From MayoClinic.com
Special to CNN.com

After your cancer treatment, you were eager to nurse your body back to health. But beyond your initial recovery, you might be interested in ways to improve your long-term health so that you can enjoy the years ahead as a cancer survivor.

The advice for cancer survivors is no different than the advice for anyone who wants to improve their health: Exercise and improve your diet. But for cancer survivors these strategies have added benefits — research shows these simple steps can improve your quality of life, smoothing your transition into survivorship. Follow this guide to what you can do to take care of your body after cancer treatment.

Exercise

Regular exercise increases your sense of well-being after cancer treatment and can speed your recovery. Cancer survivors who exercise often experience:

• Increased strength and endurance
• Stronger immune systems
• Fewer signs and symptoms of depression
• Less anxiety
• Reduced fatigue
• Less difficulty sleeping
• Improved mood
• Higher self-esteem

Adding physical activity to your daily routine won’t take a lot of extra work. Focus on small steps to make your life more active. Take the stairs more often or park farther from your destination and walk the rest of the way. Check with your doctor before you begin any exercise program.

With your doctor’s approval, start slowly and work your way up. The American Cancer Society recommends adult cancer survivors exercise for at least 30 minutes five or more days a week. As you recover and adjust, you might find more exercise makes you feel even better.

Sometimes you won’t feel like exercising, and that’s OK. Don’t feel guilty if lingering treatment side effects, such as fatigue, keep you sidelined. When you feel up to it, take a walk around the block. Do what you can, but know that rest is important to your recovery as well.

While exercise has many benefits, there’s no evidence that exercise can keep your cancer from coming back. Many cancer survivors are concerned about cancer recurrence and want to do all they can to avoid it. It’s not clear why cancer recurs in some people but not in others. Exercise won’t stop your cancer from recurring, but it can make you feel better and help prevent other diseases, such as heart disease.

Eat a balanced diet

Vary your diet to include lots of fruits and vegetables, as well as whole grains. When it comes to selecting your entrees, the American Cancer Society recommends that cancer survivors:

• Eat five or more servings of fruits and vegetables every day
• Choose healthy fats, including omega-3 fatty acids, rather than saturated fats or trans fats
• Select proteins that are low in saturated fat, such as fish, lean meats, eggs, nuts, seeds and legumes
• Opt for healthy sources of carbohydrates, such as whole grains, legumes, and fruits and vegetables

This combination of foods will ensure that you’re eating plenty of the vitamins and nutrients you need to help make your body strong.

While it may be tempting to supplement your diet with a host of vitamin and mineral supplements, resist that urge. Some cancer survivors think that if a small amount of vitamins is good, a large amount must be even better. But that isn’t the case. In fact, large amounts of certain nutrients can hurt you. If you’re concerned about getting all the vitamins you need, ask your doctor if taking a daily multivitamin is right for you.

No special diet is known to prevent cancer from recurring. However, some preliminary research in breast cancer survivors indicates that a low-fat diet may reduce the chance of breast cancer recurring. In this study, which has yet to be completed, it isn’t clear whether the slight reduction in breast cancer recurrence was from women eating less fat or from women losing weight on the restricted diet. It also isn’t clear if a low-fat diet has any application to other cancer survivors.

Maintain a healthy weight

You may have gained or lost weight during treatment. Try to get your weight to a healthy level. Talk to your doctor about what a healthy weight is for you and the best way to go about achieving that goal weight.

For cancer survivors who need to gain weight, this will likely involve coming up with ways to make food more appealing and easier to eat. You and your doctor can work together to control nausea, pain or other side effects of cancer treatment that are preventing you from getting the nutrition you need. Losing even more weight can reduce your quality of life and make recovery more difficult.

For cancer survivors who need to lose weight, take steps to lose weight slowly — no more than 2 pounds a week. Control the number of calories you eat and balance this with exercise. If you need to lose a lot of weight, it can seem daunting. Take it slowly and stick to it. Any amount of weight loss can help you feel better about yourself and improve your health.

Stop using tobacco

Kick the habit once and for all. Smoking or using chewing tobacco puts you at risk of several types of cancer. Stopping now could reduce your risk of cancer recurrence and also reduce your risk of developing a second type of cancer (second primary cancer).

If you’ve tried quitting in the past but haven’t had much success, seek help. Talk to your doctor about resources to help you quit.

Drink alcohol in moderation, if at all

If you choose to drink alcohol, keep it to a minimum. At most, women and anyone over 65 should drink no more than one drink a day, and men should drink no more than two drinks a day.

Alcohol does have health benefits in some people — for instance, consuming a drink or two a day can reduce your risk of heart disease. But it also increases the risk of certain cancers, including those of the mouth, throat, liver and breast. While it isn’t clear whether drinking alcohol can cause cancer recurrence, it can increase your risk of a second primary cancer.

Weigh the risks and benefits of drinking alcohol carefully and talk it over with your doctor.

Do what you can

While you may fear it will take an entire overhaul of your lifestyle to achieve all these goals, do what you can and make changes slowly. Easing into a healthy diet or regular exercise will make it more likely that you’ll stick with these changes for the rest of your life.

· Cancer survivors: What to expect with follow-up care

· On the job with cancer: Managing common workplace challenges

· Cancer survivors: Relationships with family and friends after treatment

· Cancer survivors: Late effects of cancer treatment

· Cancer survivors: Managing your emotions after cancer treatment

· Sexuality after cancer treatment: What women can expect

· Sexuality after cancer treatment: What men can expect

· Cancer recurrence: What it means and how to cope

October 05, 2005

ScienceDaily (Apr. 27, 2007) — A University of Nebraska Medical Center study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels. Researchers say their findings suggest health professionals should address fatigue following breast cancer surgery.

Researchers say controlling fatigue after surgery — before starting chemotherapy — is important because fatigue typically increases during chemotherapy. Between 70 to 95 percent of breast cancer patients experience fatigue while undergoing chemotherapy.

The study was published in the current issue of the Journal of Pain and Symptom Management. Having studied 130 women with early stage breast cancer (stage I, II, IIIA), it the largest study to document the prevalence of fatigue associated with altered sleep and activity patterns before chemotherapy treatment. The data confirms what was reported in a previous smaller study funded by the National Institutes of Health.

“We found women are not going into chemotherapy in the best possible shape,” said Ann Berger, Ph.D., Niedfelt Professor of Nursing, UNMC College of Nursing, who has conducted several studies over the past 15 years related to fatigue in cancer patients. “It makes it that much more difficult to reduce the fatigue during treatment. If you start out with some fatigue, it will probably increase.”

“We as health professionals need to address potential fatigue and sleep issues sooner,” said Dr. Berger, principal investigator of the study. “If women are having sleep problems after surgery, we need to address this symptom before women begin chemotherapy. “What we’ve learned might explain why we’re having problems reducing fatigue in breast cancer patients during chemotherapy.”

The published study comes from initial results of a five-year, $1.5 million grant Dr. Berger and her team received in 2003. The purpose of the study, which was funded by the National Institute of Nursing Research, a division of the National Institutes of Health, was to determine the best ways to reduce fatigue during chemotherapy and to prevent chronic fatigue after treatment.

Researchers measured sleep and activity patterns during the 48 hours prior to the first chemotherapy treatment using wristwatch-sized activity monitors called actigraphs.

Fatigue, the most prevalent and distressing symptom for breast cancer patients receiving chemotherapy, has long been accepted by health professionals and patients alike as a side effect of treatment. Researchers say there are ways to intervene, and now they have found it may be important to intervene during the recovery period after breast cancer surgery.

Researchers say disrupted sleep, low daytime activity and/or reduced activity are likely to contribute to mild fatigue before chemotherapy and moderate to severe fatigue after chemo. They say fatigue should be addressed before and after surgery. Women typically begin chemotherapy three to four weeks after surgery.

Dr. Berger said because inactivity contributes to fatigue, she and colleagues say though women need to rest for several days after surgery, they should try to regain activity when they’re able. “We’ve been telling patients for years to rest and take it easy, but in some cases, we’re finding the patients who remain inactive are the one who report higher fatigue.”

Cancer-related fatigue can have a profound impact on an individual’s life, with significant physical, emotional, social, and economic consequences that may persist for months or years after completing treatment. Even after treatment ends, between 30 and 50 percent of patients say their fatigue remains at least six months or doesn’t ever go away.

Fatigue related to cancer treatment is described as a distressing, persistent, sense of tiredness or exhaustion that is not proportional to activity. The factors associated with fatigue are the presence and severity of anxiety, pain, lower sleep quality, physical inactivity, and poor performance status, leaving little desire to work or socialize.

Dr. Berger said the findings provide an important benchmark to begin looking for interventions to reduce cancer-related fatigue.

The study was undertaken to further establish values for sleep, wake, activity, rest, circadian rhythms and fatigue and how they interrelate in women before and during the first year after chemotherapy.

University Of Nebraska (2007, April 27). Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment, According To Study. ScienceDaily. Retrieved December 4, 2007, from http://www.sciencedaily.com­ /releases/2007/04/070426135536.htm

ScienceDaily (Apr. 27, 2007) — A University of Nebraska Medical Center study has found that even before women with breast cancer undergo chemotherapy, they experience fatigue and disruptions in sleep and activity levels. Researchers say their findings suggest health professionals should address fatigue following breast cancer surgery.

Researchers say controlling fatigue after surgery — before starting chemotherapy — is important because fatigue typically increases during chemotherapy. Between 70 to 95 percent of breast cancer patients experience fatigue while undergoing chemotherapy.

The study was published in the current issue of the Journal of Pain and Symptom Management. Having studied 130 women with early stage breast cancer (stage I, II, IIIA), it the largest study to document the prevalence of fatigue associated with altered sleep and activity patterns before chemotherapy treatment. The data confirms what was reported in a previous smaller study funded by the National Institutes of Health.

“We found women are not going into chemotherapy in the best possible shape,” said Ann Berger, Ph.D., Niedfelt Professor of Nursing, UNMC College of Nursing, who has conducted several studies over the past 15 years related to fatigue in cancer patients. “It makes it that much more difficult to reduce the fatigue during treatment. If you start out with some fatigue, it will probably increase.”

“We as health professionals need to address potential fatigue and sleep issues sooner,” said Dr. Berger, principal investigator of the study. “If women are having sleep problems after surgery, we need to address this symptom before women begin chemotherapy. “What we’ve learned might explain why we’re having problems reducing fatigue in breast cancer patients during chemotherapy.”

The published study comes from initial results of a five-year, $1.5 million grant Dr. Berger and her team received in 2003. The purpose of the study, which was funded by the National Institute of Nursing Research, a division of the National Institutes of Health, was to determine the best ways to reduce fatigue during chemotherapy and to prevent chronic fatigue after treatment.

Researchers measured sleep and activity patterns during the 48 hours prior to the first chemotherapy treatment using wristwatch-sized activity monitors called actigraphs.

Fatigue, the most prevalent and distressing symptom for breast cancer patients receiving chemotherapy, has long been accepted by health professionals and patients alike as a side effect of treatment. Researchers say there are ways to intervene, and now they have found it may be important to intervene during the recovery period after breast cancer surgery.

Researchers say disrupted sleep, low daytime activity and/or reduced activity are likely to contribute to mild fatigue before chemotherapy and moderate to severe fatigue after chemo. They say fatigue should be addressed before and after surgery. Women typically begin chemotherapy three to four weeks after surgery.

Dr. Berger said because inactivity contributes to fatigue, she and colleagues say though women need to rest for several days after surgery, they should try to regain activity when they’re able. “We’ve been telling patients for years to rest and take it easy, but in some cases, we’re finding the patients who remain inactive are the one who report higher fatigue.”

Cancer-related fatigue can have a profound impact on an individual’s life, with significant physical, emotional, social, and economic consequences that may persist for months or years after completing treatment. Even after treatment ends, between 30 and 50 percent of patients say their fatigue remains at least six months or doesn’t ever go away.

Fatigue related to cancer treatment is described as a distressing, persistent, sense of tiredness or exhaustion that is not proportional to activity. The factors associated with fatigue are the presence and severity of anxiety, pain, lower sleep quality, physical inactivity, and poor performance status, leaving little desire to work or socialize.

Dr. Berger said the findings provide an important benchmark to begin looking for interventions to reduce cancer-related fatigue.

The study was undertaken to further establish values for sleep, wake, activity, rest, circadian rhythms and fatigue and how they interrelate in women before and during the first year after chemotherapy.

University Of Nebraska (2007, April 27). Fatigue Affects Breast Cancer Patients Even Before First Chemotherapy Treatment, According To Study. ScienceDaily. Retrieved December 4, 2007, from http://www.sciencedaily.com­ /releases/2007/04/070426135536.htm

Antioxidants May Aid Chemotherapy Patients

Science Daily (Apr. 27, 2007) — There is no evidence that antioxidant supplements interfere with the therapeutic effects of chemotherapy agents, according to a recent systematic review of the use of antioxidants during chemotherapy, available in the May, 2007 issue of the peer-reviewed journal Cancer Treatment Reviews. In fact, they may help increase survival rates, tumor response, and the patient’s ability to tolerate treatment.

This conclusion has important implications for patients whose oncologists discourage the use of antioxidant supplements during treatment. Until now, their concern has been that these supplements may counteract the tumor-shrinking abilities of the chemotherapy.

“This review demonstrates that there is no scientific support for the blanket objection to using antioxidants during chemotherapy. In addition, it also appears that these supplements may help mitigate the side effects of chemotherapy,” said Keith I. Block, MD, lead author of the study and Medical Director of the Block Center for Integrative Cancer Treatment. “This is significant because it increases the likelihood that patients will be able to complete their treatment.”

Co-author Dr. Robert Newman, Professor of Cancer Medicine at M. D. Anderson Cancer Center said, “This study, along with the evolving understanding of antioxidant-chemotherapy interactions, suggests that the previously held beliefs about interference do not pertain to clinical treatment.”

The analysis, titled “Impact of Antioxidant Supplementation on Chemotherapeutic Efficacy: A Systematic Review of the Evidence from Randomized Controlled Trials,” evaluated 845 articles from five scientific databases that examined the effects of taking natural antioxidant supplements concurrent with chemotherapy.

Out of the 845 studies that were analyzed, 19 met all evaluation criteria. These included the use of randomized trials with a control group, and the reporting of treatment response (tumor shrinkage) and survival data. The 1,554 patients represented had a variety of cancer types, and most had advanced or relapsed disease. Some of the antioxidants used in the trials included glutathione, vitamin A, vitamin C, vitamin E, ellagic acid, selenium and beta carotene.

Among the findings:

• All of the studies that included survival data showed similar or better survival rates for the antioxidant group than the control group.
• None of the trials supported the theory that antioxidant supplements diminish the effectiveness of chemotherapy treatments.
• All but one of the studies that reported treatment response showed similar or better response in the antioxidant group than in the control group.
• 15 of 17 trials that assessed chemotherapy toxicities, including diarrhea, weight loss, nerve damage and low blood counts, concluded that the antioxidant group suffered similar or lower rates of these side effects than the control group.

The authors noted that reducing side effects may help patients avoid having to cut back on their chemotherapy dosing, interrupt scheduled treatments, or abandon treatment altogether. This in turn, is likely to favorably impact treatment outcomes. A recent study of a group of colon cancer patients indicated that those who completed their full prescribed schedules of chemotherapy had survival rates nearly double those of patients who abandoned their chemotherapy treatment prematurely.

This new study encourages further exploration of the potential importance of antioxidant supplements as a means of improving cancer survival.

By-Jane Gross

Published: April 29, 2007

On an Internet chat room popular with breast cancer survivors, one thread — called “Where’s My Remote?” — turns the mental fog known as chemo brain into a stand-up comedy act.

Michael Houghton for The New York Times

When she can’t remember where she parked her car, Lu Ann Hudson uses a key fob that sets off a beep in it.

Narayan Mahon for The New York Times

“I had a mind like a steel trap, and I ended up with a colander for a brain,” said Linda Lowen, who underwent chemotherapy 13 years ago.

Bob Hewitt for The New York Times

Terry-Lynne Jordan leaves herself voice mail messages as reminders.

One woman reported finding five unopened gallons of milk in her refrigerator and having no memory of buying the first four. A second had to ask her husband which toothbrush belonged to her.

At a family celebration, one woman filled the water glasses with turkey gravy. Another could not remember how to carry over numbers when balancing the checkbook.

Once, women complaining of a constellation of symptoms after undergoing chemotherapy — including short-term memory loss, an inability to concentrate, difficulty retrieving words, trouble with multitasking and an overarching sense that they had lost their mental edge — were often sent home with a patronizing “There, there.”

But attitudes are changing as a result of a flurry of research and new attention to the after-effects of life-saving treatment. There is now widespread acknowledgment that patients with cognitive symptoms are not imagining things, and a growing number of oncologists are rushing to offer remedies, including stimulants commonly used for attention-deficit disorder and acupuncture.

“Until recently, oncologists would discount it, trivialize it, make patients feel it was all in their heads,” said Dr. Daniel Silverman, a cancer researcher at the University of California, Los Angeles, who studies the cognitive side effects of chemotherapy. “Now there’s enough literature, even if it’s controversial, that not mentioning it as a possibility is either ignorant or an evasion of professional duty.”

That shift matters to patients.

“Chemo brain is part of the language now, and just to have it acknowledged makes a difference,” said Anne Grant, 57, who owns a picture-framing business in New York City. Ms. Grant, who had high-dose chemotherapy and a bone marrow transplant in 1995, said she could not concentrate well enough to read, garbled her sentences and struggled with simple decisions like which socks to wear.

Virtually all cancer survivors who have had toxic treatments like chemotherapy experience short-term memory loss and difficulty concentrating during and shortly afterward, experts say. But a vast majority improve. About 15 percent, or roughly 360,000 of the nation’s 2.4 million female breast cancer survivors, the group that has dominated research on cognitive side effects, remain distracted years later, according to some experts. And nobody knows what distinguishes this 15 percent.

Most oncologists agree that the culprits include very high doses of chemotherapy, like those in anticipation of a bone marrow transplant; the combination of chemotherapy and supplementary hormonal treatments, like tamoxifen or aromatase inhibitors that lower the amount of estrogen in women who have cancers fueled by female horemones; and early-onset cancer that catapults women in their 30s and 40s into menopause.

Other clues come from studies too small to be considered definitive. One such study found a gene linked to Alzheimer’s disease in cancer survivors with cognitive deficits. Another, using PET scans, found unusual activity in the part of the brain that controls short-term recall.

The central puzzle of chemo brain is that many of the symptoms can occur for reasons other than chemotherapy.

Abrupt menopause, which often follows treatment, also leaves many women fuzzy-headed in a more extreme way than natural menopause, which unfolds slowly. Those cognitive issues are also features of depression and anxiety, which often accompany a cancer diagnosis. Similar effects are also caused by medications for nausea and pain.

Dr. Tim Ahles, one of the first American scientists to study cognitive side effects, acknowledges that studies have been too small and lacked adequate baseline data to isolate a cause.

“So many factors affect cognitive function, and the kinds of cognitive problems associated with cancer treatment can be caused by many other things than chemotherapy,” said Dr. Ahles, the director of neurocognitive research at Memorial Sloan-Kettering Cancer Center in New York.

The new interest in chemo brain is, in effect, a testimony to enormous strides in the field. Patients who once would have died now live long enough to have cognitive side effects, just as survivors of childhood leukemia did many years ago, forcing new treatment protocols to avoid learning disabilities.

“A large number of people are living long and normal lives,” said Dr. Patricia Ganz, an oncologist at U.C.L.A. who is one of the nation’s first specialists in the late side effects of treatment. “It’s no longer enough to cure them. We have to acknowledge the potential consequences and address them early on.”

As researchers look for a cause, cancer survivors are trying to figure out how to get through the day by sharing their experiences, and by tapping expertise increasingly being offered online by Web sites like www.breastcancer.org and www.cancercare.org.

There are “ask the experts” teleconferences, both live and archived, and fact sheets to download and show to a skeptical doctor. Message boards suggest sharpening the mind with Japanese sudoku puzzles or compensatory techniques devised to help victims of brain injury. There are even sweatshirts for sale saying “I Have Chemo Brain. What’s Your Excuse?”

Studies of cognitive effects have overwhelmingly been conducted among breast cancer patients because they represent, by far, the largest group of cancer survivors and because they tend to be sophisticated advocates, challenging doctors and volunteering for research.

Most researchers studying cognitive deficits say they believe that those most inclined to notice even subtle changes are high-achieving women juggling careers and families who are used to succeeding at both. They point to one study that found that complaints of cognitive deficits often did not match the results of neuro-psychological tests, suggesting that chemo brain is a subjective experience.

“They say, ‘I’ve lost my edge,’ ” said Dr. Stewart Fleishman, director of cancer supportive services at Beth Israel and St. Luke’s/Roosevelt hospitals in New York. “If they can’t push themselves to the limit, they feel impaired.”

Dr. Fleishman and others were pressed as to why a poor woman, working several jobs to feed her children, navigating the health care system and battling insurance companies, would not also need mental dexterity. “Maybe we’re just not asking them,” Dr. Fleishman said.

Overall, middle-class cancer patients tend to get more aggressive treatment, participate in support groups, enroll in studies and use the Internet for research and community more than poor and minority patients, experts say.

“The disparity plays out in all kinds of ways,” said Ellen Coleman, the associate executive director of CancerCare, which provides free support services. “They don’t approach their health care person because they don’t expect help.”

But approaching a doctor does not guarantee help. Susan Mitchell, 48, who does freelance research on economic trends, complained to her oncologist in Jackson, Miss., that her income had been halved since her breast cancer treatment last year because everything took longer for her to accomplish.

She said his reply was a shrug.

“They see their job as keeping us alive, and we appreciate that,” Ms. Mitchell said. “But it’s like everything else is a luxury. These are survivor issues, and they need to get used to the fact that lots of us are surviving.”

Among women like Ms. Mitchell, lost A.T.M. cards are as common as missing socks. Children arrive at birthday parties a week early. Wet clothes wind up in the freezer instead of the dryer. Prosthetic breasts and wigs are misplaced at the most inopportune times. And simple words disappear from memory: “The thing with numbers” will have to do for the word “calculator.”

Linda Lowen, 46, had a hysterectomy and chemotherapy for ovarian cancer 13 years ago, and says she still cannot recognize neighbors at the grocery store. “I had a mind like a steel trap, and I ended up with a colander for a brain,” said Ms. Lowen, a radio and television talk show host in Syracuse.

The other night, Ms. Lowen set out to find a good place to store her knitting supplies. She began emptying a cabinet of games that her teenage daughters no longer played. Meanwhile, she noticed a blown light bulb and went to find a replacement. That detour led to another, and five hours later she had scrubbed every surface and tidied the contents of eight drawers. But she still had no storage space for her knitting supplies.

“I have an almost childlike inability to follow through on anything,” Ms. Lowen said.

Solutions come in many forms for women whose cancer treatment has left them with cognitive deficits.

Sedra Jayne Varga, 50, an administrative assistant in family court in Manhattan, is part of a research study of the stimulant Focalin, which she said had helped. But Ms. Varga also plans to have laser surgery on her eyes so that losing her glasses will no longer be an issue.

Lu Ann Hudson, 44, a designer of financial databases in Cincinnati, relies on a key fob that sets off a beep in her car when she is looking for it in parking lots. Terry-Lynne Jordan, 43, who analyzes environmental incidents for an oil company in Calgary, Alberta, uses the calendar on her computer and voice mail messages to herself to remind her of meetings.

And Debbie Kamplain, a 32-year-old stay-at-home mother in Peoria, Ill., hired a $30-an-hour personal organizer to help her sell a house, buy another and get ready to move her family to Indiana next month.

But it is Ms. Kamplain’s 2 ½-year-old son, Daniel, who sees to it that she stays on task. Long before Daniel could talk, he would pull her over to the refrigerator if she got distracted while getting him a drink.

“Poor kid,” Ms. Kamplain said. “I say I’m going to do something, forget about it immediately, and he’s the one who has to remind Mommy about stuff.”

Nanthakomon T, Pongrojpaw D.

Department of Obstetrics and Gyecology, Faculty of Medicine, Thammasat University, Bangkok 12120, Thailand.

OBJECTIVE: To study the efficacy of ginger in prevention of nausea and vomiting after major gynecologic surgery. STUDY DESIGN: Double blind randomized controlled trial. SETTING: Department of Obstetrics and Gynecology, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, 12120, Thailand. MATERIAL AND METHOD: From March 2005 to April 2006, 120 patients who underwent major gynecologic surgery were randomized into group A (n = 60) and group B (n = 60). The patients in group A received two capsules of ginger taken one hour before the procedure (one capsule contains 0.5 gram of ginger powder). The patients in group B received the placebo. The visual analog nausea score (VANS) and frequency of vomiting were evaluated at 0, 2, 6, 12, and 24 hours after the operation. RESULTS: The results demonstrated the statistically significant differences in nausea between group A (48.3%) and group B (66.7%). The VANS was lower in group A compared to group B at 2, 6, 12, and 24 hours. The most statistically significant differences occurred at 2 and 6 hour. The incidence and frequency of vomiting in group A were lower than group B. Side effects caused by ginger were not detected. CONCLUSION: Ginger has efficacy in prevention of nausea and vomiting after major gynecologic surgery.

PMID: 17725149 [PubMed - in process]

LONDON (Reuters Health) - At least 80 percent of women who have worrying evidence of cell abnormalities on a Pap smear will not go on to develop cervical cancer, a new analysis by British researchers suggests.
All of these women will be treated “just in case,” meaning that many will undergo further tests and small operations. But cervical cancer treatments are relatively minor, and not too invasive, meaning Pap screening is still worth doing despite these problems, say Dr. Angela E. Raffle and colleagues.
“You can’t escape the fact that to be effective in cancer screening you almost have to over-treat because the cell changes and tissue changes are so common,” said Raffle, from Avon Health Authority in Bristol.
Her group analyzed screening records from 348,419 women in the Bristol area. They report their findings in Friday’s British Medical Journal.
For every 10,000 women screened between 1976 and 1996, 1,564 had abnormal cervical cells detected in the Pap smear. Of those, 818 had further investigations, of whom 543 had evidence of abnormal cervical tissue. Within this group, 176 had abnormalities that persisted for 2 or more years.
Without screening, the researchers say, 80 of these women would be expected to develop cancer by 2011, of whom 25 would die. Screening would avoid 10 of these deaths.
“In the NHS cervical screening programme, around 1,000 women need to be screened for 35 years to prevent one death,” they write.
An important implication of their results is the need to help women understand what an abnormal Pap smear really means, the researchers say. While it is important for women to have tests and not to ignore the results, trauma caused by thinking it is something akin to a death sentence is not necessary.
“We really need to change people’s perception of what’s meant by an abnormal smear,” Raffle said.
“Most of these abnormalities are no problem at all, but the treatment’s simple and we really think that everyone with a high grade abnormality needs treatment because we know that for one in eighty it will make that big, life-saving difference.”
Cervical cancer is ideal for screening, because doctors can get to the cervix without surgery, it can be treated locally, Raffle said. But the same cannot be said of all other cancers.
“I think the real implications for our findings are for prostate cancer, bowel cancer, ovarian cancer — all these others that people say we must start screening for,” the Bristol researcher said.
It is possible that a large proportion of abnormalities detected in those organs will never develop into cancer, but the treatment can be much more damaging than that for cervical cancer — involving major surgery or radiation treatment.
“Our study points to the potential for harm. It’s only minimal harm with the cervix because you’re talking about worrying people, but if you’re talking about an operation that could leave you dead, or impotent or incontinent, then it’s a different equation really,” Raffle said.