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Dr. Virginia Herrmann
Dr. Virginia Herrmann: "We should be able to reduce the incidence of cancer in our state."
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Dr. David Kastl
Scott Huska’s spontaneous decision to volunteer for a new diagnostic procedure offered by Hilton Head Regional Medical Center led to discovery of a “widow maker” arterial blockage and life-saving bypass surgery.
Photo by Sarah Welliver, Reprinted by permission of The (Hilton Head) Island Packet
Bad news, South Carolina: Your health report is back, and the results aren’t pretty.
We’re not going to sugarcoat it for you, because diabetes and obesity run rampant through the Palmetto State. So do cardiovascular disease, respiratory disease, stroke and cancer—all at rates higher than the national average. In fact, we rank a disappointing 45th in the list of healthy states according to the 2011 America’s Health Rankings, a state-by-state comparison compiled annually by United Health Foundation based on the prevalence of more than 30 medical conditions.
Poor lifestyle choices are often to blame. As a state, we tend to eat the wrong foods, smoke too much, we don’t get enough exercise and we don’t manage our stress levels. But in that, there is a silver lining. Poor habits can be changed (See "8 steps to better health"). Doctors say that if we take better care of ourselves, we can go a long way toward preventing these five chronic diseases that kill tens of thousands of South Carolinians every year.
Cancer
The term cancer is used to describe the uncontrolled growth and spread of abnormal cells. Although the survival rate for cancer has improved during the past decade, more than 500,000 people in the United States and 23,000 in South Carolina die from some form of cancer each year. According to the S.C. Department of Health and Environmental Control (DHEC), cancer is one of the highest disease-related mortality risks in the Palmetto State.
While annual screenings like colonoscopies and mammograms allow for early detection and treatment of cancers, healthy lifestyle choices are the best way to prevent cancer, says Dr. Virginia Herrmann, a surgical oncologist with the Medical University of South Carolina’s Hollings Cancer Center and medical director of the Breast Health Center at Hilton Head Hospital.
“The American Cancer Society estimates that a third of all cancer-related deaths can be attributed to poor eating habits, increased body mass index, obesity and physical inactivity,” she says. “If we can effectively promote healthy behaviors, we should be able to reduce the incidence of cancer in our state.”
The number-one way to lower your cancer risk? Stop smoking. Lung cancer, often preventable, accounts for 30 percent of all cancer-related deaths, according to the South Carolina Cancer Alliance. The American Cancer Society reports that people who stop smoking before age of 50 cut their risk of dying in the next 15 years in half.
Excluding skin cancer, Herrmann says that the risk of prostate cancer, the most common form among men, and breast cancer, the most common form among women, can be reduced with a healthy diet, regular exercise and by reducing stress.
Maintaining a healthy weight is especially important for women. “Those who are obese, or who have an elevated Body Mass Index (BMI), are more likely to develop breast cancer,” she says. Normal BMI for women is between 18.5 and 24.9. Anything over 25 is considered overweight, and over 30 is obese. The risk of developing breast cancer, especially in post-menopausal women, is higher if the BMI is above 25 and significantly higher if over 30. “Women with a BMI over 30 are more likely to die from the disease,” Herrmann says.
Excessive alcohol intake is also associated with the development of a number of cancers, including cancer of the breast, mouth, throat and esophagus, and the riskis directly related to the amount of alcohol you drink. Herrmann recommends women limit themselves to one drink per day, men no more than two.
Cardiovascular disease
Cardiovascular disease refers to conditions that damage the heart or blood vessels. The most common form, atherosclerosis, is characterized by a buildup of fatty plaques that causes hardening of the arterial walls over time. According to the American Heart Association (AHA), it is the leading cause of disease-related death in the world.
“Most people are asymptomatic and some have symptoms attached to other problems, such as indigestion,” says Dr. David Kastl, a thoracic surgeon at Hilton Head Regional Medical Center, making cardiac screening the best way to spot problems before they become life-threatening. That was certainly the case for one of his patients, Scott Huska, a hospital employee who had no suspicion that anything was wrong until he volunteered to undergo a calcium-scoring test, a new diagnostic procedure. “I asked how long it would take, and they told me about 15 minutes, so I thought, ‘Sure, why not,’” Huska says.
It proved to be a life-saving choice.
Elevated blood calcium is one indicator of cardiovascular disease and based on Huska’s results, his cardiologist ordered more screening and discovered a “widow maker,” an arterial blockage so severe that it could cause a fatal heart attack at any time. Within 24 hours, Huska had bypass surgery.
Certain risk factors for heart disease cannot be avoided. The condition is most common in men over the age of 55 and affects African-Americans at much higher rates than whites. The good news is that many other important risk factors, like obesity, high cholesterol and high blood pressure are within your control and can substantially reduce the likelihood of an attack.
“Even with improved screenings, we still encourage patients to exercise and eat healthy,” Kastl says.
Stroke
The term Sun Belt is often used to describe the southern tier of the United States, including South Carolina. It’s also known as the Stroke Belt, and DHEC reports that the coastal and Pee Dee regions of South Carolina have stroke rates so high that they’re known as the Stroke Buckle.
“Most strokes are caused by a blocked artery, which reduces blood flow to the brain. A smaller percentage of strokes result from a ruptured artery, usually in the setting of hypertension,” says Dr. James L. Bumgartner, a neurologist with Roper St. Francis Hospital in Charleston. Stroke is another leading cause of mortality in South Carolina, and nationwide, someone has a stroke every 40 seconds. A stroke-related fatality occurs every three to four minutes, and strokes are a leading cause of serious, long-term disability in adults.
According to Bumgartner, strokes bear a strong correlation to cardiovascular disease. Not surprisingly, the same preventive measures, such as controlling high cholesterol and high blood pressure, not smoking, eating right, exercising and weight control all apply. He notes, however, that strokes sometimes strike people with no signs of arterial impairment elsewhere in their bodies. That’s why knowing symptoms is so important.
Stroke symptoms include a sudden onset of numbness or weakness in the face, arm or leg; confusion; trouble speaking or understanding; trouble seeing in one or both eyes; dizziness and loss of balance; or severe headache with no known cause. If you suspect someone is having a stroke, American Stroke Association recommends that you act F.A.S.T.
- F. Facial expression. Ask the person to smile. Does one side of the face drop?
- A. Arms. Ask the person to raise both arms. Does one arm drift downward?
- S. Slurred speech. Ask the person to repeat a simple sentence. Are the words slurred? Can he or she repeat the sentence correctly?
- T. Time is critical. If the person shows any of these symptoms, call 911 or get to the hospital immediately. Brain cells are dying.
Respiratory disease
Respiratory disease is a broad category that includes asthma, influenza and pneumonia, but the biggest killer is chronic obstructive pulmonary disease (COPD)—a progressive illness that causes inflammation, loss of elasticity and tissue damage to the bronchial tubes. Although the causes of each ailment are distinctly different, they do have one common risk factor that you can control: smoking.
“About 85 percent of COPD cases are caused primarily by tobacco use,” says Dr. Lloyd Hayes, managing partner of Greenville Hospital’s Lung Center. “Smoking cessation is by far the single best thing a person can do to slow the progression of COPD and substantially decrease the loss of lung function.”
People suffering from respiratory diseases are also particularly susceptible to infection, so Hayes recommends they get annual flu shots and the pneumococcal vaccine to reduce their risk of further complications. “Since it is estimated that 50 percent of COPD sufferers go undiagnosed, anyone regularly experiencing shortness of breath, coughing and excessive mucus production should discuss these symptoms with their doctor and get annual flu vaccines,” he says.
Diabetes
Diabetes occurs when the body doesn’t produce enough insulin, a condition known as Type I diabetes, or becomes insulin resistant and cannot metabolize glucose properly, a condition known as Type II diabetes. Glucose, the fuel our cells rely on, is formed from the sugars and starches we eat. It is the job of insulin to take the sugar from the blood into the cells. In people with diabetes, glucose builds up in the blood instead of going into cells and can lead to eye and nerve damage, as well as kidney and heart disease. In South Carolina, diabetes is also one of the leading causes of amputation.
Healthy lifestyle choices are the best way to prevent and manage diabetes, says Dr. John Bruch, an endocrinologist and the medical director of Diabetes Services at Greenville Hospital. “It is very different from other types of disease,” he says. “You can’t just take a pill or undergo corrective surgery; it requires active lifestyle changes and self-management.”
Fountain Inn resident Clarise Spriggs has a lot of experience living with diabetes; both her husband and her son have it. So, when she learned of Greenville Hospital’s Power to Prevent Diabetes program, she finally committed to make some serious lifestyle changes to head off developing diabetes herself. Now 40 pounds lighter, she is filled with energy and blogs about her experiences at ourhamandeggs.com. “Initially, I had 1,001 reasons why I couldn’t do this,” she says, “but I finally realized you’re never too old to change.”
Spriggs sets an example more people should follow. The American Diabetes Association reports that nearly 24 million children and adults in the United States are living with diabetes. An additional 57 million Americans are at risk.
Surprisingly, many people are not even aware that they have diabetes. The Centers for Disease Control and Prevention estimates 20 percent of affected people remain undiagnosed. “Many of the symptoms, like frequent urination, increased thirst and recurrent yeast infections go unnoticed,” Bruch says. “Anyone over age 35 who is overweight or has high blood pressure, a family history of the disease, or has suffered from gestational diabetes is at increased risk.”
Fortunately for people diagnosed as “pre-diabetic” (blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes), acquiring a full-blown case is not inevitable. Studies show people with elevated glucose levels can prevent or delay the onset of diabetes through weight loss and exercise. Intense exercise for 30 minutes a day, five days a week, and eating a low-fat, complex- carbohydrate diet can reduce the progression by up to 55 percent, Bruch says.
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Palmetto State health by the numbers
32 Percentage of adults who are obese, or roughly1,134,000 people. Obesity rates have more than doubled in South Carolina since 1990, and now we rank third on the list of fattest states.
21 Percentage of adults who smoke, or approximately 744,000 people. While the prevalence of smoking has steadily declined in recent years, our rate is still higher than the national average. In a 2009 report, DHEC called smoking “the leading preventable cause of death and disease in South Carolina” and estimated the direct cost of treating smoking-related illness at $1 billion.
41.8 and 32.6 Percentage of adults diagnosed with high cholesterol and high blood pressure, respectively. Both conditions contribute to heart disease and strokes.
10.7 Percentage of adults with diabetes. The 2011 America’s Health Rankings puts the number of diagnosed cases at 379,000, but state health officials estimate an additional 300,000 South Carolinians have the condition and don’t know it.
Source: 2011 America’s Health Rankings
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Get More
Read the full America’s Health Rankings 2011 Report on South Carolina