For example, since the 1960s, advances in medicine have helped limit heart attacks by over 50% in industrialized nations. But now, 80% of global heart disease-related deaths occur in less wealthy nations, including most of Asia. TIME Magazine reports that deaths from CVD rose by 53.4% from 1988 to 1996. The World Health Organization estimates that in 2010, 60% of heart patients will be Indian².

In Malaysia, occurrence of CVD rose by 14% in five years from 1995 to 2000. In 2001, about 20% of deaths in Malaysian government hospitals was due to heart attacks or strokes³. In Singapore, CVD is responsbile for over 30% (or almost one in three) of deaths and ranks as the second leading cause of death after cancer. However, with more and more people taking up smoking and falling prey to diabetes, high cholesterol and obesity, all key risk factors of CVD, it is likely that death from CVD in Malaysia and Singapore could rapidly increase over the next few years.

A Malfunctioning Heart

What makes CVD an unstoppable killer is that it is usually silent. For most people, a heart attack or sudden death is the only indication that all’s not well with their heart.

The following are some signs and symptoms of CVD:

Atherosclerosis & Heart Attack
Atherosclerosis is the build-up of fat on heart-vessel walls. This build-up is also called plaque. Blood flow may be blocked as the plaque grows or ruptures. Robbed of blood supply, the heart begins to beat erratically or simply stops beating.

Angina
Angina is a medical term for the chest pain felt when the heart is deprived of sufficient blood and oxygen. Angina can be the first sign of heart disease and may also be felt along the shoulders, back, jaw, neck and arms.

Congestive Heart Failure
When a weak heart begins to shut down, blood will begin to pool, causing a “congestion” in the body’s tissues. This gradually causes an enlargement of the heart. Swelling in the legs and ankles is a symptom of congestive heart failure.

However, many of the above symptoms could go unnoticed or be confused for symptoms of other diseases.

For example, angina can be confused with pain from heartburn or lung inflammation so it is critical to obtain accurate diagnosis. Other than angina, common symptoms of CVD include breathing problems, fatigue, palpitations, leg pain, and fainting. As flu, heartburn, lung inflammation, kidney disease and other diseases share some of these symptoms many people overlook the fact that it is their heart that could be malfunctioning.

An electrocardiogram (ECG) is a device used to detect underlying heart conditions. However, an ECG may not reflect a severe problem if the patient is not experiencing symptoms at the time of the test. Some experts recommend that the best option for anyone who has high risk of getting CVD and does not want to be a CVD statistic is timely health screening.

Heart disease is not the only silent, global killer. Even with over US$200 billion spent on cancer research, the disease remains one that is difficult to diagnose and treat.

Cancer: The Incurable Mutant

Cancer is caused by mutating genes. It is a challenging battle to win because a cancer cell has the uncanny ability to change its identity. Normally, a strong immune system is well-equipped to identify and fight emerging cancer cells. But a weak immune system is unable to do this, causing cancer cells to spread. As the cancer spreads, tumors that are formed display a variety of traits, making therapy difficult.

Today, only 63% of those with cancer can hope to survive for five years or more⁴. Every year, cancer kills about 7 million people and affects 10 million others⁵. Even with all the publicity surrounding it, hope for a cancer cure seems more distant than ever.

Lung, colorectal (cancer of the colon and rectum), breast and prostate cancer are among the most common cancers. The Cancer journal reports that Singaporeans have the highest colorectal cancer rate in Asia – which could be closely linked to a diet rich in saturated fat. Other cancer risk factors include smoking, obesity, diabetes, allergies, viral infections, as well as exposure to pesticides and chemical additives.

Identifying Cancer

Cancers can be as silent as they come, rarely producing symptoms till it is too late. General telltale signs of cancer include a lump or thickening in the breast or testicles, changes or sudden growth of warts or moles, skin sores that don’t heal, changes in bowel or bladder habits, a persistent cough or coughing of blood, constant indigestion, unusual bleeding, sudden and excessive weight loss as well as chronic fatigue. Just as with CVD, these symptoms could be easily mistaken for other conditions.

A mammogram is used to screen for breast cancer. Although it is highly recommended to go for regular mammograms, such screening methods are not without errors. For example, studies have found that up to 43% of mammograms could show wrong results. Of the patients who are asked to have a biopsy, only 11% to 25% with suspicious lesions actually have a malignancy. Fluctuations were also found in the ability to discriminate between benign and malignant cells^6,7.

Errors have also been found in a variety of other screening methods. X-rays that are able to pick out lumps may still miss lumps hidden under tissues or the heart. The Journal of the American Medical Association reports that virtual colonoscopy, a screening method for colorectal cancer, actually had a 45% error rate for suspicious tumors of about 10 millimeters in diameter and a 60% error rate for tumors of about six millimeters in diameter. Of eight patients who were ultimately diagnosed with cancer, virtual colonoscopy missed the disease in two⁸.

Preventive Healthcare

With so many lives being lost to CVD and cancer, there is a pressing need for early and reliable detection. Death from these diseases may be prevented by advanced, thorough and timely health screening. Following a healthy diet and active lifestyle may be excellent measures for prevention but even then, they may not be able to fully erase a genetic predisposition for these diseases.

The benefits of early detection are manifold. It gives precious peace of mind. It also allows doctors to intervene before the disease enters a severe stage. For example, heart disease does not begin with a heart attack. It starts much earlier with elevated blood cholesterol and the build-up of plaque. Similarly, small cancerous lesions may be detected and treated before they spread throughout the body.

All is not lost. New and improved detection and imaging techniques like PET and CT scans may allow doctors to detect the earliest hints of atherosclerosis and the tiniest cancerous lumps, assuring patients early treatment and increasing chances for quicker remission.

References:
1. The American Heart Association at http://www.americanheart.org
2. Walsh, Bryan. Asia’s War With Heart Disease. TIME. 10 May 2004.
3. Dhanoa, Geeta. Cardiovascular Diseases - The Looming Threat To Malaysia And Singapore. Frost & Sullivan. 21 June 2004. http://www.hospitalpharma.com/PressReleases/pressrel.asp?ROW_ID=365
4. Leaf, Clifton. Why We’re Losing The War On Cancer [And How To Win It]. FORTUNE. 22 March 2004. Vol. 149 No. 5.
5. The American Cancer Society at http://www.cancer.org
6. Kovalerchuk B. et al., 2000, The Reliability Of Computer Aided Diagnosis, Computers And Biomedical Research, 33, p. 296
http://www.idealibrary.com/servlet/citation/0010-4809/33/296
7. Machine Learning Application to Breast Cancer Detection & Treatment. (Undated). http://www.miningmachines.com/pdf/MiningMachines_cancer.pdf
8. Tanner, Lindsay. Study Questions Reliability Of New Cancer Detection Method. Associated Press. 13 April 2004. http://www.signonsandiego.com/news/health/20040413-1305-virtualcolonoscopy.html
9. The Cancer Research Institute at http://www.cancerresearch.org

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Imagine you are in your doctor’s waiting room. For the past few weeks, you’ve been anxiously waiting for a cancer test result. Now, your doctor tells you that a tumor has been found but you need more tests to reveal its exact location and to see whether it is malignant. Even then, your doctor may not be able to tell how advanced it is or how it should be treated.

This would have been a typical scenario in the past. However, today, there is a new, hybrid screening technology called the PET/CT, which is revolutionizing medical imaging, especially in the areas of brain disorders, heart disease and cancer. PET/CT marries the PET and CT technologies in just one scan, giving quick, non-invasive, painless and accurate diagnosis when it matters most.

What Is PET/CT?

PET stands for Positron Emission Tomography. Before a PET scan, a patient is injected with a signal-emitting tracer (usually a form of glucose) to acquire high resolution, three-dimensional (3D) images of the body. Diseased cells use glucose more rapidly than normal cells. The PET scanner highlights areas where glucose is used more quickly – helping doctors to detect suspicious cells and evaluate whether they are cancerous.

CT refers to Computed Tomography. It obtains images from different angles around the body. The information is then computed to show a cross-section of the body’s tissues and organs.

While CT outlines the structure and locality of the disease, PET describes its behavior. As such, putting the two together allows doctors to see with pinpoint precision, and in less than 20 minutes, the locality of a disease, how advanced it is and whether it is new or recurring. These results can help doctors to offer appropriate and timely treatment to control or even prevent the disease.

Cutting-Edge Contrast

PET/CT is becoming highly instrumental in countering doubts or contradictory results produced by conventional screening methods.

For example, an ECG (electrocardiogram) may show coronary heart disease even when none exists. Or a lump found to be benign in a SPECT scan (Single Photon Emission Computed Tomography) may actually be cancerous. The PET/CT has an almost instantaneous ability to distinguish a false-positive or false-negative result, giving the patient precious peace of mind.

For cancer, a PET/CT scan can make the all-important distinction between benign and malignant cells. This helps patients avoid the need for more tests, which are both uncomfortable and costly. For example, a blood test may show an abnormally high number of cancer antigens but cannot reveal where the lump is. An x-ray, MRI (Magnetic Resonance Imaging), CT scan, mammogram or sonography may detect where the lump is but not whether it is malignant – so, a biopsy is still needed to indicate the presence of cancer. Biopsies can be uncomfortable. They can also show erroneous readings and thus, cause psychological trauma.

Using PET in addition to CT also increases chances of detecting smaller, recurring and persistent cells that have been left over after treatment. A CT alone may not be able to detect small tumors below 10 millimeters in size. Doctors have also found PET to be better than CT in predicting which patients will survive and who will need more aggressive treatment¹.

Surgery after the cancer has spread usually does not benefit the patient. Studies prove that PET can reduce the number of futile lung cancer surgeries by 50%². A huge advantage with using the PET is that any tumor detected is very likely curable as it is usually at an early stage.

PET/CT can also reveal whether existing treatment, such as chemotherapy, is effective, or whether methods with less side effects may be employed.

PET/CT is also used for detection of cardiovascular diseases. Traditionally, doctors used diagnostic methods like the ECG, treadmill test or a surgical procedure called a coronary angiogram. An ECG may only detect a heart problem if the patient is experiencing symptoms at the time. Treadmill tests have been known to be wrong in 40% of cases. A coronary angiogram, although quite accurate, does carry a one in 1,000 risk of causing significant complications such as heart attack, stroke, kidney failure or even death.

Experts say that PET is currently the safest and best way to detect whether the heart muscle is dead or inactive. A CT scan helps doctors look directly at the arteries without expensive and invasive procedures like the angiogram. So marrying the PET and CT in one machine allows doctors to not only assess quickly and accurately whether a patient has heart disease but also whether surgery, like a coronary artery bypass, would be safe and beneficial to the patient³.

Are All PET/CTs The Same?

An award-winning photographer cannot produce high-definition images with a low quality camera. Similarly, an experienced doctor may still make a mistake if his diagnostic equipment is not up to par.

There are many types of PET/CTs available but they are not all the same. A distinguishing factor between them is the ability to capture more “slices” in a shorter scanning time. To understand this better, imagine a raisin loaf. Cut it into two – you will get two thick parts. Now, cut the loaf into eight, 10 or 16 slices – you get thinner slices and are also able to see raisins that were previously hidden within the two thick parts.

Many PET/CTs in use today are dual slice or six-slice varieties. The latest PET/CT technology however, employs more slices. By showing thinner slices of scanned tissues in a shorter scanning time, these machines can detect previously hidden tumors or even tumors as small as 2 to 3 millimeters.

Newer PET/CT devices also employ LSO crystal technology as opposed to the conventional BGO crystal. LSO crystals produce quicker, clearer images while minimizing scanning errors. Advanced scanning software is also allowing doctors to obtain more defined images, for instance, of a beating heart, allowing doctors to better monitor heart health.

Preventive Healthcare

When the difference is between life and death, even a marginal error can have a profound impact.

So what can the patient do? For one, choosing a responsible healthcare center is paramount. There is a constant shift in the currents of medical technology and only patient-centric centers will take the initiative to be constantly updated. The advanced PET/CT technology for one is offering a lot of respite where doctors and patients were once forced to play guessing games about health.

But technology alone cannot save lives. Much depends on the people using it. An experienced and quick-thinking doctor will understand the possibility of machine error and take necessary steps to avert wrong readings.

Preventive healthcare is always the best bet. But when prevention is no longer possible, we need the assurance that both doctor and machine are going to give us the excellent care, diagnosis and treatment we deserve.

References:
1. PET Scan In Cancer Diagnosis. John Muir/Mt. Diablo Health System. (Undated). http://www.johnmuirmtdiablo.com/index.php/publications42.html
2. Tracey, Elizabeth MS. High-Tech PET Scan 'Sees' Cancer Better. WebMD News Archive. 24 May 2000. http://my.webmd.com/content/article/25/1728_57856
3. Computer Imaging / Tomography. American Heart Association. 23 Aug 2004. http://www.americanheart.org/presenter.jhtml?identifier=4554#positron

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Every year between 200,000 and 500,000 people die from the flu¹. In the time that it takes you to order a burger and a large side of fries, pay and sit down to have your meal, all in less than 2 minutes, someone somewhere would have died of cancer or heart disease or may be diagnosed with diabetes. About 9 per cent of the adult population in Singapore has diabetes, a key risk factor of heart disease, and about 80 per cent of all diabetics suffer from Type 2 diabetes, which can be controlled by diet and exercise.

Let us take a moment to pause and consider. Are we destined to die before our time due to a disease? Why do some people die of a disease while others manage to recover? Why do some people recover very quickly or never fall ill at all?

Every one of us has the ability to live long and full lives. This is because we are each blessed with the best doctor inside us – the human immune system. And prevention starts with a strong immune system.

Our immune system is an amazing piece of work. At any given second, it can call upon countless battalions of immune cells, organs and chemical substances to mount a counter-offensive against disease-causing agents like germs, pollutants and parasites.

Nutritional Immunology is a science that studies the link between nutrition and the immune system’s ability to ward off illness. Food that is high in salt, sugar and fat can cause the immune system to malfunction, and thus, bring about illnesses like cancer, heart disease and diabetes. But when we constantly reinforce it with disease-fighting nutrients such as antioxidants, phytochemicals and polysaccharides, our immune system can remain in tip top condition. These nutrients are best obtained from wholesome plant foods. That is why it is essential to eat at least 5 to 9 servings of fruits and vegetables every day.

Nutritional Immunology aids researchers in selecting the most nutritionally powerful plant foods and guides the processing of these plant foods to retain the optimal amount of nutrients. It stresses on a healthy lifestyle through regular exercise, proper rest and stress management. Nutritional Immunology also focuses on education. Many people fall ill simply because they lack knowledge about nutrition.

As a clinic that emphasizes prevention and education before treatment, Excellence Healthcare strongly advocates the principles of this science. By choosing to eat wholesome food and following a healthier lifestyle, we can prevent many illnesses that will prematurely rob us of the time we want to spend achieving dreams and being with loved ones. For added precaution, we also advise timely health screening to avoid being taken by surprise. A disease detected at its early stage is very likely to be curable. But when we wait until there is pain or discomfort, it may already be too late.

So don’t wait till you are ill before you take action. Nutritional Immunology is an ideal pathway to a fuller, healthier life, as it is committed to enhancing the quality of life. It is never too late to embrace its teachings. Visit your healthcare practitioner today for the first step in discovering more about enhancing your health.

References:
1. The World Health Organization Website at http://www.who.int
2. The Centers for Disease Control and Prevention Website at http://www.cdc.gov

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