflammation and tumor growth. On the other hand, diets high in whole grains, fruits and vegetables contain natural antioxidants that have been shown to help prevent cancer.

Cruciferous vegetables like broccoli, kale and cauliflower are especially beneficial because they contain multiple compounds that act specifically against cancer and help balance hormones. A whole foods, low-glycemic (low-sugar) diet, combined with physical activity, has also been shown to protect against cancer risk. And you should always stay hydrated with plenty of filtered water.

Supplemental Help

Research shows that nutritional supplements can play an important role in protecting against breast cancer. Medicinal mushrooms such as Trametes versicolor, Ganoderma lucidum, Phellinus linteus; extracts of the herbs skullcap, astragalus and turmeric; the flavonoid quercetin; and the compound DIM (diindolylmethane) have all shown effects against breast cancer.

An integrative breast care formula containing these ingredients has been shown in a number of published studies to reduce breast cancer aggressiveness and decrease the expression of specific metastatic cancer genes.

A 2012 preclinical study on this advanced breast formula was performed at Indiana University and published in the journal Oncology Reports. Results demonstrated that the formula slowed highly aggressive triple negative breast cancer and prevented lung metastasis by up to 70 percent. Gene analysis showed that the combination of ingredients in this formula suppressed two genes implicated in the metastatic process: PLAU and CXCR4. These genetic findings had been previously reported in earlier studies on the same formula.

Another important supplement is modified citrus pectin (MCP), which blocks excess galectin-3 throughout the body, significantly reducing cancer growth and metastasis. A recent study published in Integrative Cancer Therapiesshowed that the combination of MCP and the breast formula mentioned above further reduced breast cancer and metastasis by up to 40 percent compared to controls. MCP also controls inflammation, boosts immunity against cancer and safely removes cancer-causing heavy metals from the body.

Mind-Body Connections

In all this, never forget the role chronic stress can play in fueling cancer. Use available tools to keep stress at bay: long walks, yoga, and spending time with friends and family. Remember, cancer hates positivity. Kill it with kindness, and don’t give in to pessimism.

Above all, we are seeing the most successes against breast cancer using highly individualized programs that take into account a person’s physical, mental and emotional health. The goal is to strategically combine a number of approaches that can work together synergistically to fight cancer while simultaneously supporting your health from many different angles. For more information about breast health, diagnosis and treatment, download my freewellness guide on this important topic.

http://easyhealthoptions.com/cancer/reduce-your-risk-of-breast-cancer/