Harvard Health Blog

A simple blood test to check seemingly healthy men for hidden prostate cancer does more harm than good and shouldn’t be part of routine medical care. That’s the long-awaited final recommendation from the United States Preventive Services Task Force (USPSTF), published today in Annals of Internal Medicine. About half of men over age 40 get this test as part of a regular checkup. It measures the amount of a protein called prostate-specific antigen, or PSA, in the bloodstream. An above-normal PSA level can signal hidden prostate cancer. But it can also be a sign of prostate infection, an enlarged prostate, and other problems. Hunting for hidden disease in the absence of any outward signs or symptoms is called screening. The task force says that for every 1,000 men who have routine PSA tests, 0 to 1 deaths from prostate cancer will be prevented. But that is offset by 3 serious cardiovascular deaths due to treatment, along with 47 men who will live with treatment-related erectile dysfunction or incontinence.

Since bisphosphonates such as alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel), and zoledronic acid (Reclast) were first introduced in the mid-1990s, they’ve become a staple of osteoporosis treatment. Yet an FDA review recently published in The New England Journal of Medicine questions whether there’s any benefit to staying on these drugs long-term—especially considering their potential for side effects. A report released today in the Archives of Internal Medicine highlights one of those side effects, linking bisphosphonate use to a higher risk of unusual fractures in the femur (thighbone). If you’ve been taking bisphosphonates long-term, you may be wondering, “What now?” If you’ve been taking bisphosphonates for less than five years you probably don’t need to change what you’re doing. But if you’ve been on these drugs for more than five years, talk to your doctor about whether it’s worth continuing.

Millions of people with heart disease who take the blood thinner clopidogrel (Plavix) can now look forward to having fatter wallets. Plavix lost its patent protection this month, and on May 17 the Food and Drug Administration gave several companies the okay to sell its generic form. Clopidogrel users can now buy brand-name Plavix for a premium price, or equally effective generic clopidogrel in a 75-mg dose at a much lower cost. The change may also save lives. “We have seen more than a few patients have heart attacks because they had stopped taking clopidogrel due to the expense,” said Dr. Thomas Lee, professor of medicine at Harvard Medical School and Co-Editor in Chief of the Harvard Heart Letter. “I think the lower price is going to save some lives.” Before a company can sell a generic version of a drug, it must prove to the FDA that the drug is as effective and safe as the original.

In an effort to stem the smoldering epidemic of hepatitis C, the Centers for Disease Control and Prevention is proposing today that all Baby Boomers—anyone born between 1945 and 1965—have a one-time test for hepatitis C. This widespread but often silent disease can lead to liver damage, and even death.

A new series of books is bringing readers the kind of inspirational stories that have made Chicken Soup for the Soul books international bestsellers plus with trusted health advice from Harvard Medical School. The combination of stories providing hope, inspiration, and great person-to-person advice plus straight talk and life-changing medical information from Harvard doctors will help readers live healthier, more satisfying lives. Each book focuses on a single topic. The first four will be available beginning May 22, 2012. They are Chicken Soup for the Soul: Boost Your Brain Power! by top neurologist Dr. Marie Pasinski; Chicken Soup for the Soul: Say Goodbye to Back Pain! by leading physical medicine expert Dr. Julie Silver; Chicken Soup for the Soul: Say Goodbye to Stress! by noted psychologist Dr. Jeff Brown; and Chicken Soup for the Soul: Say Hello to a Better Body! by respected internist Dr. Suzanne Koven.

An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.

The other day I saw a mother hand an iPhone to a young baby in a stroller. I cringed because it made me think of how much time my young kids spend on the iPad and in front of the TV. It’s a dilemma for parents. Is it okay to let your daughter play with your phone so you can get five minutes of quiet in a restaurant, or will that permanently scuttle her attention span? Ann Densmore, Ed.D., an expert in speech and language development and co-author of Your Successful Preschooler, offers some practical advice for parents. “Screen time is here to stay for young children and we can’t stop it,” she told me. “The world is now inescapably online and digital. Even schools are replacing textbooks with iPads and digital texts. So moms and dads really need to figure out what’s right for their families.”

Over the past decade, the percentage of Americans with high cholesterol has been declining, from 19.1% to 14.3% of women, and 17.2% to 12.2% of men, according to a new report from the National Center for Health Statistics. Where we’re falling short is in checking our cholesterol. About 70% of women and 66% of men had their cholesterol tested in the past 5 years—slightly under the 80% objective. If your numbers aren’t quite where they should be, there are a number of ways you can help bring them back into a healthy range. Many people turn to a statin or other cholesterol-lowering medication. But it makes sense to try diet and exercise first.

Surviving cancer was once a challenging achievement. Today, more than 12 million Americans are cancer survivors, and many live long after their diagnoses. New guidelines from the American Cancer Society (ACS) offer them science-based advice for eating better and staying active—two keys to healthy living for cancer survivors and everyone else. The report, called Nutrition and Physical Activity Guidelines for Cancer Survivors, is available for free from the ACS website. The guidelines provide specific advice for survivors of a variety of major cancers: prostate, colorectal, lung, breast, ovarian, endometrial, upper GI, head and neck, and hematologic. They urge cancer survivors to maintain a healthy weight, avoid inactivity and return to normal daily activities as soon as possible following diagnosis, eventually aim to exercise at least 150 minutes per week, and follow an eating pattern that is rich in vegetables, fruits, and whole grains.

Computer games are being touted as a way to keep the body fit. Can they do the same for your brain? Most experts say “Not so fast.” As described in Improving Memory: Understanding age-related memory loss, a new Special Health Report from Harvard Medical School, people who play these games might get better at the tasks they practice while playing, but the games don’t seem to improve users’ overall brain skills, such as attention, memory, use of language, and ability to navigate. To stretch and exercise your brain, choose an activity you enjoy—reading, playing cards, or doing crossword puzzles are some good examples. If you’re feeling ambitious, try learning to speak a new language or play a musical instrument. Most of these activities come at a much lower cost than brain-training programs, and you’ll probably find them to be a lot more enjoyable, too.

Migraine was once a largely unpreventable and untreatable condition. Today there are dozens of prescription and over-the-counter medications, and even a few herbal preparations, proven to prevent migraine. Unfortunately, only about one-third of people who could benefit from a preventive therapy take one. New guidelines from the American Academy of Neurology and the American Headache Society highlight effective treatments, which should make choosing a preventive agent simpler and safer for migraine sufferers. The guidelines were published in the April 24, 2012 issue of the journal Neurology. The guidelines endorse the use of butterbur extract, an herbal preparation, for preventing migraine, along with several over-the-counter medications, such as ibuprofen and naproxen, and a bevy of prescription medications, including divalproex sodium (Depakote), sodium valproate, topiramate (Topamax), and beta blockers such as propranolol (Inderal, generic versions), metoprolol (Lopressor, generic versions), and timolol.

Warren Buffett may be the second richest man in America, but he appears to be getting the poorest medical advice. Buffett announced to Berkshire Hathaway shareholders last week that he has early stage prostate cancer that “is not remotely life-threatening or even debilitating in any meaningful way.” If Buffett’s cancer had been detected because he […]

The hemoglobin A1c reading is an important number for people with diabetes. It’s a measure of the average blood sugar level over the preceding three months. For years, the American Diabetes Association recommended that almost everyone with type 2 diabetes should aim for an HbA1c level less than 7%. Keeping blood sugar as low as possible, called “tight control,” was thought to limit the havoc caused by diabetes. New guidelines from the American Diabetes Association (ADA) and European Association for the Study of Diabetes recommend taking a more “patient-centered approach.” For people who are newly diagnosed with type 2 diabetes but who are otherwise in good health, the ADA still suggests aiming for an HbA1C of 6.0% to 6.5%. For people who have had diabetes for a while, an HbA1c goal of 7.5% to 8.0%, or even higher, may be more appropriate.

Sleeping poorly night after night—because you are trying to burn the candle at both ends or you work night or rotating shifts—has long-term health consequences. People who don’t average at least six hours of sleep a night are more likely to be overweight or develop various medical problems. New research from Harvard-affiliated Brigham and Women’s Hospital shows that lack of sleep plays a complex and powerful role in the development of type 2 diabetes. Among volunteers who lived in a sleep lab for several weeks, their bodies made less insulin after meals when they got under 5.5 hours of sleep a night for three weeks. As a result, their blood sugar levels went haywire. Some of the people had blood sugar levels high enough to have been diagnosed as prediabetic.

As Benjamin Franklin once wrote, “nothing is certain but death and taxes.” A new study suggests that death and taxes are more than just unrelated “certainties,” and that one (paying taxes) could lead to the other. Over the last 30 years, an average of 226 Americans died in motor vehicle accidents on the day taxes were due (usually April 15th), compared to 213 on other days. The authors speculated that the increase may be due to distracted driving because of the added stress of tax day, more alcohol drinking, or less sleep. If the JAMA findings are real, staying off the road on tax day could ever so slightly reduce your chances of getting into an accident on the road. But there are other, better ways to keep yourself and others safe while driving every day of the year.

A test used to give doctors a close-up view of the pancreas, called endoscopic retrograde cholangiopancreatography (ERCP), often cause a painful inflammation of the pancreas (pancreatitis). According to report in the New England Journal of Medicine, a single dose of indomethacin, a powerful nonsteroidal anti-inflammatory drug, can help prevent this post-procedure problem. About half a million Americans have ERCP each year. As many as one in six develop pancreatitis afterward. In a randomized controlled trial that included men and women who had just undergone ERCP, administration of an indomethacin suppository right after the procedure cut the rate of post-ERCP pancreatitis almost in half. Once a person has pancreatitis, the chances he or she will have it again go up. That’s why the New England Journal report is good news for anyone who needs to undergo ERCP.

In a proactive effort to help stem healthcare spending, nine medical specialty organizations have published their top 5 lists of tests, treatments, or services that are unnecessary or at least should include a thorough conversation between patients and their doctors regarding the benefits and risks of before undertaking the procedure. The lists are part of a campaign called Choosing Wisely, organized by the American Board of Internal Medicine Foundation. The purpose of making these lists, says the foundation, is to help doctors and their patients talk about tests and procedures in order to choose the ones that are supported by evidence; don’t duplicate other tests or procedures; are free from harm; and are really needed.

Today is National Walking Day. Join the celebration by taking a walk. This particular health observance is sponsored by the American Heart Association (AHA). Although it applies to everyone, it’s really aimed at adults who spend most of the workday sitting. The heart association hopes to get workers out of the office, store, or factory for a 30-minute walk. And not just today, but every day. If you don’t exercise, or do it only now and then, walking is an excellent way to get more physical activity. Just 30 minutes a day of brisk walking (or other moderate exercise), helps your heart, blood vessels, muscles, brain, and the rest of your body. If you don’t usually exercise, use National Walking Day as an invitation to get started. If you do exercise, use the day to invite a friend to get on the path to better health with a walk.

Bisphenol A, or BPA, has been used for decades to make hard plastic water bottles and to coat the inside of food cans. Tiny amounts of BPA migrate from these containers into water or food, and then into people. BPA is thought to mimic the effects of the hormone estrogen, which can interfere with growth and throw off normal hormonal interactions. In 2008, the Natural Resources Defense Council petitioned the FDA to ban the use of BPA in food packaging. The FDA finally responded last week. It denied the petition, saying the organization didn’t provide compelling data to make the case for a ban. The FDA didn’t rule out further action. In the meantime, there are several things you can do to minimize your BPA exposure.

The term “personalized medicine” is still something of an abstract idea. In an audacious experiment, Stanford molecular geneticist Michael Snyder gave it a face—his own—and showed what it can do. Snyder and a large team of colleagues first sequenced his DNA, revealing his complete genetic library. Then they analyzed blood samples he gave every few weeks for two years. This was akin to taking a 3-D movie of his inner workings to observe how genes, the molecules that read and decode them (RNA), the proteins they make, and other substances interact during health and illness. The team saw how Snyder’s body responded to a cold at the very beginning of the study. Midway through, they watched as molecular changes wrought by a respiratory infection tipped him into full-blown diabetes.

For decades, the word “autism” meant an immutable brain disorder, one determined solely by genes and that was only marginally responsive to therapies. Today it is coming to mean something different and more manageable. A growing body of research is dramatically changing the face and future of autism. In The Autism Revolution, a new book from Harvard Health Publishing that I wrote with Karen Weintraub, I explain this evolution in autism science and offer strategies for families to help their children right now. One practical finding is that autism is not just a brain disorder but a whole-body condition. Treating digestive and immune system problems can make a profound difference in the family’s life, and even in the autism itself. Another finding is that autism may not necessarily be fixed for life, and that some kids improve with time and treatment.