We take about 20,000 breaths each day. For a healthy man that should translate into 12 to 14 breaths per minute, says breath researcher and psychologist Dr. Gay Hendricks. Catch yourself breathing normally and calculate your per-minute rate. If it is higher than that, your health is in jeopardy and you should make deep, comfortable, slower breathing a priority, Dr. Hendricks says.
Much of the “breathwork” taught by experts today is drawn from ancient Oriental spiritual teachings. Many of the health claims for ancient Taoist, Hindu, and Yogic breathing exercises have been substantiated in the laboratory. One such exercise, alternate nostril breathing, is a proven tension-tamer and mental energizer, Dr. Hendricks says. Here’s how he teaches it.
Close off one nostril with the index finger of your dominant hand and breathe out and then in through the open nostril, slowly, gently, fully. Then close off the other nostril, still using your dominant index finger, and breathe out and then in through the open nostril. Keep your belly muscles relaxed and breathe comfortably, slowly in and out of your abdomen. Put your attention on the sensations of the breath leaving your nose and the breath returning. Alternate like this for two minutes, and then switch to the index finger of your non-dominant hand and continue for two minutes. Switch back to your dominant hand for one more minute, and then rest for a minute with your hands in your lap. Just don’t try it while you have a runny nose.
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How breast cancer spreads
Cells from the primary tumour can spread to other parts of the body to produce secondary tumours. This spread is known as metastasis and can occur via the blood or lymph vessels. The secondary tumours are called metastases. Spread may also be local, to areas around the breast, or even across the abdominal or pleural cavities.
Breast cancer most commonly metastasises to bone, lung, liver, ovaries and brain. Lymph node metastases are the first to occur and are the most commonly seen. The malignant cells become lodged in these areas and multiply to form further tumours.
Although both breasts can be affected simultaneously, it is more usual for the second breast to become involved after a period of years, if at all. Rarely, spread to the second breast occurs via the lymph vessels.
Differentiation of tumours
Tumours can be well differentiated, containing easily identifiable cells which clearly resemble the tissue from which they were derived; poorly differentiated, with a mixture of cells which it is difficult to identify; or moderately differentiated, an intermediate form. The prognosis for a well-differentiated tumour is always better than for a poorly differentiated one.
Staging
There are various methods of classifying the development of breast cancer, known as staging. The TMN method, used until quite recently, is now generally considered unhelpful as it relies on subjective observation and has a high inter-observer variation.
Staging of cancers of the breast is now based on factors such as the following.
* Has the tumour infiltrated into a large area (i.e. what size is it) or is there evidence of lymphatic or blood vessel invasion?
* Is it well differentiated, i.e. does it look like normal breast tissue that has gone out of control?
* Are the auxiliary lymph nodes involved?
* Is the tumour confined to the ducts of the breast (intraductal cancer)?
This last factor is important because tumours which are completely contained within a duct can usually be cured by surgical removal of tissue containing the duct and the growth within it. Intraductal tumours, once removed, do not tend to recur.
A commonly used system stages cancers on a scale of I to IV, tumours at stage I (confined to the breast) having the best prognosis; stage IV denotes metastatic cancer at distant sites within the body.
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Evidence over many years shows that whatever financial and other resources are put at the disposal of western medicine will be swallowed up. In fact one researcher has calculated that by doubling the current expenditure longevity would not be altered significantly. Half of the increased expenditure since the 1950s has gone in higher prices. The other half has gone largely on more hospital beds, more technology, more hospital admissions, more health employees and more in-patient days in hospital. But in spite of all of this the major killers-heart disease, strokes and cancer-have declined little. The exception to this is the decline in heart disease deaths in the US that has occurred over the last fifteen years. This has almost certainly come about as the result of lifestyle changes and not increased expenditure on curative medicine. Although it is difficult to make
accurate estimates it is generally agreed that about 2 per cent of healthcare expenditure goes on preventive medicine in most western countries, yet we are told from the cradle that prevention pays and that a stitch in time saves nine. Just how true are these claims?
Trying to assess the value of a preventive programme is a complex task. It is not too difficult to work out the cost-effectiveness of a simple curative procedure because the end-point is often fairly clear and you know what the starting point (an ill person) is. But when it comes to spending money on prevention there are many problems, some of which arise because the person involved is healthy and the benefit conferred on him or her, or on society, may not be easily quantifiable in terms of money and may occur many years after the original expenditure on the preventive measure.
When trying to work out how financially worth while a preventive health programme is we have to consider four main points: (1) The positive and negative effects of the programme; (2) how many of these effects can be clearly related to a preventive programme; (3) what value can be put on the results and (4) the balance of the advantages and disadvantages of the programme.
As an example let’s look at screening for breast cancer. The effects of the programme will include: the cost of convincing women they should be screened; the cost of their time off work or other duties to go to be screened; the cost of actually getting there; the cost of the screening itself (both in people and equipment); the cost of following up the abnormal findings; the cost of treating those who have abnormalities but who would have otherwise gone untreated; the cost of any doctor-induced problems (i.e. other problems which the screening programme itself brings into being) and their follow-up treatment; and the savings resulting from the reduced use of medical and other facilities by the women who have a cancer detected early and so do not need more expensive treatment.
The next step involves putting values on the programme. There are several questions that need to be answered. Obviously the cost of convincing women to be screened has to be related to the numbers who actually come forward. If it costs 100 pounds per woman simply to persuade her to be screened this alters the whole balance of worth of such a screening to the community. What about the increase in doctor-induced diseases? Is it possible that by having too many false negatives we give women false confidence, causing them to ignore lumps in the future? Or that by giving too many false positives we worry people so that they end up having unnecessary and worrying operations?
The last thing we really have to be sure about is what good the screening actually does and which part of it is most worth while. Obviously doing a total physical examination and an X-ray every six months would be a way of detecting breast cancer early but the side-effects of the X-rays, and the costs, would be enormous.
Lastly, a price has to be put on the whole thing and this can be difficult. The actual cost of delivering the medical side of such a programme is, of course, easily worked out but the benefits (peace of mind, improvement in life expectancy and so on) are much more difficult to evaluate financially.
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If you’re having a hard time pinpointing the hidden calories in your diet, take a tip from Jim Gorman. The 33-year-old public relations supervisor from Hoboken, New Jersey, will tell you to look in the bottom of your empty glass. He knows from experience.
In 1995, Jim gave up all sugary beverages and alcohol for Lent, resolving to drink only water and club soda. By the time Easter rolled around, he was 20 pounds lighter. “I wasn’t really looking to lose weight,” he says. “But I have to admit that I was a bit bulkier than I wanted to be.”
Since then, Jim has kept his weight between 158 and 163 pounds, appropriate for his 5-foot-11-inch frame. He attributes his trim physique to his continued ban on sugary beverages. “Staying away from soda, lemonade, sweetened iced tea, and other flavored drinks has made all the difference on the scale,” he says.
While Jim sticks with water and club soda at home, he may order a beer or two when he’s socializing with friends. “I don’t
WINNING ACTION
Be wary of liquid calories. Alcohol and sugary beverages can contribute to weight gain—and they don’t do a thing to fill you up. A 12-ounce glass of beer supplies 146 calories; 12 ounces of soda, 150 calories; and 8 ounces of fruit juice, about 100 calories. If you’re having a tough time losing weight, take account of your liquid calories. Substitute water for your sugary beverages. You’ll be a lot happier eating a 300-calorie meal than quaffing a few colas. As for alcohol, save it for special occasions (like losing 10 more pounds), and stick to light beer or wine.
And remember to sip, not gulp.
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