health

Family History of Breast Cancer May Increase Males' Risk

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | November 19th, 2018

Dear Doctor: My husband's mother had breast cancer, and so did both of his aunts. He's really worried about our two daughters' risk, but I've read that breast cancer can affect men as well. Shouldn't he also be worried about himself?

Dear Reader: Most breast cancer is diagnosed in women, but you're correct -- it occurs in men as well. One percent of all breast cancers are found in men. For men who inherited the BRCA1 or BRCA2 genes, the incidence of breast cancer rises to 6 percent. (The BR of BRCA comes from the word "breast," and the CA from the word "cancer.")

Both boys and girls have a small amount of breast tissue around and beneath the nipple. When girls reach puberty, their bodies make hormones that cause the growth and development of the glands and ducts that will make and carry milk, as well as the surrounding tissues to support those structures. Men have significantly lower levels of these so-called female hormones, so their breasts don't develop in the same way. However, men still have that slight amount of breast tissue. And though the small number of glands and ducts found in male breast tissue are not functional, they can still be the site of breast cancer.

Male breast cancer can occur at any age but is more commonly found in older men. In addition to age, risk factors for men include a family history of breast cancer and the inherited gene mutations discussed above. Other risk factors include exposure to whole-chest radiation, as in certain cancer treatments, and liver disease. That's because one of the liver's many roles is the balancing of our sex hormones. In severe liver disease, hormone levels can become skewed and lead to an abundance of estrogen, which raises breast cancer risk.

As with all cancers, early detection is important. Since men have less breast tissue, lumps or other abnormalities can be easier to find. However, that same lack of tissue means there's less distance for cancer to travel and spread to surrounding tissues. Another factor is the lack of awareness that male breast cancer exists, which makes it easy to ignore warning signs. For men with a history of breast cancer in their families, as with your husband's, performing regular breast exams is a good idea. In addition to lumps, keep an eye out for changes to the skin or nipple, including redness, scaliness, dimpling or puckering, discharge from the nipple, and breast or nipple pain.

If anyone in your or your husband's family has the BRCA mutation, then your husband may want to consider genetic testing. If he does decide to follow through, we strongly recommend enlisting the help of a genetic counselor. At the very least, this family history of breast cancer should be information that your husband shares with your family doctor. When caught in the earliest stages, which accounts for close to half of all diagnoses, the five-year survival rate for male breast cancer is 100 percent. We can't think of a better reason to become vigilant.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Parents Worried That Social Media Is Making Their Teens Anxious

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | November 16th, 2018

Dear Doctor: My wife and I worry about how social media rules the lives of all four of our teens, especially our two daughters. I get that there must be some upsides, but mostly we see it making the kids stressed and anxious. Are we overreacting? Should we take their phones away?

Dear Reader: When you consider that the era of social media is already 15 years old (remember Myspace, which launched in 2003?), it means that today's teens have never lived in a world without it. According to a recent survey from the Pew Research Center, 95 percent of teens either own a smartphone or have regular access to one. Ninety percent of teens say they go online multiple times per day, while almost half report being online "almost constantly."

While there can be real benefits to this kind of connectedness, it has become clear that the potential for negative behaviors and experiences is all too real. On the plus side, there is the chance to expand social circles and strengthen existing friendships.

But social media sites are also ripe for bullying, spreading rumors, ostracism and peer pressure. Another challenge is the stress associated with curating a social media presence, as well as the unrealistic expectations that get generated regarding physical appearance. And then there's the fact that this all takes place on public platforms and in real time, where the number of "likes" and the tenor of comments can wreak havoc on a teen's sense of self-worth. It's not surprising that you, like so many parents, are seeing your kids struggle.

When it comes to anxiety, no, you're not overreacting. Anxiety now tops depression as the main mental health issue among teens and young adults. That's not to say social media is the sole reason for this, but recent studies cite it as a contributing factor. Our teens grew up at the same time as the social media landscape. In a way, these kids have been the unofficial test subjects of this new means of social connection. And while it's tempting to ditch the smartphones and cancel the family's mobile plan, the truth is that social media is here to stay.

Instead, you're going to have to wade into the fray yourselves.

First, identify and learn the apps your kids are using. Snapchat and YouTube are the most popular at the moment. A year from now, it will likely be something different. The more you understand about the workings and nuances of your child's online platforms, the more likely she or he will be able to talk to you about them and to accept help if it's ever needed.

The goal here isn't to spy on or even "friend" your kids on social media, but to become fluent in the world that has so much of their attention. We also think it's a good idea to implement a family program -- that means kids AND adults -- of screen hygiene. Put devices away during homework, during meals and at bedtime. Yes, you're worried about the kids, but we know from experience that the grown-ups in the room can benefit from this kind of media fast as well.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Readers Offer Feedback on Weight Loss and Extra Sunlight

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | November 14th, 2018

Hello again, dear readers! Once again, you've kept our mailboxes brimming, so let's get right to work.

On the subject of dark chocolate, which continues to tantalize scientists with potential positive effects on the heart, mood and memory, a number of readers wrote to ask whether cocoa powder also offers the same health benefits. Because those powders have been so heavily processed, it's believed that they may not offer the same benefits as those of regular dark chocolate. As to how much dark chocolate to eat (another very popular question), the current thinking is no more than 1 to 2 ounces per day.

A reader who relies on Tang, the fruit-flavored drink powder, to help him drink enough water every day wonders whether going through 2 pounds of the product each month is OK. On one hand, the powder is fortified with minerals and contains fewer calories than fruit juice. However, the sugar content in Tang is akin to that of a soft drink. We think it would be wise to wean yourself from the habit and switch to water instead. Flavor boosters like a squeeze of lemon or lime, a few slices of cucumber or a quick grate of ginger can help you make the transition.

We heard from several readers regarding a column about the herpes virus. Specifically, they asked us to include information about L-lysine, an amino acid that some studies have shown to be effective in easing symptoms in herpes outbreaks. A reader in Ventura, California, wrote, "I and two other women I know deal with outbreaks, pain and itching by taking L-Lysine. It helps heal the sores and cuts back on the itching and is also very effective for taking care of cold sores. It's not expensive, and you can find it at your local drug store." A reader from Florida reports that taking L-lysine for several days at first sign of herpes symptoms, typically localized tingling, will head off the infection.

After reading a column about weight loss strategies, a reader shared her own recent experience. "I'm 83, 5 feet 7 inches and weighed 130 pounds, so I didn't need to lose a lot of weight, but I wanted my clothes to fit better," she wrote. "I eliminated alcohol, beef, pasta, potatoes, wheat and sugar from my diet, and continued to eat as much as I wanted of everything else. Snacks were nuts and fruit. The result -- I lost 5 pounds in about three weeks and have maintained this weight, even though I now eat whole grain wheat again."

And, finally, we heard from a reader in Sun City, Arizona, responding to a column about sunlight and mood. "I come from the Midwest, where we went for days without sunlight and it was depressing," she wrote. "Now, I live where we have sunlight almost every day. I find that I don't have to go outside to enjoy it -- just seeing it makes me have a good feeling and a good day."

Thank you all for your kind words, and for your suggestions, criticisms and thoughts. We love hearing from you.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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