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What causes Heart Failure ?
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Heart failure is caused by other diseases and conditions that damage the heart muscle. It is most commonly caused by coronary artery disease, including heart attack. Diabetes and high blood pressure also contribute to heart failure risk. People who have had a heart attack are at high risk of developing heart failure.
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What are the symptoms of Heart Failure ?
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The most common symptoms of heart failure include shortness of breath or difficulty breathing, feeling tired, and swelling. Swelling is caused by fluid build-up in the body. Fluid buildup can lead to weight gain and frequent urination, as well as coughing.
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How many people are affected by Heart Failure ?
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Approximately 5 million people in the United States have heart failure. It contributes to 300,000 deaths each year. It is the number one cause of hospitalizations for people over the age of 65.
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Who is at risk for Heart Failure? ?
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Heart failure is more common in - people who are 65 years old or older - African-Americans - people who are overweight - people who have had a heart attack - men. people who are 65 years old or older African-Americans people who are overweight people who have had a heart attack men. Aging can weaken the heart muscle. Older people also may have had diseases for many years that led to heart failure. African Americans are more likely to have heart failure than people of other races. They're also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure. Excess weight puts strain on the heart. Being overweight also increases your risk of heart disease and type 2 diabetes. These diseases can lead to heart failure. A history of a heart attack puts people at greater risk for heart failure. Men have a higher rate of heart failure than women.
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How to prevent Heart Failure ?
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Ways to prevent heart failure include - keeping your cholesterol and blood pressure levels healthy - keeping diabetes in check - maintaining a healthy weight - quitting smoking - following a heart healthy diet - limiting the amount of alcohol you drink - eating a diet low in salt because salt can cause extra fluid to build up in your body and also contribute to high blood pressure. Older adults should limit their sodium (salt) intake to1500 mg a day (about 2/3 tsp of salt). - getting regular exercise. Aim for at least 30 minutes a day of exercise. Check with your doctor before starting any exercise program. For information about exercises that older adults can do safely, see Exercises to Try or visit Go4Life, the exercise and physical activity campaign for older adults from the National Institute on Aging. keeping your cholesterol and blood pressure levels healthy keeping diabetes in check maintaining a healthy weight quitting smoking following a heart healthy diet limiting the amount of alcohol you drink eating a diet low in salt because salt can cause extra fluid to build up in your body and also contribute to high blood pressure. Older adults should limit their sodium (salt) intake to1500 mg a day (about 2/3 tsp of salt). getting regular exercise. Aim for at least 30 minutes a day of exercise. Check with your doctor before starting any exercise program. For information about exercises that older adults can do safely, see Exercises to Try or visit Go4Life, the exercise and physical activity campaign for older adults from the National Institute on Aging.
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What is (are) Heart Failure ?
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Keeping your cholesterol levels healthy can help prevent coronary artery disease. Your goal for LDL, or "bad," cholesterol depends on how many other risk factors you have. Here are recommended LDL cholesterol goals. - If you don't have coronary heart disease or diabetes and have one or no risk factors, your LDL goal is less than 160 mg/dL. - If you don't have coronary heart disease or diabetes and have two or more risk factors, your LDL goal is less than 130 mg/dL. - If you do have coronary heart disease or diabetes, your LDL goal is less than 100 mg/dL. If you don't have coronary heart disease or diabetes and have one or no risk factors, your LDL goal is less than 160 mg/dL. If you don't have coronary heart disease or diabetes and have two or more risk factors, your LDL goal is less than 130 mg/dL. If you do have coronary heart disease or diabetes, your LDL goal is less than 100 mg/dL. The goal for HDL, or "good," cholesterol is above 40 in men and above 50 in women. The goal for triglycerides, another fat in the blood, is below 150.
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How to diagnose Heart Failure ?
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There is not one specific test to diagnose heart failure. Because the symptoms are common for other conditions, your doctor will determine if you have heart failure by doing a detailed medical history, an examination, and several tests. During a physical exam, a doctor will listen for abnormal heart sounds and lung sounds that indicate fluid buildup, as well as look for signs of swelling. If there are signs of heart failure, the doctor may order several tests, including: - an EKG, or electrocardiogram, to measure the rate and regularity of the heartbeat - a chest X-ray to evaluate the heart and lungs - a BNP blood test to measure the level of a hormone called BNP that increases when heart failure is present. an EKG, or electrocardiogram, to measure the rate and regularity of the heartbeat a chest X-ray to evaluate the heart and lungs a BNP blood test to measure the level of a hormone called BNP that increases when heart failure is present.
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How to diagnose Heart Failure ?
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Once initial tests have been performed, your doctor may decide to send you to a cardiologist, a specialist in diagnosis and treatment of heart disease. A cardiologist will perform a physical exam and may order other tests. There are several tests that can identify the cause of heart failure. These tests include: - An echocardiogram is one of the most useful tests for diagnosing heart failure. This test uses sound waves to create a picture of the heart and shows how well the heart is filling with blood. Your doctor uses this test to determine whether any areas of your heart are damaged. An echocardiogram is one of the most useful tests for diagnosing heart failure. This test uses sound waves to create a picture of the heart and shows how well the heart is filling with blood. Your doctor uses this test to determine whether any areas of your heart are damaged. - A Holter monitor, which is a small box that is attached to patches placed on your chest. The monitor, which is worn for 24 hours, provides a continuous recording of heart rhythm during normal activity. A Holter monitor, which is a small box that is attached to patches placed on your chest. The monitor, which is worn for 24 hours, provides a continuous recording of heart rhythm during normal activity. - An exercise stress test captures your EKG and blood pressure before, during, or after exercise to see how your heart responds to exercise. This test tells doctors how your heart responds to activity. An exercise stress test captures your EKG and blood pressure before, during, or after exercise to see how your heart responds to exercise. This test tells doctors how your heart responds to activity.
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What are the treatments for Heart Failure ?
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Treatment for heart failure includes lifestyle changes medications specialized care for those in advanced stages of the disease.
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What are the treatments for Heart Failure ?
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Lifestyle changes to treat heart failure may include - reducing salt and fluid intake - following a heart healthy diet - adopting a plan to lose weight - quitting smoking - engaging in physical activity. reducing salt and fluid intake following a heart healthy diet adopting a plan to lose weight quitting smoking engaging in physical activity.
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What are the treatments for Heart Failure ?
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Many medications are used to manage heart failure. They include diuretics, ACE inhibitors, beta blockers and digoxin. Diuretics are used to reduce fluid buildup. ACE inhibitors work to improve heart failure in many ways, including lowering blood pressure. Beta blockers can also improve heart failure in many ways, including slowing the heart rate. Digoxin affects the hormones that worsen heart failure.
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What are the treatments for Heart Failure ?
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For severe heart failure, patients may require additional oxygen, a mechanical heart pump, or a heart transplant.
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What is (are) Heart Failure ?
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More detailed information on heart failure is available at http://www.nhlbi.nih.gov/health/dci
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What is (are) Anxiety Disorders ?
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Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. However, anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. These feelings can interfere with daily activities such as job performance, school work, and relationships. (Watch the video to learn about the types of anxiety disorders. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Anxiety Disorders in Older Adults Studies estimate that anxiety disorders affect up to 15 percent of older adults in a given year. More women than men experience anxiety disorders. They tend to be less common among older adults than younger adults. But developing an anxiety disorder late in life is not a normal part of aging. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In older adults, anxiety disorders often occur at the same time as depression, heart disease, diabetes, and other medical problems. In some cases, these other problems need to be treated before a person can respond well to treatment for anxiety. There are three types of anxiety disorders discussed here. - generalized anxiety disorder - social phobia - panic disorder generalized anxiety disorder social phobia panic disorder Generalized Anxiety Disorder (GAD) All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. Learn more about generalized anxiety disorder (GAD). Social Phobia In social phobia, a person fears being judged by others or of being embarrassed. This fear can get in the way of doing everyday things such as going to work, running errands, or meeting with friends. People who have social phobia often know that they shouldn't be so afraid, but they can't control their fear. Learn more about social phobia. Panic Disorder In panic disorder, a person has sudden, unexplained attacks of terror, and often feels his or her heart pounding. During a panic attack, a person feels a sense of unreality, a fear of impending doom, or a fear of losing control. Panic attacks can occur at any time. Learn more about panic disorder. Anxiety Disorders Are Treatable In general, anxiety disorders are treated with medication, specific types of psychotherapy, or both. Treatment choices depend on the type of disorder, the persons preference, and the expertise of the doctor. If you think you have an anxiety disorder, talk to your doctor.
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What are the symptoms of Anxiety Disorders ?
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Excessive, Irrational Fear Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread. Unlike the relatively mild, brief anxiety caused by a specific event (such as speaking in public or a first date), severe anxiety that lasts at least six months is generally considered to be problem that might benefit from evaluation and treatment. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In older adults, anxiety disorders often occur at the same time as depression, heart disease, diabetes, and other medical problems. In some cases, these other problems need to be treated before a person can respond well to treatment for anxiety. Symptoms of Generalized Anxiety Disorder (GAD) GAD develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress. People with GAD cant seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They cant relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include - fatigue - headaches - muscle tension - muscle aches - difficulty swallowing - trembling - twitching - irritability - sweating - nausea - lightheadedness - having to go to the bathroom frequently - feeling out of breath - hot flashes. fatigue headaches muscle tension muscle aches difficulty swallowing trembling twitching irritability sweating nausea lightheadedness having to go to the bathroom frequently feeling out of breath hot flashes. When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they dont avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe. Symptoms of Social Phobia In social phobia, a person fears being judged by others or of being embarrassed. This fear can get in the way of doing everyday things such as going to work, running errands or meeting with friends. People who have social phobia often know that they shouldn't be so afraid, but they can't control their fear. People with social phobia tend to - be very anxious about being with other people and have a hard time talking to them, even though they wish they could - be very self-conscious in front of other people and feel embarrassed - be very afraid that other people will judge them - worry for days or weeks before an event where other people will be - stay away from places where there are other people - have a hard time making friends and keeping friends - blush, sweat, or tremble around other people - feel nauseous or sick to their stomach when with other people. be very anxious about being with other people and have a hard time talking to them, even though they wish they could be very self-conscious in front of other people and feel embarrassed be very afraid that other people will judge them worry for days or weeks before an event where other people will be stay away from places where there are other people have a hard time making friends and keeping friends blush, sweat, or tremble around other people feel nauseous or sick to their stomach when with other people. Symptoms of Panic Disorder In panic disorder, a person has sudden, unexplained attacks of terror, and often feels his or her heart pounding. During a panic attack, a person feels a sense of unreality, a fear of impending doom, or a fear of losing control. Panic attacks can occur at any time. People with panic disorder may have - sudden and repeated attacks of fear - a feeling of being out of control during a panic attack - an intense worry about when the next attack will happen - a fear or avoidance of places where panic attacks have occurred in the past - physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain. sudden and repeated attacks of fear a feeling of being out of control during a panic attack an intense worry about when the next attack will happen a fear or avoidance of places where panic attacks have occurred in the past physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain. Seeking Treatment Anxiety disorders are treatable. If you think you have an anxiety disorder, talk to your doctor. If your doctor thinks you may have an anxiety disorder, the next step is usually seeing a mental health professional. It is advisable to seek help from professionals who have particular expertise in diagnosing and treating anxiety. Certain kinds of cognitive and behavioral therapy and certain medications have been found to be especially helpful for anxiety.
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How to diagnose Anxiety Disorders ?
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Anxiety disorders sometimes run in families, but no one knows for sure why some people have them while others don't. Anxiety disorders are more common among younger adults than older adults, and they typically start in early life. However, anyone can develop an anxiety disorder at any time. Below are risk factors for these anxiety disorders. - Generalized Anxiety Disorder (GAD) - Social Anxiety Disorder (Social Phobia) - Panic Disorder Generalized Anxiety Disorder (GAD) Social Anxiety Disorder (Social Phobia) Panic Disorder Generalized Anxiety Disorder - Risk Factors Generalized anxiety disorder (GAD) affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age. The average age of onset is 31 years old. Social Phobia - Risk Factors Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Panic Disorder - Risk Factors Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited. Diagnosis Can Be Difficult There are a number of reasons why it can be difficult to accurately diagnose an anxiety disorder in older adults. - Anxiety disorders among older adults frequently occur at the same time as other illnesses such as depression, diabetes, heart disease, or a number of other medical illnesses. Problems with cognition (thinking) and changes in life circumstances can also complicate matters. Sometimes the physical signs of these illnesses can get mixed up with the symptoms of anxiety, making it difficult to determine if a person has a true anxiety disorder. For instance, a person with heart disease sometimes has chest pain, which can also be a symptom of a panic disorder. Anxiety disorders among older adults frequently occur at the same time as other illnesses such as depression, diabetes, heart disease, or a number of other medical illnesses. Problems with cognition (thinking) and changes in life circumstances can also complicate matters. Sometimes the physical signs of these illnesses can get mixed up with the symptoms of anxiety, making it difficult to determine if a person has a true anxiety disorder. For instance, a person with heart disease sometimes has chest pain, which can also be a symptom of a panic disorder. - Doctors can have difficulty distinguishing between anxiety caused by adapting to difficult life changes, and a true anxiety disorder. For example, if you fell and broke a hip, you may be justifiably fearful of going out for a while. But that would not mean you have developed an anxiety disorder. Doctors can have difficulty distinguishing between anxiety caused by adapting to difficult life changes, and a true anxiety disorder. For example, if you fell and broke a hip, you may be justifiably fearful of going out for a while. But that would not mean you have developed an anxiety disorder. - Sometimes the worrying symptoms of a medical illness can lead to an anxiety disorder. Or, sometimes the side effects of medication can cause anxiety. Also, a disability or a change in lifestyle caused by a medical illness may lead to an anxiety disorder. Muscle tightness, feeling very tense all the time, and difficulty sleeping can also be symptoms of a physical illness or an anxiety disorder, complicating diagnosis. Sometimes the worrying symptoms of a medical illness can lead to an anxiety disorder. Or, sometimes the side effects of medication can cause anxiety. Also, a disability or a change in lifestyle caused by a medical illness may lead to an anxiety disorder. Muscle tightness, feeling very tense all the time, and difficulty sleeping can also be symptoms of a physical illness or an anxiety disorder, complicating diagnosis. Diagnosis Here is how these anxiety disorders are diagnosed. - Generalized Anxiety Disorder (GAD) - Panic Disorder - Social Anxiety Disorder (Social Phobia) Generalized Anxiety Disorder (GAD) Panic Disorder Social Anxiety Disorder (Social Phobia) Generalized Anxiety Disorder (GAD) - Diagnosis GAD can be diagnosed once a person worries excessively about a variety of everyday problems for at least 6 months. People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can be symptoms of GAD, but they don't always get the help they need right away. It may take doctors some time to be sure that a person has GAD instead of something else. Social Phobia - Diagnosis A doctor can tell that a person has social phobia if the person has had symptoms for at least 6 months. Social phobia usually starts during youth. Without treatment, it can last for many years or a lifetime. Panic Disorder - Diagnosis People with panic disorder may sometimes go from doctor to doctor for years and visit the emergency room repeatedly before someone correctly diagnoses their condition. This is unfortunate, because panic disorder is one of the most treatable of all the anxiety disorders, responding in most cases to certain kinds of medication or certain kinds of cognitive psychotherapy, which help change thinking patterns that lead to fear and anxiety. If You Have Symptoms Anxiety disorders are treatable. If you think you have an anxiety disorder, talk to your family doctor. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist. You should feel comfortable talking with the mental health specialist you choose. If you do not, seek help elsewhere. Once you find a mental health specialist you are comfortable with, you should work as a team and make a plan to treat your anxiety disorder together. Talk About About Past Treatment People with anxiety disorders who have already received treatment for an anxiety disorder should tell their doctor about that treatment in detail. If they received medication, they should tell their doctor what medication was used, what the dosage was at the beginning of treatment, whether the dosage was increased or decreased while they were under treatment, what side effects may have occurred, and whether the treatment helped them become less anxious. If they received psychotherapy, they should describe the type of therapy, how often they attended sessions, and whether the therapy was useful.
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what research (or clinical trials) is being done for Anxiety Disorders ?
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Clinical trials are part of clinical research and at the heart of all treatment advances. Clinical trials look at new ways to prevent, detect, or treat disease. The National Institute of Mental Health at NIH supports research studies on mental health and disorders. To learn how clinical trials work, see Participating in Clinical Trials. To see NIH-funded studies currently recruiting participants in anxiety disorders, visit www.ClinicalTrials.gov and type in "anxiety disorders." Clinical Trials.gov is the NIH/National Library of Medicine's registry of federally and privately funded clinical trials for all disease. To see personal stories of people who have volunteered for clinical trials, visit NIH Clinical Trials Research and You.
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How many people are affected by Anxiety Disorders ?
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Studies estimate that anxiety disorders affect around 15 percent of older adults in a given year. More women than men experience anxiety disorders. They tend to be less common among older adults than younger adults. But developing an anxiety disorder late in life is not a normal part of aging.
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What is (are) Anxiety Disorders ?
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Anxiety disorders are a collection of disorders that include generalized anxiety disorder (GAD), social phobia, and panic disorder.
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What is (are) Anxiety Disorders ?
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All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. People with GAD cant seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They cant relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes. When their anxiety level is mild, people with GAD can function socially and hold down a job. Although they dont avoid certain situations as a result of their disorder, people with GAD can have difficulty carrying out the simplest daily activities if their anxiety is severe. Learn more about generalized anxiety disorder (GAD).
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What is (are) Anxiety Disorders ?
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In social phobia, a person fears being judged by others or of being embarrassed. This fear can get in the way of doing everyday things such as going to work, running errands or meeting with friends. People who have social phobia often know that they shouldn't be so afraid, but they can't control their fear. People with social phobia tend to - be very anxious about being with other people and have a hard time talking to them, even though they wish they could - be very self-conscious in front of other people and feel embarrassed - be very afraid that other people will judge them - worry for days or weeks before an event where other people will be - stay away from places where there are other people - have a hard time making friends and keeping friends - blush, sweat, or tremble around other people - feel nauseous or sick to their stomach when with other people. be very anxious about being with other people and have a hard time talking to them, even though they wish they could be very self-conscious in front of other people and feel embarrassed be very afraid that other people will judge them worry for days or weeks before an event where other people will be stay away from places where there are other people have a hard time making friends and keeping friends blush, sweat, or tremble around other people feel nauseous or sick to their stomach when with other people. Learn more about social phobia.
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What is (are) Anxiety Disorders ?
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In panic disorder, a person has sudden, unexplained attacks of terror, and often feels his or her heart pounding. During a panic attack, a person feels a sense of unreality, a fear of impending doom, or a fear of losing control. Panic attacks can occur at any time. People with panic disorder may have - sudden and repeated attacks of fear - a feeling of being out of control during a panic attack - an intense worry about when the next attack will happen - a fear or avoidance of places where panic attacks have occurred in the past - physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain. sudden and repeated attacks of fear a feeling of being out of control during a panic attack an intense worry about when the next attack will happen a fear or avoidance of places where panic attacks have occurred in the past physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain. Learn more about panic disorder.
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Who is at risk for Anxiety Disorders? ?
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Generalized anxiety disorder (GAD) affects about 6.8 million American adults, including twice as many women as men. The disorder develops gradually and can begin at any point in the life cycle, although the years of highest risk are between childhood and middle age. The average age of onset is 31 years old. Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder, which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Panic disorder affects about 6 million American adults and is twice as common in women as men. Panic attacks often begin in late adolescence or early adulthood, but not everyone who experiences panic attacks will develop panic disorder. Many people have just one attack and never have another. The tendency to develop panic attacks appears to be inherited.
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What are the treatments for Anxiety Disorders ?
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Most insurance plans, including health maintenance organizations (HMOs), will cover treatment for anxiety disorders. Check with your insurance company and find out. If you dont have insurance, the Health and Human Services division of your county government may offer mental health care at a public mental health center that charges people according to how much they are able to pay. If you are on public assistance, you may be able to get care through your state Medicaid plan. To learn about more mental health resources, see Help for Mental Illness, from the National Institute of Mental Health at NIH.
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What is (are) Anxiety Disorders ?
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Cognitive behavioral therapy (CBT) is a type of psychotherapy that is very useful in treating anxiety disorders. It can help people change the thinking patterns that support their fears and change the way they react to anxiety-provoking situations. For example, cognitive behavioral therapy can help people with panic disorder learn that their panic attacks are not really heart attacks and help people with social phobia learn how to overcome the belief that others are always watching and judging them. When people are ready to confront their fears, they are shown how to use exposure techniques to desensitize themselves to situations that trigger their anxieties.
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What are the treatments for Anxiety Disorders ?
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Exposure-based treatment has been used for many years to treat specific phobias. The person gradually encounters the object or situation that is feared, perhaps at first only through pictures or tapes, then later face-to-face. Sometimes the therapist will accompany the person to a feared situation to provide support and guidance. Exposure exercises are undertaken once the patient decides he is ready for it and with his cooperation. To be effective, therapy must be directed at the persons specific anxieties and must be tailored to his or her needs. A typical side effect is temporary discomfort involved with thinking about confronting feared situations.
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What is (are) Depression ?
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Everyone feels blue or sad now and then, but these feelings don't usually last long and pass within a couple of days. When a person has depression, it interferes with daily life and normal functioning, and causes pain for both the person with depression and those who care about him or her. Doctors call this condition "depressive disorder," or "clinical depression." Depression in Older Adults Important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness. For instance, the death of a loved one, moving from work into retirement, or dealing with a serious illness can leave people feeling sad or anxious. After a period of adjustment, many older adults can regain their emotional balance, but others do not and may develop depression. Depression is a common problem among older adults, but it is NOT a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more physical ailments. However, when older adults do suffer from depression, it may be overlooked because they may be less willing to talk about feelings of sadness or grief, or they may show different, less obvious symptoms, and doctors may be less likely to suspect or spot it. Sometimes it can be difficult to distinguish grief from major depression. Grief after loss of a loved one is a normal reaction to the loss and generally does not require professional mental health treatment. However, grief that lasts for a very long time following a loss may require treatment. Test Depression and Suicide Though it is widely believed that suicide more often affects young people, suicide is a serious problem among older adults, too particularly among older men and depression is usually a major contributing factor. Adults 65 and older have a suicide rate that is higher than the rate for the national population, but there are some major differences between older men and women. While suicide rates for older women are somewhat lower than those for young and middle-aged women, rates among men 75 and older are higher than those for younger men. In fact, white men age 85 and older have the highest suicide rate in the United States. Types of Depression There are several types of depression. The most common types are major depressive disorder and dysthymic disorder. - Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, concentrate, eat, and enjoy activities he or she once liked. Major depression prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life. - Dysthymic disorder, also called dysthymia, is a less severe but more long-lasting form of depression. Dysthymia is characterized by symptoms lasting two years or longer that keep a person from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetime. Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, concentrate, eat, and enjoy activities he or she once liked. Major depression prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life. Dysthymic disorder, also called dysthymia, is a less severe but more long-lasting form of depression. Dysthymia is characterized by symptoms lasting two years or longer that keep a person from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetime. Other types of depression include subsyndromal depression, psychotic depression. and bipolar depression. - Subsyndromal depression is common among older adults. It includes less severe but clear symptoms of depression that fall short of being major depression or dysthymia. Having subsyndromal depression may increase a person's risk of developing major depression. - Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). - Bipolar depression, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression). Subsyndromal depression is common among older adults. It includes less severe but clear symptoms of depression that fall short of being major depression or dysthymia. Having subsyndromal depression may increase a person's risk of developing major depression. Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Bipolar depression, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression).
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What causes Depression ?
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Several lines of research have shown that depressive illnesses are disorders of the brain. But the exact causes for these illnesses are not yet clear and are still being studied. Changes in the Brain Imaging technologies show that the brains of people with depression look different or are working differently than those who do not have the illness. The areas of the brain that control moods, thinking, sleep, appetite, and behavior appear not to be functioning well. The scans also show very high or very low levels of important brain chemicals. But these images do not reveal WHY the depression has occurred. Many Possible Causes In general, there is no one cause or risk factor for depression. It most likely results from many factors, such as family history, life experiences, and environment. Older adults with depression may have had it when they were younger, or they may have a family history of the illness. They may also be going through difficult life events, such as losing a loved one, a difficult relationship with a family member or friend, or financial troubles. For older adults who experience depression for the first time later in life, other factors may be at play. Depression may be related to changes that occur in the brain and body as a person ages. For example, some older adults who are at risk for illnesses such as heart disease or stroke may have hardening and inflammation of the blood vessels, and blood may not be able to flow normally to the body's organs, including the brain. Over time, this blood vessel disease and restricted blood flow can damage nearby brain tissue and harm the nerve connections that help different parts of the brain communicate with each other. If this happens, an older adult with no family history of depression may develop what some doctors call "vascular depression." Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease. This type of depression can appear in the early stages of these diseases, before many symptoms appear. Depression Can Occur With Other Illnesses Depression can also co-occur with other serious medical illnesses such as diabetes, cancer, and Parkinson's disease. Depression can make these conditions worse, and vice versa. Sometimes, medications taken for these illnesses may cause side effects that contribute to depression. Because many older adults face these illnesses along with various social and economic difficulties, some health care professionals may wrongly conclude that these problems are the cause of the depression -- an opinion often shared by patients themselves. All these factors can cause depression to go undiagnosed or untreated in older people. Yet, treating the depression will help an older adult better manage other conditions he or she may have.
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What are the symptoms of Depression ?
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Common Symptoms There are many symptoms associated with depression, and some will vary depending on the individual. However, some of the most common symptoms are listed below. If you have several of these symptoms for more than two weeks, you may have depression. - feeling nervous or emotionally "empty" - feelings of excessive guilt or worthlessness - tiredness or a "slowed down" feeling - restlessness and irritability - feeling like life is not worth living - sleep problems, including trouble getting to sleep, wakefulness in the middle of the night, or sleeping too much - eating more or less than usual, usually with unplanned weight gain or loss - having persistent headaches, stomach-aches or other chronic pain that does not go away when treated - loss of interest in once pleasurable activities, including sex - frequent crying - difficulty focusing, remembering or making decisions - thoughts of death or suicide, or a suicide attempt feeling nervous or emotionally "empty" feelings of excessive guilt or worthlessness tiredness or a "slowed down" feeling restlessness and irritability feeling like life is not worth living sleep problems, including trouble getting to sleep, wakefulness in the middle of the night, or sleeping too much eating more or less than usual, usually with unplanned weight gain or loss having persistent headaches, stomach-aches or other chronic pain that does not go away when treated loss of interest in once pleasurable activities, including sex frequent crying difficulty focusing, remembering or making decisions thoughts of death or suicide, or a suicide attempt Is it Depression or Something Else? The first step to getting appropriate treatment is to visit a doctor. Certain medications taken for other medical conditions, vitamin B12 deficiency, some viruses, or a thyroid disorder can cause symptoms similar to depression. If an older adult is taking several medications for other conditions and is depressed, seeing a doctor is especially important. A doctor can rule out medications or another medical condition as the cause of the depression by doing a complete physical exam, interview, and lab tests. If these other factors can be ruled out, he or she may refer you to a mental health professional, such as a psychologist, counselor, social worker, or psychiatrist. Some doctors called geriatric psychiatrists and clinical geropsychologists are specially trained to treat depression and other mental illnesses in older adults. The doctor or mental health professional will ask about the history of your symptoms, such as when they started, how long they have lasted, their severity, whether they have occurred before, and if so, whether they were treated and how. He or she will then diagnose the depression and work with you to choose the most appropriate treatment.
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what research (or clinical trials) is being done for Depression ?
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Treating Older Adults Studies show that the majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy or a combination of both. In addition, research has indicated that treating depression in older adults often improves the outcomes of co-existing medical conditions. Some research has also suggested that the risk for developing depression in people who have had a stroke may be reduced if they receive preventative treatment with an antidepressant or talk therapy. Special Considerations However, there are some special considerations that doctors must take into account when treating older adults. The commonly prescribed medications for depression may not work well for some older adults because they may interact unfavorably with other medications being taken for other conditions. Some older adults with depression may also have some problems thinking clearly, and these individuals often respond poorly to the drugs. Which Form of Treatment Is Most Effective? Many older adults prefer to get counseling or psychotherapy for depression rather than add more medications to those they are already taking for other conditions. Research suggests that for older adults, psychotherapy is just as likely to be an effective first treatment for depression as taking an antidepressant. There is a great deal of evidence indicating that cognitive-behavioral therapy (CBT), including a version called problem solving therapy, may be an especially useful type of psychotherapy for treating older adults and improving their quality of life. However, a practical issue to consider when deciding on treatment is that it may be harder for many older people to find or be able to travel to meetings with a well-trained psychotherapist than to get a prescription for antidepressant medication from their primary care doctor. Also, some research suggests that treatment with medication may be more effective if the depression is quite severe or if the older adult is coping with other serious illnesses. Overall, research has suggested that, when possible, a combination of medication and psychotherapy treatment is likely to be most effective in treating depression in older adults and, in particular, for reducing the number of new episodes. Late-Life Depression is Often Undiagnosed Despite progress in treatment research, late-life depression often goes undiagnosed or is inadequately treated in older adults. In fact, several studies have found that up to 75 percent of older adults who die by suicide had visited their primary care doctors within one month of their deaths. Collaborative or comprehensive care may lead to better treatment results. Collaborative Care The Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) offered antidepressant medication and/or psychotherapy to depressed older adults, along with a "care manager" -- a social worker, nurse or psychologist -- who monitored their symptoms, side effects of medication, and progress. The study found that those participants who had case-managed care got better more quickly, had longer periods without depression, and in general responded better to treatment than those who did not have case-managed care. Another study called the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) trial also found that collaborative care was more effective than usual care, and was less expensive over the long run as well. Improving Diagnosis of Depression Several studies are looking at ways to help older adults get better access to depression treatment. One is developing and testing an education and intervention program to help primary care clinics and providers identify and treat late-life depression. Another study found that depressed older adults who had a "care manager" monitor their symptoms, side effects, and progress got better more quickly -- and stayed better longer -- than those who did not have case-managed care. Still other projects are investigating ways of improving older adults engagement in and ability to follow treatment plans for depression. Researchers are also looking at ways to - better understand the relationship between other medical illnesses and depression - integrate treatment for depression with treatments for other medical conditions a person may have - produce a quicker response to treatment - develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) - help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. better understand the relationship between other medical illnesses and depression integrate treatment for depression with treatments for other medical conditions a person may have produce a quicker response to treatment develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. Findings from these and other studies will provide important information for doctors to treat late-life depression. In a Crisis? Get Help! If you are in a crisis... If you are thinking about harming yourself or attempting suicide, tell someone who can help immediately. - Call your doctor. - Call 911 for emergency services. - Go to the nearest hospital emergency room. - Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to be connected to a trained counselor at a suicide crisis center nearest you. Call your doctor. Call 911 for emergency services. Go to the nearest hospital emergency room. Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to be connected to a trained counselor at a suicide crisis center nearest you.
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What is (are) Depression ?
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Depression is more than just feeling blue or sad. It is an illness. When you have depression, it interferes with daily life and normal functioning, and causes pain for both you and those who care about you.
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What is (are) Depression ?
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Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with your ability to work, sleep, concentrate, eat, and enjoy activities you once liked. Major depression keeps a person from functioning normally. Dysthymic disorder, or dysthymia, is a less severe but sometimes more long-lasting form of depression. It is characterized by symptoms lasting two years or longer that keep you from functioning normally or feeling well. Subsyndromal depression, affecting many older adults, includes real symptoms of depression that are less severe than major depression or dysthymia. Having sybsydromal depression may increase your risk of developing major depression. Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Bipolar depression also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression).
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Who is at risk for Depression? ?
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The risk factors for depression are family history, life experiences, and environment. If you have depression, you may have experienced it when you were younger, and may have a family history of the illness. You may also be going through difficult life events, such as physical or psychological trauma, losing a loved one, a difficult relationship with a family member or friend, or financial troubles. Any of these stressful experiences can lead to depression. For older adults who experience depression for the first time later in life, other factors may be at play. Depression may be related to changes that occur in the brain and body as a person ages. For example, some older adults who are at risk for illnesses such as heart disease or stroke may have hardening and inflammation of the blood vessels, and blood may not be able to flow normally to the body's organs, including the brain. Over time, this blood vessel disease and restricted blood flow can damage nearby brain tissue and harm the nerve connections that help different parts of the brain communicate with each other. If this happens, an older adult with no family history of depression may develop what some doctors call "vascular depression." Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease. This type of depression can appear in the early stages of these diseases, before many symptoms appear.
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What are the symptoms of Depression ?
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Symptoms of depression often vary depending upon the person. Common symptoms include - feeling nervous or emotionally empty - tiredness or a "slowed down" feeling - feeling guilty or worthless - restlessness and irritability - feeling like life is not worth living - sleep problems such as insomnia, oversleeping or wakefulness in the middle of the night - eating more or less than usual, usually with unplanned weight gain or loss - having persistent headaches, stomach-aches or other chronic pain that does not go away when treated - loss of interest in once pleasurable activities - frequent crying - difficulty focusing, remembering or making decisions - thoughts of death or suicide. feeling nervous or emotionally empty tiredness or a "slowed down" feeling feeling guilty or worthless restlessness and irritability feeling like life is not worth living sleep problems such as insomnia, oversleeping or wakefulness in the middle of the night eating more or less than usual, usually with unplanned weight gain or loss having persistent headaches, stomach-aches or other chronic pain that does not go away when treated loss of interest in once pleasurable activities frequent crying difficulty focusing, remembering or making decisions thoughts of death or suicide.
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What are the treatments for Depression ?
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Medications called antidepressants work to normalize brain chemicals called neurotransmitters, notably serotonin, norepinephrine, and dopamine. Scientists studying depression have found that these chemicals, and possibly others, are involved in regulating mood, but they are unsure of exactly how they work. Newer Antidepressants. The newest and most popular types of antidepressant medications are called selective serotonin reuptake inhibitors (SSRIs). They include fluoxetine (Prozac), citalopram (Celexa) and several others. Similar to SSRIs are serotonin and norepinephrine reuptake inhibitors (SNRIs) and include venlafaxine (Effexor) and duloxetine (Cymbalta). Another newer antidepressant bupropion (Wellbutrin) is neither an SSRI nor an SNRI but is popular as well. Older Antidepressants. Older antidepressants, called tricyclics and monoamine oxidase inhibitors (MAOIs), are still used sometimes, too. However, these older antidepressants are not as popular as the newer ones because they tend to have more side effects. However, medications affect everyone differently so talk with your doctor to decide which type is best for you. Practical Considerations. People taking MAOIs must follow strict food and medicine restrictions to avoid potentially serious interactions. If you take an MAOI, your doctor should give you a complete list of foods, medicines, and substances to avoid. MAOIs can also react with SSRIs to produce a serious condition called "serotonin syndrome," which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life threatening conditions. MAOIs should not be taken with SSRIs. Caution is required when combining any serotonergic medication (not just MAOIs) with SSRIs. For example, in 2006 the FDA issued specific warnings against using triptans that are commonly-prescribed to treat migraine headaches together with SSRIs or SNRIs. Using these medications together can cause serotonin syndrome.
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What are the treatments for Depression ?
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A bushy, wild-growing plant with yellow flowers, St John's wort has been used for centuries in many folk and herbal remedies. It is commonly used in Europe to treat mild depression, and it is a top-seller in the United States as well. In a study funded by the National Institutes of Health, the herb was found to be no more effective than a placebo (sugar pill) in treating adults suffering from major depression. Other research has shown that St. John's wort can interact unfavorably with other drugs. The herb interferes with certain drugs used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. Because of these potential interactions, older adults should always consult with their doctors before taking any herbal supplement. Another product sold as a dietary supplement, S-adenosyl methionine (SAMe), has shown promise in controlled trials as helpful when added to an SSRI antidepressant that is only partially effective.
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What are the treatments for Depression ?
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Several studies are looking at ways to help older adults get better access to depression treatment. One is developing and testing an education and intervention program to help primary care clinics and providers identify and treat late-life depression. Another study found that depressed older adults who had a "care manager" monitor their symptoms, side effects, and progress got better more quickly -- and stayed better longer -- than those who did not have case-managed care. Still other projects are investigating ways of improving older adults engagement in and ability to follow treatment plans for depression. Researchers are also looking at ways to - better understand the relationship between other medical illnesses and depression - integrate treatment for depression with treatments for other medical conditions a person may have - produce a quicker response to treatment - develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) - help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. better understand the relationship between other medical illnesses and depression integrate treatment for depression with treatments for other medical conditions a person may have produce a quicker response to treatment develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression.
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What is (are) Parkinson's Disease ?
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A Brain Disorder Parkinson's disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination. It affects about half a million people in the United States although the numbers may be much higher. The average age of onset is 60 years, and the risk of developing Parkinson's goes up with age. Parkinson's disease was first described in 1817 by James Parkinson, a British doctor who published a paper on what he called "the shaking palsy." In this paper, he described the major symptoms of the disease that would later bear his name. Four Main Symptoms Parkinson's disease belongs to a group of neurological conditions called movement disorders. The four main symptoms of Parkinson's are: - tremor, or trembling in hands, arms, legs, jaw, or head - rigidity, or stiffness of the limbs and trunk - bradykinesia, or slowness of movement - postural instability, or impaired balance. tremor, or trembling in hands, arms, legs, jaw, or head rigidity, or stiffness of the limbs and trunk bradykinesia, or slowness of movement postural instability, or impaired balance. Parkinson's symptoms usually begin gradually and get worse over time. As the symptoms become more severe, people with the disorder may have difficulty walking, talking, or completing other simple tasks. They also experience non-motor, or movement, symptoms including mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue. Parkinson's disease not only affects the brain, but the entire body. While the brain involvement is responsible for the core features, other affected locations contribute to the complicated picture of Parkinson's. Parkinson's disease is both chronic, meaning it lasts for a long time, and progressive, meaning its symptoms grow worse over time. It is not contagious. Diagnosis Can Be Difficult About 60,000 Americans are diagnosed with Parkinson's disease each year. However, it's difficult to know exactly how many have it because many people in the early stages of the disease think their symptoms are due to normal aging and do not seek help from a doctor. Also, diagnosis is sometimes difficult because there are no medical tests that can diagnose the disease with certainty and because other conditions may produce symptoms of Parkinson's. For example, people with Parkinson's may sometimes be told by their doctors that they have other disorders, and people with diseases similar to Parkinson's may be incorrectly diagnosed as having Parkinson's. A persons good response to the drug levodopa may support the diagnosis. Levodopa is the main therapy for Parkinsons disease. Who Is at Risk? Both men and women can have Parkinsons disease. However, the disease affects about 50 percent more men than women. While the disease is more common in developed countries, studies also have found an increased risk of Parkinson's disease in people who live in rural areas and in those who work in certain professions, suggesting that environmental factors may play a role in the disorder. Researchers are focusing on additional risk factors for Parkinsons disease. One clear risk factor for Parkinson's is age. The average age of onset is 60 years and the risk rises significantly with advancing age. However, about 5 to 10 percent of people with Parkinson's have "early-onset" disease which begins before the age of 50. Early-onset forms of Parkinson's are often inherited, though not always, and some have been linked to specific gene mutations. Juvenile Parkinsonism In very rare cases, parkinsonian symptoms may appear in people before the age of 20. This condition is called juvenile parkinsonism. It is most commonly seen in Japan but has been found in other countries as well. It usually begins with dystonia (sustained muscle contractions causing twisting movements) and bradykinesia (slowness of movement), and the symptoms often improve with levodopa medication. Juvenile parkinsonism often runs in families and is sometimes linked to a mutated gene. Some Cases Are Inherited Evidence suggests that, in some cases, Parkinsons disease may be inherited. An estimated 15 to 25 percent of people with Parkinson's have a known relative with the disease. People with one or more close relatives who have Parkinson's have an increased risk of developing the disease themselves, but the total risk is still just 2 to 5 percent unless the family has a known gene mutation for the disease. A gene mutation is a change or alteration in the DNA or genetic material that makes up a gene. Researchers have discovered several genes that are linked to Parkinson's disease. The first to be identified was alpha-synuclein or SNCA. Inherited cases of Parkinsons disease are caused by mutations in the LRRK2, PARK2 or parkin, PARK7 or DJ-1, PINK1, or SNCA genes, or by mutations in genes that have not yet been identified.
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What causes Parkinson's Disease ?
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A Shortage of Dopamine Parkinson's disease occurs when nerve cells, or neurons, in an area of the brain that controls movement become impaired and/or die. Normally, these neurons produce an important brain chemical known as dopamine, but when the neurons die or become impaired, they produce less dopamine. This shortage of dopamine causes the movement problems of people with Parkinson's. Dopamine is a chemical messenger, or neurotransmitter. Dopamine is responsible for transmitting signals between the substantia nigra and multiple brain regions. The connection between the substantia nigra and the corpus striatum is critical to produce smooth, purposeful movement. Loss of dopamine in this circuit results in abnormal nerve-firing patterns within the brain that cause impaired movement. Loss of Norepinephrine People with Parkinson's also have loss of the nerve endings that produce the neurotransmitter norepinephrine. Norepinephrine, which is closely related to dopamine, is the main chemical messenger of the sympathetic nervous system. The sympathetic nervous system controls many automatic functions of the body, such as heart rate and blood pressure. The loss of norepinephrine might help explain several of the non-movement features of Parkinson's, such as fatigue, irregular blood pressure, decreased gastric motility or movement of food through the digestive tract, and postural hypotension. Postural hypotension is a sudden drop in blood pressure when a person stands up from a sitting or lying-down position. It may cause dizziness, lightheadedness, and in some cases, loss of balance or fainting. Lewy Bodies in Brain Cells Many brain cells of people with Parkinson's contain Lewy bodies. Lewy bodies are unusual deposits or clumps of the brain protein alpha-synuclein, along with other proteins, which are seen upon microscopic examination of the brain. Researchers do not yet know why Lewy bodies form or what role they play in the development of Parkinson's. The clumps may prevent the cell from functioning normally, or they may actually be helpful, perhaps by keeping harmful proteins "locked up" so the cells can function. Genetic Mutations Although some cases of Parkinson's appear to be hereditary, and a few can be traced to specific genetic mutations, most cases are sporadic. Sporadic means the disease occurs randomly and does not seem to run in families. Many researchers now believe that Parkinson's disease results from a combination of genetic and environmental factors. Scientists have identified several genetic mutations associated with Parkinson's including mutations in the alpha-synuclein gene. They think that many more genes may be linked to the disorder. Studying the genes responsible for inherited cases of Parkinson's can help researchers understand both inherited and sporadic cases. The same genes and proteins that are altered in inherited cases may also be altered in sporadic cases by environmental toxins or other factors. Researchers also hope that discovering genes will help identify new ways of treating Parkinson's. Environmental Toxins Although researchers increasingly recognize the importance of genetics in Parkinson's disease, most believe environmental exposures increase a person's risk of developing the disease. Even in inherited cases, exposure to toxins or other environmental factors may influence when symptoms of the disease appear or how the disease progresses. There are a number of toxins that can cause parkinsonian symptoms in humans. Researchers are pursuing the question of whether pesticides and other environmental factors not yet identified also may cause Parkinson's disease. Viruses are another possible environmental trigger for Parkinson's. Mitochondria and Free Radicals Research suggests that mitochondria may play a role in the development of Parkinson's disease. Mitochondria are the energy-producing components of the cell and are major sources of free radicals. Free radicals are molecules that damage membranes, proteins, DNA, and other parts of the cell. This damage is called oxidative stress. Changes to brain cells caused by oxidative stress, including free radical damage to DNA, proteins, and fats, have been found in people with Parkinson's. Clinical studies now underway test whether agents thought to improve energy metabolism and decrease oxidative stress slow the progression of Parkinson's disease. Recent evidence suggests that mutations in genes linked to Parkinsons disease result in mitochondrial dysfunction. Buildup of Harmful Proteins Other research suggests that the cell's protein disposal system may fail in people with Parkinson's, causing proteins like alpha-synuclein to build up to harmful levels and trigger premature cell death. Additional studies have found that clumps of protein that develop inside brain cells of people with Parkinson's may contribute to the death of nerve cells, or neurons. However, the exact role of the protein deposits remains unknown. These studies also found that inflammation, because of protein accumulation, toxins or other factors, may play a role in the disease. However, the exact role of the protein deposits remains unknown. Researchers are exploring the possibility of vaccine development to decrease or prevent the accumulation of alpha-synuclein. While mitochondrial dysfunction, oxidative stress, inflammation, and many other cellular processes may contribute to Parkinson's disease, scientists still do not know what causes cells that produce dopamine to die. Genes Linked to Parkinsons Researchers have discovered several genes that are linked to Parkinson's disease. The first to be identified was alpha-synuclein or SNCA . Studies have found that Lewy bodies from people with the sporadic form of Parkinson's contain clumps of alpha-synuclein protein. This discovery revealed a possible link between hereditary and sporadic forms of the disease. Other genes linked to Parkinson's include PARK2, PARK7, PINK1, and LRRK2. PARK2, PARK7, and PINK1 cause rare, early-onset forms of the disease. Mutations in the LRRK2 gene are common in specific populations, including in people with Parkinson's in North Africa. Researchers are continuing to study the normal functions and interactions of these genes in order to find clues about how Parkinson's develops. They also have identified a number of other genes and chromosome regions that may play a role in Parkinson's, but the nature of these links is not yet clear. Whole genome wide association studies, or GWAS, of thousands of people with Parkinson's disease are now underway to find gene variants that allow for an increased risk of developing Parkinson's but are not necessarily causes of this disorder by themselves. A recent international study found that two genes containing mutations known to cause rare hereditary forms of Parkinsons disease are also associated with the more common sporadic form of the disease. This finding came from a GWAS which looked at DNA samples of European people who had Parkinsons disease and from those who did not have the disorder.
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What are the symptoms of Parkinson's Disease ?
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Parkinson's disease does not affect everyone the same way. Symptoms of the disorder and the rate of progression differ among people with the disease. Sometimes people dismiss early symptoms of Parkinson's as the effects of normal aging. There are no medical tests to definitively diagnose the disease, so it can be difficult to diagnose accurately. Early Symptoms Early symptoms of Parkinson's disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly or that their handwriting is slow and looks cramped or small. This very early period may last a long time before the more classic and obvious symptoms appear. Friends or family members may be the first to notice changes in someone with early Parkinson's. They may see that the person's face lacks expression and animation, a condition known as "masked face," or that the person does not move an arm or leg normally. They also may notice that the person seems stiff, unsteady, or unusually slow. As the Disease Progresses As the disease progresses, symptoms may begin to interfere with daily activities. The shaking or tremor may make it difficult to hold utensils steady or read a newspaper. Tremor is usually the symptom that causes people to seek medical help. People with Parkinson's often develop a so-called parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward (called festination), and reduced swinging of the arms. They also may have trouble initiating or continuing movement, which is known as freezing. Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other. Four Primary Symptoms The four primary symptoms of Parkinson's are tremor, rigidity, slowness of movement (bradykinesia), and impaired balance (postural instability). - Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. It usually disappears during sleep or improves with a deliberate movement. - Rigidity, or a resistance to movement, affects most people with Parkinson's. It becomes obvious when another person tries to move the individual's arm, such as during a neurological examination. The arm will move only in ratchet-like or short, jerky movements known as "cogwheel" rigidity. - Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it may make simple tasks somewhat difficult. Activities once performed quickly and easily, such as washing or dressing, may take several hours. - Postural instability, or impaired balance, causes people with Parkinson's to fall easily. They also may develop a stooped posture with a bowed head and droopy shoulders. Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. It usually disappears during sleep or improves with a deliberate movement. Rigidity, or a resistance to movement, affects most people with Parkinson's. It becomes obvious when another person tries to move the individual's arm, such as during a neurological examination. The arm will move only in ratchet-like or short, jerky movements known as "cogwheel" rigidity. Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it may make simple tasks somewhat difficult. Activities once performed quickly and easily, such as washing or dressing, may take several hours. Postural instability, or impaired balance, causes people with Parkinson's to fall easily. They also may develop a stooped posture with a bowed head and droopy shoulders. Other Symptoms A number of other symptoms may accompany Parkinson's disease. Some are minor; others are not. Many can be treated with medication or physical therapy. No one can predict which symptoms will affect an individual person, and the intensity of the symptoms varies from person to person. Many people note that prior to experiencing motor problems of stiffness and tremor, they had symptoms of a sleep disorder, constipation, decreased ability to smell, and restless legs. Other symptoms include - depression - emotional changes - difficulty swallowing and chewing - speech changes - urinary problems or constipation - skin problems, sleep problems - dementia or other cognitive problems - orthostatic hypotension (a sudden drop in blood pressure when standing up from a sitting or lying down position) - muscle cramps and dystonia (twisting and repetitive movements) - pain - fatigue and loss of energy - sexual dysfunction. depression emotional changes difficulty swallowing and chewing speech changes urinary problems or constipation skin problems, sleep problems dementia or other cognitive problems orthostatic hypotension (a sudden drop in blood pressure when standing up from a sitting or lying down position) muscle cramps and dystonia (twisting and repetitive movements) pain fatigue and loss of energy sexual dysfunction. A number of disorders can cause symptoms similar to those of Parkinson's disease. People with Parkinson's-like symptoms that result from other causes are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinson's, certain medical tests, as well as response to drug treatment, may help to distinguish them from Parkinson's. Diagnosis Can Be Difficult There are currently no blood, or laboratory tests to diagnose sporadic Parkinson's disease. Diagnosis is based on a person's medical history and a neurological examination, but the disease can be difficult to diagnose accurately. Early signs and symptoms of Parkinson's may sometimes be dismissed as the effects of normal aging. A doctor may need to observe the person for some time until it is clear that the symptoms are consistently present. Improvement after initiating medication is another important hallmark of Parkinson's disease. Doctors may sometimes request brain scans or laboratory tests to rule out other diseases. However, computed tomography (CT) and magnetic resonance imaging (MRI) brain scans of people with Parkinson's usually appear normal. Recently, the FDA (Food and Drug Administration) has approved an imaging technique called DaTscan, which may help to increase accuracy of the diagnosis of Parkinsons disease. Since many other diseases have similar features but require different treatments, it is very important to make an exact diagnosis as soon as possible to ensure proper treatment.
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What are the treatments for Parkinson's Disease ?
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Deep Brain Stimulation Deep brain stimulation, or DBS, is a surgical procedure used to treat a variety of disabling disorders. It is most commonly used to treat the debilitating symptoms of Parkinsons disease. Deep brain stimulation uses an electrode surgically implanted into part of the brain. The electrodes are connected by a wire under the skin to a small electrical device called a pulse generator that is implanted in the chest. The pulse generator and electrodes painlessly stimulate the brain in a way that helps to stop many of the symptoms of Parkinson's such as tremor, bradykinesia, and rigidity. DBS is primarily used to stimulate one of three brain regions: the subthalamic nucleus, the globus pallidus, or the thalamus. Researchers are exploring optimal generator settings for DBS, whether DBS of other brain regions will also improve symptoms of Parkinsons disease, and also whether DBS may slow disease progression. Deep brain stimulation usually reduces the need for levodopa and related drugs, which in turn decreases dyskinesias and other side effects. It also helps to relieve on-off fluctuation of symptoms. People who respond well to treatment with levodopa tend to respond well to DBS. Unfortunately, older people who have only a partial response to levodopa may not improve with DBS. Complementary and Supportive Therapies A wide variety of complementary and supportive therapies may be used for Parkinson's disease. Among these therapies are standard physical, occupational, and speech therapies, which help with gait and voice disorders, tremors and rigidity, and decline in mental functions. Other supportive therapies include diet and exercise. Diet At this time there are no specific vitamins, minerals, or other nutrients that have any proven therapeutic value in Parkinson's disease. Some early reports have suggested that dietary supplements might protect against Parkinson's. Also, a preliminary clinical study of a supplement called coenzyme Q10 suggested that large doses of this substance might slow disease progression in people with early-stage Parkinson's. This supplement is now being tested in a large clinical trial. Other studies are being conducted to find out if caffeine, antioxidants, nicotine, and other dietary factors may help prevent or treat the disease. While there is currently no proof that any specific dietary factor is beneficial, a normal, healthy diet can promote overall well-being for people with Parkinson's disease, just as it would for anyone else. A high protein meal, however, may limit levodopa's effectiveness because for a time afterwards less levodopa passes through the blood-brain barrier. Exercise Exercise can help people with Parkinson's improve their mobility and flexibility. It can also improve their emotional well-being. Exercise may improve the brain's dopamine production or increase levels of beneficial compounds called neurotrophic factors in the brain. Other Therapies Other complementary therapies include massage therapy, yoga, tai chi, hypnosis, acupuncture, and the Alexander technique, which improves posture and muscle activity. There have been limited studies suggesting mild benefits from some of these therapies, but they do not slow Parkinson's disease and to date there is no convincing evidence that they help. However, this remains an active area of investigation.
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what research (or clinical trials) is being done for Parkinson's Disease ?
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In recent years, research on Parkinson's has advanced to the point that halting the progression of the disease, restoring lost function, and even preventing the disease are all considered realistic goals. While the goal of preventing Parkinson's disease may take years to achieve, researchers are making great progress in understanding and treating it. Genetics Research One of the most exciting areas of Parkinson's research is genetics. Studying the genes responsible for inherited cases can help researchers understand both inherited and sporadic cases of the disease. Identifying gene defects can also help researchers - understand how Parkinson's occurs - develop animal models that accurately mimic the death of nerve cells in humans - identify new approaches to drug therapy - improve diagnosis. understand how Parkinson's occurs develop animal models that accurately mimic the death of nerve cells in humans identify new approaches to drug therapy improve diagnosis. Researchers funded by the National Institute of Neurological Disorders and Stroke are gathering information and DNA samples from hundreds of families with members who have Parkinson's and are conducting large-scale studies to identify gene variants that are associated with increased risk of developing the disease. They are also comparing gene activity in Parkinson's with gene activity in similar diseases such as progressive supranuclear palsy. In addition to identifying new genes for Parkinson's disease, researchers are trying to learn about the function of genes known to be associated with the disease, and about how gene mutations cause disease. Effects of Environmental Toxins Scientists continue to study environmental toxins such as pesticides and herbicides that can cause Parkinson's symptoms in animals. They have found that exposing rodents to the pesticide rotenone and several other agricultural chemicals can cause cellular and behavioral changes that mimic those seen in Parkinson's. Role of Lewy Bodies Other studies focus on how Lewy bodies form and what role they play in Parkinson's disease. Some studies suggest that Lewy bodies are a byproduct of a breakdown that occurs within nerve cells, while others indicate that Lewy bodies are protective, helping neurons "lock away" abnormal molecules that might otherwise be harmful. Identifying Biomarkers Biomarkers for Parkinson's -- measurable characteristics that can reveal whether the disease is developing or progressing -- are another focus of research. Such biomarkers could help doctors detect the disease before symptoms appear and improve diagnosis of the disease. They also would show if medications and other types of therapy have a positive or negative effect on the course of the disease. The National Disorders of Neurological Disorders and Stroke has developed an initiative, the Parkinsons Disease Biomarkers Identification Network (PD-BIN), designed specifically to address these questions and to discover and validate biomarkers for Parkinsons disease. Transcranial Therapies Researchers are conducting many studies of new or improved therapies for Parkinson's disease. Studies are testing whether transcranial electrical polarization (TEP) or transcranial magnetic stimulation (TMS) can reduce the symptoms of the disease. In TEP, electrodes placed on the scalp are used to generate an electrical current that modifies signals in the brain's cortex. In TMS, an insulated coil of wire on the scalp is used to generate a brief electrical current. Drug Discovery A variety of new drug treatments for Parkinson's disease are in clinical trials. Several MAO-B inhibitors including selegiline, lazabemide, and rasagiline, are being tested to determine if they have neuroprotective effects in people with Parkinsons disease. The National Institute of Neurological Disorders and Stroke has launched a broad effort to find drugs to slow the progression of Parkinson's disease, called NET-PD or NIH Exploratory Trials in Parkinson's Disease. The first studies tested several compounds; one of these, creatine, is now being evaluated in a larger clinical trial. The NET-PD investigators are testing a highly purified form of creatine, a nutritional supplement, to find out if it slows the decline seen in people with Parkinson's. Creatine is a widely used dietary supplement thought to improve exercise performance. Cellular energy is stored in a chemical bond between creatine and a phosphate. More recently, NET-PD has initiated pilot studies to test pioglitazone, a drug that has been shown to stimulate mitochondrial function. Because mitochondrial function may be less active in Parkinsons disease, this drug may protect vulnerable dopamine neurons by boosting mitochondrial function. Cell Implantation Another potential approach to treating Parkinson's disease is to implant cells to replace those lost in the disease. Starting in the 1990s, researchers conducting a controlled clinical trial of fetal tissue implants tried to replace lost dopamine-producing nerve cells with healthy ones from fetal tissue in order to improve movement and the response to medications. While many of the implanted cells survived in the brain and produced dopamine, this therapy was associated with only modest functional improvements, mostly in patients under the age of 60. Some of the people who received the transplants developed disabling dyskinesias that could not be relieved by reducing anti-parkinsonian medications. Stem Cells Another type of cell therapy involves stem cells. Some stem cells derived from embryos can develop into any kind of cell in the body, while others, called progenitor cells, are less flexible. Researchers are developing methods to improve the number of dopamine-producing cells that can be grown from embryonic stem cells in culture. Other researchers are also exploring whether stem cells from adult brains might be useful in treating Parkinson's disease. Recent studies suggest that some adult cells from skin can be reprogrammed to an embryonic-like state, resulting in induced pluripotent stem cells (iPSC) that may someday be used for treatment of Parkinsons. In addition, development and characterization of cells from people with sporadic or inherited Parkinsons may reveal information about cellular mechanisms of disease and identify targets for drug development. Gene Therapy A number of early clinical trials are now underway to test whether gene therapy can improve Parkinson's disease. Genes which are found to improve cellular function in models of Parkinson's are inserted into modified viruses. The genetically engineered viruses are then injected into the brains of people with Parkinson's disease. Clinical studies have focused on the therapeutic potential of neurotrophic factors, including GDNF and neurturin, and enzymes that produce dopamine. These trials will test whether the viruses, by lending to the production of the protective gene product, improve symptoms of Parkinson's over time. The National Institute of Neurological Disorders and Stroke also supports the Morris K. Udall Centers of Excellence for Parkinson's Disease Research program . These Centers, located across the USA, study cellular mechanisms underlying Parkinsons disease, identify and characterize disease-associated genes, and discover and develop potential therapeutic targets. The Centers' multidisciplinary research environment allows scientists to take advantage of new discoveries in the basic, translational and clinical sciences that could lead to clinical advances for Parkinsons disease.
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What is (are) Parkinson's Disease ?
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Parkinson's disease is a brain disorder that leads to shaking, stiffness, and difficulty with walking, balance, and coordination. It currently affects about half a million people in the United States, although the numbers may be much higher. Parkinson's disease is both chronic, meaning it lasts for a long time, and progressive, meaning its symptoms grow worse over time. It is not contagious.
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What are the symptoms of Parkinson's Disease ?
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Parkinson's belongs to a group of neurological conditions called movement disorders. The four main symptoms of Parkinson's disease are: - tremor, or trembling in hands, arms, legs, jaw, or head - rigidity, or stiffness of the limbs and trunk - bradykinesia, or slowness of movement - postural instability, or impaired balance. tremor, or trembling in hands, arms, legs, jaw, or head rigidity, or stiffness of the limbs and trunk bradykinesia, or slowness of movement postural instability, or impaired balance. Other symptoms include depression, emotional changes, difficulty swallowing, speech changes, urinary problems, sleep problems, and dementia and other cognitive problems. Parkinson's symptoms usually begin gradually and get worse over time. As the symptoms become more severe, people with the disorder may have difficulty walking, talking, or completing other simple tasks. They also experience non-motor, or movement, symptoms including mental and behavioral changes, sleep problems, depression, memory difficulties, and fatigue. Parkinson's disease not only affects the brain, but the entire body. While the brain involvement is responsible for the core features, other affected locations contribute to the complicated picture of Parkinson's.
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Who is at risk for Parkinson's Disease? ?
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About 60,000 Americans are diagnosed with Parkinson's disease each year. The disease strikes about 50 percent more men than women. The average age of onset is 60 years, and the risk of developing the disease increases with age. Parkinson's disease is also more common in developed countries, possibly because of increased exposure to pesticides or other environmental toxins.
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What causes Parkinson's Disease ?
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Parkinson's disease occurs when nerve cells, or neurons, in an area of the brain that controls movement die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine, but once the neurons become impaired, they produce less dopamine and eventually die. It is this shortage of dopamine that causes the movement problems of people with Parkinson's.
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What is (are) Parkinson's Disease ?
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Dopamine is a brain chemical messenger, or neurotransmitter. It is responsible for transmitting signals between a brain region called the substantia nigra and multiple brain regions. The connection between the substantia nigra and the corpus striatum is critical to produce smooth, purposeful movement. Loss of dopamine results in abnormal nerve-firing patterns within the brain that cause impaired movement.
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What is (are) Parkinson's Disease ?
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Lewy bodies are unusual deposits or clumps of the brain protein alpha-synuclein, along with other proteins, which are seen upon microscopic examination of the brain. Many brain cells of people with Parkinson's disease contain Lewy bodies. Researchers do not yet know why Lewy bodies form or what role they play in the development of Parkinson's disease. The clumps may prevent the cell from functioning normally, or they may actually be helpful, perhaps by keeping harmful proteins "locked up" so that the cells can function.
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How to diagnose Parkinson's Disease ?
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There are currently no blood or laboratory tests to diagnose sporadic Parkinson's disease. Diagnosis is based on a person's medical history and a neurological examination, but the disease can be difficult to diagnose accurately. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. However, computed tomography (CT) and magnetic resonance imaging (MRI) brain scans of people with Parkinson's usually appear normal. Recently, the FDA (Food and Drug Administration) has approved an imaging technique called DaTscan, which may help to increase accuracy of the diagnosis of Parkinsons disease. Since many other diseases have similar features but require different treatments, it is very important to make an exact diagnosis as soon as possible to ensure proper treatment.
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What is (are) Parkinson's Disease ?
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The main therapy for Parkinson's disease is the drug levodopa, also called L-dopa. It is a simple chemical found naturally in plants and animals. Nerve cells use levodopa to make dopamine to replenish the brain's supply. Levodopa helps to reduce tremors and other symptoms of Parkinson's disease during the early stages of the disease. It allows most people with Parkinson's to extend the period of time in which they can lead relatively normal, productive lives.
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What is (are) Parkinson's Disease ?
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Carbidopa is a drug that is usually given along with levodopa. It delays the body's conversion of levodopa into dopamine until the levodopa reaches the brain. This prevents or reduces some of the side effects that often accompany levodopa therapy. Carbidopa also reduces the amount of levodopa needed.
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What are the treatments for Parkinson's Disease ?
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Yes. Other medications available to treat some symptoms and stages of Parkinson's disease include direct dopamine agonists, MAO-B inhibitors, COMT inhibitors, an anti-viral drug, and anticholinergics. Direct dopamine agonists are drugs that mimic the role of dopamine in the brain. They can be used in the early stages of the disease, or later on to give a more prolonged and steady dopaminergic effect in people who experience "wearing off" or "on-off" effects from taking the drug. Dopamine agonists are generally less effective than levodopa in controlling rigidity and bradykinesia. They can cause confusion in older adults. MAO-B inhibitors are another class of drugs that can reduce the symptoms of Parkinson's by causing dopamine to build up in surviving nerve cells. COMT inhibitors prolong the effects of levodopa by preventing the breakdown of dopamine. COMT inhibitors can usually make it possible to reduce a person's dose of levodopa. Amantadine, an old antiviral drug, can help reduce Parkinson's symptoms in the early stages of the disease, and again in later stages to treat dyskinesias. Anticholinergics can help reduce tremors and muscle rigidity.
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What are the symptoms of Parkinson's Disease ?
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Doctors may prescribe a variety of medications to treat the non-motor symptoms of Parkinson's disease, such as depression and anxiety. Hallucinations, delusions, and other psychotic symptoms may be caused by some drugs prescribed for Parkinson's. Therefore, reducing or stopping those Parkinson's medications may make these symptoms of psychosis go away. A variety of treatment options, including medications, also are available to treat orthostatic hypotension, the sudden drop in blood pressure that occurs upon standing.
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What is (are) Parkinson's Disease ?
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Deep brain stimulation, or DBS, is a surgical procedure used to treat a variety of disabling disorders. It is most commonly used to treat the debilitating symptoms of Parkinsons disease. Deep brain stimulation uses an electrode surgically implanted into part of the brain. The electrodes are connected under the skin to a small electrical device called a pulse generator, implanted in the chest. The generator and electrodes painlessly stimulate the brain to help stop many Parkinson's symptoms such as tremor, bradykinesia, and rigidity. DBS is primarily used to stimulate one of three brain regions: the subthalamic nucleus, the globus pallidus, or the thalamus. Researchers are exploring optimal generator settings for DBS, whether DBS of other brain regions will also improve symptoms of Parkinsons disease, and also whether DBS may slow disease progression. Deep brain stimulation usually reduces the need for levodopa and related drugs, which in turn decreases dyskinesias and other side effects. It also helps to relieve "on-off" fluctuation of symptoms. People who respond well to treatment with levodopa, even if only for a short period, tend to respond well to DBS.
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what research (or clinical trials) is being done for Parkinson's Disease ?
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Genetics is one of the most exciting areas of Parkinson's disease research. Studying the genes responsible for inherited cases can help researchers understand both inherited and sporadic cases of the disease. Sporadic means the disease occurs randomly and does not seem to run in families. Identifying gene defects can also help researchers - understand how the disease occurs - develop animal models that accurately mimic the death of nerve cells in human Parkinson's disease - identify new drug targets - improve diagnosis. understand how the disease occurs develop animal models that accurately mimic the death of nerve cells in human Parkinson's disease identify new drug targets improve diagnosis.
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What is (are) Parkinson's Disease ?
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The Parkinsons Disease Biomarkers Identification Network, or PD-BIN, is an initiative developed by the National Institute of Neurological Disorders and Stroke to discover and validate biomarkers for Parkinsons disease. Biomarkers are measurable characteristics that can reveal whether the disease is developing or progressing. Biomarkers could help doctors detect Parkinsons disease before symptoms appear and improve diagnosis of the disorder.
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What is (are) Parkinson's Disease ?
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The National Institute of Neurological Disorders and Stroke (NINDS) has launched a broad effort called NIH Exploratory Trials in Parkinson's Disease, or NET-PD, to find drugs to slow the progression of Parkinson's disease. The first studies tested several compounds. One of these, a nutritional supplement called creatine, is now being evaluated in a larger clinical trial to find out if it slows the clinical decline seen in people with Parkinson's disease. For more information on NET-PD trials visit: http://parkinsontrial.ninds.org.
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What is (are) Breast Cancer ?
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How Tumors Form The body is made up of many types of cells. Normally, cells grow, divide and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Breast cancer occurs when malignant tumors form in the breast tissue. Who Gets Breast Cancer? Breast cancer is one of the most common cancers in American women. It is most common among women between the ages of 45-85. (Watch the video to learn more about breast cancer survival rates. To enlarge the videos appearing on this page, click the brackets in the lower right-hand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Men can get breast cancer too, although they account for only 1 percent of all reported cases. Read more about breast cancer in men. When Breast Cancer Spreads When cancer grows in breast tissue and spreads outside the breast, cancer cells are often found in the lymph nodes under the arm. If the cancer has reached these nodes, it means that cancer cells may have spread, or metastasized, to other parts of the body. When cancer spreads from its original location in the breast to another part of the body such as the brain, it is called metastatic breast cancer, not brain cancer. Doctors sometimes call this "distant" disease. Learn about different kinds of breast cancer. Breast Cancer is Not Contagious Breast cancer is not contagious. A woman cannot "catch" breast cancer from other women who have the disease. Also, breast cancer is not caused by an injury to the breast. Most women who develop breast cancer do not have any known risk factors or a history of the disease in their families. Treating and Surviving Breast Cancer Today, more women are surviving breast cancer than ever before. Nearly three million women are breast cancer survivors. (Watch the video to hear a woman discuss surviving breast cancer.) There are several ways to treat breast cancer, but all treatments work best when the disease is found early. As a matter of fact, when it is caught in its earliest stage, 98.5 percent of women with the disease are alive five years later. Every day researchers are working to find new and better ways to detect and treat cancer. Many studies of new approaches for women with breast cancer are under way. With early detection, and prompt and appropriate treatment, the outlook for women with breast cancer can be positive. To learn more about what happens after treatment, see Surviving Cancer.
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Who is at risk for Breast Cancer? ?
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Some women develop breast cancer and others do not, and the risk factors for the disease vary. Breast cancer may affect younger women, but three-fourths of all breast cancers occur in women between the ages of 45 to 85. In Situ and Invasive Breast Cancer Researchers often talk about breast cancer in two ways: in situ and invasive. In situ refers to cancer that has not spread beyond its site of origin. Invasive applies to cancer that has spread to the tissue around it. This chart shows what the approximate chances are of a woman getting invasive breast cancer in her lifetime. Risk Factors Risk factors are conditions or agents that increase a person's chances of getting a disease. Here are the most common risk factors for breast cancer. - Older age. The risk of breast cancer in a 70 year old woman is about 10 times that of a 30 year old woman, but risk decreases after age 85. Older age. The risk of breast cancer in a 70 year old woman is about 10 times that of a 30 year old woman, but risk decreases after age 85. - Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. - Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. - Never being pregnant or having your first child in your mid-30s or later. Never being pregnant or having your first child in your mid-30s or later. - Early menstruation. Having your first menstrual period before age 12. Early menstruation. Having your first menstrual period before age 12. - Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. - Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. - Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. - Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. - Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. - Gaining weight after menopause, especially after natural menopause and/or after age 60. Gaining weight after menopause, especially after natural menopause and/or after age 60. - Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. - Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Five percent to 10 percent of all breast cancers are thought to be inherited. Get information about the BRCA1 and BRCA2 genetic mutations and testing for them. Warning Signs When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. - a lump or thickening in or near the breast or in the underarm area - a change in the size or shape of the breast - a dimple or puckering in the skin of the breast - a nipple turned inward into the breast - fluid, other than breast milk, from the nipple, especially if it's bloody - scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) - dimples in the breast that look like the skin of an orange. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast a dimple or puckering in the skin of the breast a nipple turned inward into the breast fluid, other than breast milk, from the nipple, especially if it's bloody scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) dimples in the breast that look like the skin of an orange. Don't Ignore Symptoms You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible. Some women believe that as they age, health problems are due to "growing older." Because of this myth, many illnesses go undiagnosed and untreated. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Talk to your doctor.
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Who is at risk for Breast Cancer? ?
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What Is Cancer Prevention? Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer. When studying ways to prevent cancer, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor. Anything that decreases your chance of developing cancer is called a cancer protective factor. Risk Factors Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including - changing lifestyle or eating habits - avoiding things known to cause cancer - taking medicine to treat a precancerous condition or to keep cancer from starting. changing lifestyle or eating habits avoiding things known to cause cancer taking medicine to treat a precancerous condition or to keep cancer from starting. (For more on risk factors, see the chapter on "Risk Factors.") Here are protective factors for breast cancer. Less Exposure to Estrogen Decreasing the length of time a woman's breast tissue is exposed to estrogen may help lower her risk of developing breast cancer. Exposure to estrogen is reduced in the following ways. - Early pregnancy. Estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. - Breast-feeding. Estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed. - Surgical removal of the ovaries. The ovaries make estrogen. The amount of estrogen made by the body can be greatly reduced by removing one or both ovaries. Also, drugs may be taken to lower the amount of estrogen made by the ovaries. - Late menstruation. Menstrual periods that start at age 14 or older decreases the number of years the breast tissue is exposed to estrogen. - Early menopause. The fewer years a woman menstruates, the shorter the time her breast tissue is exposed to estrogen. Early pregnancy. Estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding. Estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed. Surgical removal of the ovaries. The ovaries make estrogen. The amount of estrogen made by the body can be greatly reduced by removing one or both ovaries. Also, drugs may be taken to lower the amount of estrogen made by the ovaries. Late menstruation. Menstrual periods that start at age 14 or older decreases the number of years the breast tissue is exposed to estrogen. Early menopause. The fewer years a woman menstruates, the shorter the time her breast tissue is exposed to estrogen. Exercise Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight. Learn more about the benefits of exercise for older adults. For exercises tailored to older adults, visit Go4Life, the exercise and physical activity campaign from the National Institute on Aging (NIA) at NIH. Estrogen-only Hormone Therapy After Hysterectomy Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy. Learn about menopausal hormone therapy and cancer. Selective Estrogen Receptor Modulators (SERMs) Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (SERMs). SERMs act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues. Treatment with tamoxifen or raloxifene lowers the risk of breast cancer in postmenopausal women. Tamoxifen also lowers the risk of breast cancer in high-risk premenopausal women. With either drug, the reduced risk lasts for several years after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene. Prophylactic Mastectomy Some women who have a high risk of breast cancer may choose to have a prophylactic mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision. Learn more about surgery to reduce the risk of breast cancer. Prophylactic Oophorectomy Premenopausal women who have a high risk of breast cancer due to certain changes in the BRCA1 and BRCA2 genes may choose to have a prophylactic oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Prophylactic oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density. Unclear As Risk Factors It is not clear whether the following affect the risk of breast cancer. - Oral contraceptives. Taking oral contraceptives ("the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Some oral contraceptives contain estrogen. Progestin-only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. - Environment. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer. Oral contraceptives. Taking oral contraceptives ("the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Some oral contraceptives contain estrogen. Progestin-only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. Environment. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer. For More Information Clinical trials are taking place in many parts of the country. Information about clinical trials can be found at http://www.cancer.gov/clinicaltrials on the website of the National Cancer Institute (NCI). Check NCI's list of cancer clinical trials for breast cancer prevention trials that are now accepting patients.
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How to diagnose Breast Cancer ?
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Most cancers in their early, most treatable stages do not cause any symptoms. That is why it's important to have regular tests to check for cancer long before you might notice anything wrong. Detecting Breast Cancer Through Screening When breast cancer is found early, it is more likely to be treated successfully. Checking for cancer in a person who does not have any symptoms is called screening. Screening tests for breast cancer include, among others, clinical breast exams and mammograms. Recent studies have shown that ultrasound and MRI's may also be useful complementary screening tools, particularly in women with mammograms that are not definitive. During a clinical breast exam, the doctor or other health care professional checks the breasts and underarms for lumps or other changes that could be a sign of breast cancer. A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel. (Watch the video to learn more about digital mammography and dense breasts. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Who Should Have a Mammography? Several studies show that mammography screening has reduced the number of deaths from breast cancer. However, some other studies have not shown a clear benefit from mammography. Scientists are continuing to examine the level of benefit that mammography can produce. The U.S. Preventive Services Task Force (USPSTF) recommends a screening mammography for women 50-74 years every two years. Learn more about the USPSTF mammography recommendations here. Between 5 and 10 percent of mammogram results are abnormal and require more testing. Most of these follow-up tests confirm that no cancer was present. Worried about the cost of a mammogram? Learn about free and low-cost screenings. (Centers for Disease Control and Prevention) How Biopsies are Performed If needed, the most common follow-up test a doctor will recommend is called a biopsy. This is a procedure where a small amount of fluid or tissue is removed from the breast to make a diagnosis. A doctor might perform fine needle aspiration, a needle or core biopsy, or a surgical biopsy. - With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab. - For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous. - In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells. With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab. For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous. In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells. Another type of surgical biopsy that removes less breast tissue is called an image-guided needle breast biopsy, or stereotactic biopsy. Eighty percent of U.S. women who have a surgical breast biopsy do not have cancer. However, women who have breast biopsies are at higher risk of developing breast cancer than women who have never had a breast biopsy. Other Detection Methods Magnetic resonance imaging, or MRI, and ultrasound are two other techniques which, as supplements to standard mammography, might help detect breast cancer with greater accuracy. Genetic Detection The most comprehensive study to date of gene mutations in breast cancer, published in September 2012, confirmed that there are four primary subtypes of breast cancer, each with its own biology. The four groups are called intrinsic subtypes of breast cancer and include HER2-enriched (HER2E), Luminal A (LumA), Luminal B (LumB) and Basal-like. The outlook for survival is different for each of these subtypes of breast cancer. Researchers found that one subtype, Basal-like breast cancer, shares many genetic features with a form of ovarian cancer, and that both may respond similarly to drugs that reduce tumor growth or target DNA repair. The authors hope that discovery of these mutations will be an important step in the effort to improve therapies for breast cancer. For the time being, there are no genetic tests that are commercially available based solely on these findings. Soon, however, knowing extensively which breast cancer gene mutations a woman has should help guide precision treatment.
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What are the treatments for Breast Cancer ?
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There are many treatment options for women with breast cancer. The choice of treatment depends on your age and general health, the stage of the cancer, whether or not it has spread beyond the breast, and other factors. If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better outcomes. Working With a Team of Specialists People with cancer often are treated by a team of specialists. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. (Watch the video about this breast cancer survivor's treatment. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Clinical Trials for Breast Cancer Some breast cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Women with breast cancer who are interested in taking part in a clinical trial should talk to their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. See a list of the current clinical trials on breast cancer.
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What are the treatments for Breast Cancer ?
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There are a number of treatments for breast cancer, but the ones women choose most often -- alone or in combination -- are surgery, hormone therapy, radiation therapy, and chemotherapy. What Standard Treatments Do Here is what the standard cancer treatments are designed to do. - Surgery takes out the cancer and some surrounding tissue. - Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. - Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - Chemotherapy uses anti-cancer drugs to kill most cancer cells. Surgery takes out the cancer and some surrounding tissue. Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. Chemotherapy uses anti-cancer drugs to kill most cancer cells. Treatment for breast cancer may involve local or whole body therapy. Doctors use local therapies, such as surgery or radiation, to remove or destroy breast cancer in a specific area. Whole body, or systemic, treatments like chemotherapy, hormonal, or biological therapies are used to destroy or control cancer throughout the body. Some patients have both kinds of treatment. Treating Early-Stage Breast Cancer If you have early-stage breast cancer, one common treatment available to you is a lumpectomy combined with radiation therapy. A lumpectomy is surgery that preserves a woman's breast. In a lumpectomy, the surgeon removes only the tumor and a small amount of the surrounding tissue. The survival rate for a woman who has this therapy plus radiation is similar to that for a woman who chooses a radical mastectomy, which is complete removal of a breast. If Cancer Has Spread Locally If you have breast cancer that has spread locally -- just to other parts of the breast -- your treatment may involve a combination of chemotherapy and surgery. Doctors usually first shrink the tumor with chemotherapy and then remove it through surgery. Shrinking the tumor before surgery may allow a woman to avoid a mastectomy and keep her breast. In the past, doctors would remove a lot of lymph nodes near breast tumors to see if the cancer had spread. Some doctors also use a method called sentinel node biopsy. Using a dye or radioactive tracer, surgeons locate the first or sentinel lymph node closest to the tumor, and remove only that node to see if the cancer has spread. If Cancer Has Spread Beyond the Breast If the breast cancer has spread to other parts of the body, such as the lung or bone, you might receive chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. Radiation therapy may also be useful to control tumors in other parts of the body. Get more information about treatment options for breast cancer and for recurrent breast cancer.
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what research (or clinical trials) is being done for Breast Cancer ?
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New Technologies Several new technologies offer hope for making future treatment easier for women with breast cancer. - Using a special tool, doctors can today insert a miniature camera through the nipple and into a milk duct in the breast to examine the area for cancer. Using a special tool, doctors can today insert a miniature camera through the nipple and into a milk duct in the breast to examine the area for cancer. - Researchers are testing another technique to help women who have undergone weeks of conventional radiation therapy. Using a small catheter -- a tube with a balloon tip -- doctors can deliver tiny radioactive beads to a place on the breast where cancer tissue has been removed. This can reduce the therapy time to a matter of days. Researchers are testing another technique to help women who have undergone weeks of conventional radiation therapy. Using a small catheter -- a tube with a balloon tip -- doctors can deliver tiny radioactive beads to a place on the breast where cancer tissue has been removed. This can reduce the therapy time to a matter of days. New Drug Combination Therapies New drug therapies and combination therapies continue to evolve. - A mix of drugs may increase the length of time you will live or the length of time you will live without cancer. It may someday prove useful for some women with localized breast cancer after they have had surgery. A mix of drugs may increase the length of time you will live or the length of time you will live without cancer. It may someday prove useful for some women with localized breast cancer after they have had surgery. - New research shows women with early-stage breast cancer who took the drug letrozole, an aromatase inhibitor, after they completed five years of tamoxifen therapy significantly reduced their risk of breast cancer recurrence. New research shows women with early-stage breast cancer who took the drug letrozole, an aromatase inhibitor, after they completed five years of tamoxifen therapy significantly reduced their risk of breast cancer recurrence. Treating HER2-Positive Breast Cancer Herceptin is a drug commonly used to treat women who have a certain type of breast cancer. This drug slows or stops the growth of cancer cells by blocking HER2, a protein found on the surface of some types of breast cancer cells. Approximately 20 to 25 percent of breast cancers produce too much HER2. These "HER2 positive" tumors tend to grow faster and are generally more likely to return than tumors that do not overproduce HER2. Results from clinical trials show that those patients with early-stage HER2 positive breast cancer who received Herceptin in combination with chemotherapy had a 52 percent decrease in risk in the cancer returning compared with patients who received chemotherapy treatment alone. Cancer treatments like chemotherapy can be systemic, meaning they affect whole tissues, organs, or the entire body. Herceptin, however, was the first drug used to target only a specific molecule involved in breast cancer. Another drug, Tykerb, was approved by the U.S. Food and Drug Administration for use for treatment of HER2-positive breast cancer. Because of the availability of these two drugs, an international trial called ALTTO was designed to determine if one drug is more effective, safer, and if taking the drugs separately, in tandem order, or together is better. Unfortunately, the results, released in 2014, showed that taking two HER2-targeted agents together was no better than taking one alone in improving survival. The TAILORx Trial In an attempt to further specialize breast cancer treatment, The Trial Assigning Individualized Options for Treatment, or TAILORx, enrolled 10,000 women to examine whether appropriate treatment can be assigned based on genes that are frequently associated with risk of recurrence of breast cancer. The goal of TAILORx is important because the majority of women with early-stage breast cancer are advised to receive chemotherapy in addition to radiation and hormonal therapy, yet research has not demonstrated that chemotherapy benefits all of them equally. TAILORx seeks to examine many of a woman's genes simultaneously and use this information in choosing a treatment course, thus sparing women unnecessary treatment if chemotherapy is not likely to be of substantial benefit to them.
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What is (are) Breast Cancer ?
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The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous.
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What is (are) Breast Cancer ?
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Breast cancer occurs when a malignant tumor forms in the breast tissue. The cancer can be found in the breast itself or in the ducts and lymph nodes that surround the breast.
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What is (are) Breast Cancer ?
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When cancer spreads from its original location in the breast to another part of the body such as the brain, it is called metastatic breast cancer, not brain cancer. Doctors sometimes call this "distant" disease.
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Who is at risk for Breast Cancer? ?
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Did You Know: Breast Cancer Statistics? Breast cancer is one of the most common cancers in American women. It is most common among women between the ages of 45-85. Today, more women are surviving breast cancer than ever before. Over two million women are breast cancer survivors. (Watch the video to learn more about breast cancer survival rates. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Men can get breast cancer too, although they account for only one percent of all reported cases. Read more about breast cancer in men.
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What are the symptoms of Breast Cancer ?
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When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. - a lump or thickening in or near the breast or in the underarm area - a change in the size or shape of the breast - a dimple or puckering in the skin of the breast - a nipple turned inward into the breast - fluid, other than breast milk, from the nipple, especially if it's bloody - scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) - dimples in the breast that look like the skin of an orange. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast a dimple or puckering in the skin of the breast a nipple turned inward into the breast fluid, other than breast milk, from the nipple, especially if it's bloody scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) dimples in the breast that look like the skin of an orange. Don't Ignore Symptoms You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible. Some women believe that as they age, health problems are due to "growing older." Because of this myth, many illnesses go undiagnosed and untreated. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Talk to your doctor.
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What is (are) Breast Cancer ?
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One definition of cure is being alive and free of breast cancer for 5 years. If the cancer is found early, a woman's chances of survival are better. In fact, nearly 98 percent of women who discover their breast cancer when it is near the site of origin and still small in size are alive 5 years later. However, women whose cancer is diagnosed at a late stage, after it has spread to other parts of the body, have only a 23.3 percent chance of surviving 5 years. To learn more about what happens after treatment, see Surviving Cancer.
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Who is at risk for Breast Cancer? ?
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Risk factors are conditions or agents that increase a person's chances of getting a disease. Here are the most common risk factors for breast cancer. - Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. - Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. - Never being pregnant or having your first child in your mid-30s or later. - Early menstruation. Having your first menstrual period before age 12. - Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. - Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. - Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. - Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. - Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. - Gaining weight after menopause, especially after natural menopause and/or after age 60. - Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. - Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Five percent to 10 percent of all breast cancers are thought to be inherited. Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. Never being pregnant or having your first child in your mid-30s or later. Early menstruation. Having your first menstrual period before age 12. Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. Gaining weight after menopause, especially after natural menopause and/or after age 60. Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Five percent to 10 percent of all breast cancers are thought to be inherited. Get information about the BRCA1 and BRCA2 genetic mutations and testing for them. This chart shows what the approximate chances are of a woman getting invasive breast cancer in her lifetime.
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How to prevent Breast Cancer ?
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When studying ways to prevent breast cancer, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor. Anything that decreases your chance of developing cancer is called a cancer protective factor. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including - changing lifestyle or eating habits - avoiding things known to cause cancer - taking medicine to treat a precancerous condition or to keep cancer from starting. changing lifestyle or eating habits avoiding things known to cause cancer taking medicine to treat a precancerous condition or to keep cancer from starting.
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What are the symptoms of Breast Cancer ?
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When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. - a lump or thickening in or near the breast or in the underarm area - a change in the size or shape of the breast - ridges or pitting of the breast; the skin looks like the skin of an orange - a change in the way the skin of the breast, areola, or nipple looks or feels; for example, it may be warm, swollen, red, or scaly - nipple discharge or tenderness, or the nipple is pulled back or inverted into the breast. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast ridges or pitting of the breast; the skin looks like the skin of an orange a change in the way the skin of the breast, areola, or nipple looks or feels; for example, it may be warm, swollen, red, or scaly nipple discharge or tenderness, or the nipple is pulled back or inverted into the breast. You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible.
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What is (are) Breast Cancer ?
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A mammogram can often detect breast changes in women who have no signs of breast cancer. Often, it can find a breast lump before it can be felt. If the results indicate that cancer might be present, your doctor will advise you to have a follow-up test called a biopsy.
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Who is at risk for Breast Cancer? ?
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The risks of breast cancer screening tests include the following. - Finding breast cancer may not improve health or help a woman live longer. Screening may not help you if you have fast-growing breast cancer or if it has already spread to other places in your body. Also, some breast cancers found on a screening mammogram may never cause symptoms or become life-threatening. Finding these cancers is called overdiagnosis. Finding breast cancer may not improve health or help a woman live longer. Screening may not help you if you have fast-growing breast cancer or if it has already spread to other places in your body. Also, some breast cancers found on a screening mammogram may never cause symptoms or become life-threatening. Finding these cancers is called overdiagnosis. - False-negative test results can occur. Screening test results may appear to be normal even though breast cancer is present. A woman who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms. False-negative test results can occur. Screening test results may appear to be normal even though breast cancer is present. A woman who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms. - False-positive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isnt) is usually followed by more tests (such as biopsy), which also have risks. False-positive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isnt) is usually followed by more tests (such as biopsy), which also have risks. - Anxiety from additional testing may result from false positive results. In one study, women who had a false-positive screening mammogram followed by more testing reported feeling anxiety 3 months later, even though cancer was not diagnosed. However, several studies show that women who feel anxiety after false-positive test results are more likely to schedule regular breast screening exams in the future. Anxiety from additional testing may result from false positive results. In one study, women who had a false-positive screening mammogram followed by more testing reported feeling anxiety 3 months later, even though cancer was not diagnosed. However, several studies show that women who feel anxiety after false-positive test results are more likely to schedule regular breast screening exams in the future. - Mammograms expose the breast to radiation. Being exposed to radiation is a risk factor for breast cancer. The risk of breast cancer from radiation exposure is higher in women who received radiation before age 30 and at high doses. For women older than 40 years, the benefits of an annual screening mammogram may be greater than the risks from radiation exposure. Mammograms expose the breast to radiation. Being exposed to radiation is a risk factor for breast cancer. The risk of breast cancer from radiation exposure is higher in women who received radiation before age 30 and at high doses. For women older than 40 years, the benefits of an annual screening mammogram may be greater than the risks from radiation exposure. - There may be pain or discomfort during a mammogram. During a mammogram, the breast is placed between 2 plates that are pressed together. Pressing the breast helps to get a better x-ray of the breast. Some women have pain or discomfort during a mammogram. There may be pain or discomfort during a mammogram. During a mammogram, the breast is placed between 2 plates that are pressed together. Pressing the breast helps to get a better x-ray of the breast. Some women have pain or discomfort during a mammogram. Some women worry about radiation exposure, but the risk of any harm from a mammogram is actually quite small. The doses of radiation used are very low and considered safe. The exact amount of radiation used during a mammogram will depend on several factors. For instance, breasts that are large or dense will require higher doses to get a clear image. Learn more about the risks of breast cancer screening.
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What are the treatments for Breast Cancer ?
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You can seek conventional treatment from a specialized cancer doctor, called an oncologist. The oncologist will usually assemble a team of specialists to guide your therapy. Besides the oncologist, the team may include a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. You might also be eligible to enroll in a clinical trial to receive treatment that conventional therapies may not offer.
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what research (or clinical trials) is being done for Breast Cancer ?
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Clinical trials are research studies on people to find out whether a new drug or treatment is both safe and effective. New therapies are tested on people only after laboratory and animal studies show promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found at http://www.cancer.gov/clinicaltrials on the website of the National Cancer Institute (NCI). Check NCI's list of cancer clinical trials for breast cancer prevention trials that are now accepting patients.
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What are the treatments for Breast Cancer ?
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Once breast cancer has been found, it is staged. Staging means determining how far the cancer has progressed. Through staging, the doctor can tell if the cancer has spread and, if so, to what parts of the body. More tests may be performed to help determine the stage. Knowing the stage of the disease helps the doctor plan treatment. Staging will let the doctor know - the size of the tumor and exactly where it is in the breast. - if the cancer has spread within the breast. - if cancer is present in the lymph nodes under the arm. - If cancer is present in other parts of the body. the size of the tumor and exactly where it is in the breast. if the cancer has spread within the breast. if cancer is present in the lymph nodes under the arm. If cancer is present in other parts of the body. Read more details about the stages of breast cancer.
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What are the treatments for Breast Cancer ?
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Standard treatments for breast cancer include - surgery that takes out the cancer and some surrounding tissue - radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. - chemotherapy that uses anti-cancer drugs to kill cancer most cells - hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. surgery that takes out the cancer and some surrounding tissue radiation therapy that uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. chemotherapy that uses anti-cancer drugs to kill cancer most cells hormone therapy that keeps cancer cells from getting most of the hormones they need to survive and grow. (Watch the video to learn about one breast cancer survivor's story. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
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What is (are) Breast Cancer ?
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There are two types of breast-conserving surgery -- lumpectomy and partial mastectomy. - Lumpectomy is the removal of the tumor and a small amount of normal tissue around it. A woman who has a lumpectomy almost always has radiation therapy as well. Most surgeons also take out some of the lymph nodes under the arm. Lumpectomy is the removal of the tumor and a small amount of normal tissue around it. A woman who has a lumpectomy almost always has radiation therapy as well. Most surgeons also take out some of the lymph nodes under the arm. - Partial or segmental mastectomy is removal of the cancer, some of the breast tissue around the tumor, and the lining over the chest muscles below the tumor. Often, surgeons remove some of the lymph nodes under the arm. In most cases, radiation therapy follows. Partial or segmental mastectomy is removal of the cancer, some of the breast tissue around the tumor, and the lining over the chest muscles below the tumor. Often, surgeons remove some of the lymph nodes under the arm. In most cases, radiation therapy follows.
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What are the treatments for Breast Cancer ?
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Even if the surgeon removes all of the cancer that can be seen at the time of surgery, a woman may still receive follow-up treatment. This may include radiation therapy, chemotherapy, or hormone therapy to try to kill any cancer cells that may be left. Treatment that a patient receives after surgery to increase the chances of a cure is called adjuvant therapy.
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What are the treatments for Breast Cancer ?
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Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells and shrink tumors. This therapy often follows a lumpectomy, and is sometimes used after mastectomy. During radiation therapy, a machine outside the body sends high-energy beams to kill the cancer cells that may still be present in the affected breast or in nearby lymph nodes. Doctors sometimes use radiation therapy along with chemotherapy, or before or instead of surgery.
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What are the treatments for Breast Cancer ?
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Chemotherapy is the use of drugs to kill cancer cells. A patient may take chemotherapy by mouth in pill form, or it may be put into the body by inserting a needle into a vein or muscle. Chemotherapy is called whole body or systemic treatment if the drug(s) enter the bloodstream, travel through the body, and kill cancer cells throughout the body. Treatment with standard chemotherapy can be as short as two months or as long as two years. Targeted therapies, usually in pill form, have become more common and focus on either a gene or protein abnormality and usually have few adverse side-effects as they directly affect the abnormality and not other cells or tissues in the body. Sometimes chemotherapy is the only treatment the doctor will recommend. More often, however, chemotherapy is used in addition to surgery, radiation therapy, and/or biological therapy.
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What are the treatments for Breast Cancer ?
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Hormonal therapy keeps cancer cells from getting the hormones they need to grow. This treatment may include the use of drugs that change the way hormones work. Sometimes it includes surgery to remove the ovaries, which make female hormones. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body. Often, women with early-stage breast cancer and those with metastatic breast cancer -- meaning cancer that has spread to other parts of the body -- receive hormone therapy in the form of tamoxifen. Hormone therapy with tamoxifen or estrogens can act on cells all over the body. However, it may increase the chance of developing endometrial cancer. If you take tamoxifen, you should have a pelvic examination every year to look for any signs of cancer. A woman should report any vaginal bleeding, other than menstrual bleeding, to her doctor as soon as possible.
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What are the treatments for Breast Cancer ?
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Certain drugs that have been used successfully in other cancers are now being used to treat some breast cancers. A mix of drugs may increase the length of time you will live, or the length of time you will live without cancer. In addition, certain drugs like Herceptin and Tykerb taken in combination with chemotherapy, can help women with specific genetic breast cancer mutations better than chemotherapy alone.
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What is (are) Glaucoma ?
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Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. While glaucoma can strike anyone, the risk is much greater for people over 60. How Glaucoma Develops There are several different types of glaucoma. Most of these involve the drainage system within the eye. At the front of the eye there is a small space called the anterior chamber. A clear fluid flows through this chamber and bathes and nourishes the nearby tissues. (Watch the video to learn more about glaucoma. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and result in loss of vision. Open-angle Glaucoma The most common type of glaucoma is called open-angle glaucoma. In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet. When fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye. Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build. If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result. There is no cure for glaucoma. Vision lost from the disease cannot be restored. However, there are treatments that may save remaining vision. That is why early diagnosis is important. See this graphic for a quick overview of glaucoma, including how many people it affects, whos at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms.
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What causes Glaucoma ?
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Nearly 2.7 million people have glaucoma, a leading cause of blindness in the United States. Although anyone can get glaucoma, some people are at higher risk. They include - African-Americans over age 40 - everyone over age 60, especially Hispanics/Latinos - people with a family history of glaucoma. African-Americans over age 40 everyone over age 60, especially Hispanics/Latinos people with a family history of glaucoma. In addition to age, eye pressure is a risk factor. Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. Thats why a comprehensive dilated eye exam is very important. It can help your eye care professional determine what level of eye pressure is normal for you. Another risk factor for optic nerve damage relates to blood pressure. Thus, it is important to also make sure that your blood pressure is at a proper level for your body by working with your medical doctor. (Watch the animated video to learn more about the causes of glaucoma. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
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What are the symptoms of Glaucoma ?
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Symptoms of Glaucoma Glaucoma can develop in one or both eyes. The most common type of glaucoma, open-angle glaucoma, has no symptoms at first. It causes no pain, and vision seems normal. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains. Tests for Glaucoma Glaucoma is detected through a comprehensive eye exam that includes a visual acuity test, visual field test, dilated eye exam, tonometry, and pachymetry. (Watch the animated video to learn more about testing for glaucoma. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) A visual acuity test uses an eye chart test to measure how well you see at various distances. A visual field test measures your side or peripheral vision. It helps your eye care professional tell if you have lost side vision, a sign of glaucoma. In a dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours. In tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. With pachymetry, a numbing drop is applied to your eye. Your eye care professional uses an ultrasonic wave instrument to measure the thickness of your cornea.
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What are the treatments for Glaucoma ?
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Although open-angle glaucoma cannot be cured, it can usually be controlled. While treatments may save remaining vision, they do not improve sight already lost from glaucoma. The most common treatments for glaucoma are medication and surgery. Medications Medications for glaucoma may be either in the form of eye drops or pills. Some drugs reduce pressure by slowing the flow of fluid into the eye. Others help to improve fluid drainage. (Watch the video to learn more about coping with glaucoma. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) For most people with glaucoma, regular use of medications will control the increased fluid pressure. But, these drugs may stop working over time. Or, they may cause side effects. If a problem occurs, the eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem. Read or listen to ways some patients are coping with glaucoma. Surgery Laser surgery is another treatment for glaucoma. During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This results in a series of small changes that makes it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs. Researching Causes and Treatments Through studies in the laboratory and with patients, NEI is seeking better ways to detect, treat, and prevent vision loss in people with glaucoma. For example, researchers have discovered genes that could help explain how glaucoma damages the eye. NEI also is supporting studies to learn more about who is likely to get glaucoma, when to treat people who have increased eye pressure, and which treatment to use first.
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What is (are) Glaucoma ?
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Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. The most common form of the disease is open-angle glaucoma. With early treatment, you can often protect your eyes against serious vision loss. (Watch the video to learn more about glaucoma. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) See this graphic for a quick overview of glaucoma, including how many people it affects, whos at risk, what to do if you have it, and how to learn more. See a glossary of glaucoma terms.
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What is (are) Glaucoma ?
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The optic nerve is a bundle of more than 1 million nerve fibers. It connects the retina to the brain.
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What is (are) Glaucoma ?
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Open-angle glaucoma is the most common form of glaucoma. In the normal eye, the clear fluid leaves the anterior chamber at the open angle where the cornea and iris meet. When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye. Sometimes, when the fluid reaches the angle, it passes too slowly through the meshwork drain, causing the pressure inside the eye to build. If the pressure damages the optic nerve, open-angle glaucoma -- and vision loss -- may result.
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Who is at risk for Glaucoma? ?
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Anyone can develop glaucoma. Some people are at higher risk than others. They include - African-Americans over age 40 - everyone over age 60, especially Hispanics/Latinos - people with a family history of glaucoma. African-Americans over age 40 everyone over age 60, especially Hispanics/Latinos people with a family history of glaucoma. See this graphic for a quick overview of glaucoma, including how many people it affects, whos at risk, what to do if you have it, and how to learn more.
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How to prevent Glaucoma ?
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At this time, we do not know how to prevent glaucoma. However, studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. So, if you fall into one of the higher risk groups for the disease, make sure to have a comprehensive dilated eye exam at least once every one to two years. Get tips on finding an eye care professional. Learn what a comprehensive dilated eye exam involves.
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What are the symptoms of Glaucoma ?
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At first, open-angle glaucoma has no symptoms. It causes no pain. Vision seems normal. Without treatment, people with glaucoma will slowly lose their peripheral, or side vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains.
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What are the treatments for Glaucoma ?
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Yes. Immediate treatment for early stage, open-angle glaucoma can delay progression of the disease. That's why early diagnosis is very important. Glaucoma treatments include medicines, laser surgery, conventional surgery, or a combination of any of these. While these treatments may save remaining vision, they do not improve sight already lost from glaucoma.
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what research (or clinical trials) is being done for Glaucoma ?
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Through studies in the laboratory and with patients, the National Eye Institute is seeking better ways to detect, treat, and prevent vision loss in people with glaucoma. For example, researchers have discovered genes that could help explain how glaucoma damages the eye. NEI also is supporting studies to learn more about who is likely to get glaucoma, when to treat people who have increased eye pressure, and which treatment to use first.
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Who is at risk for Glaucoma? ?
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Encourage them to have a comprehensive dilated eye exam at least once every two years. Remember -- lowering eye pressure in glaucoma's early stages slows progression of the disease and helps save vision. Get tips on finding an eye care professional.
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What is (are) Glaucoma ?
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National Eye Institute National Institutes of Health 2020 Vision Place Bethesda, MD 20892-3655 301-496-5248 E-mail: 2020@nei.nih.gov www.nei.nih.gov The Glaucoma Foundation 80 Maiden Lane, Suite 700 New York, NY 10038 212-285-0080 Glaucoma Research Foundation 251 Post Street, Suite 600 San Francisco, CA 94108 1-800-826-6693
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What is (are) Peripheral Arterial Disease (P.A.D.) ?
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Arteries Clogged With Plaque Peripheral arterial disease (P.A.D.) is a disease in which plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in the body's arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. P.A.D. usually affects the arteries in the legs, but it can also affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. Blocked blood flow to your legs can cause pain and numbness. It also can raise your risk of getting an infection in the affected limbs. Your body may have a hard time fighting the infection. Why is P.A.D. Dangerous? Over time, the plaque may crack and cause blood clots to form. These blood clots can block arteries, causing pain, numbness, inflammation, and even permanent tissue damage in the affected part of the body. If severe enough, blocked blood flow can cause tissue death (also called gangrene.) In very serious cases, this can lead to leg amputation. P.A.D. currently affects 8 million to 12 million Americans. About 1 in every 20 Americans over the age of 50 has P.A.D. African Americans are more than twice as likely as Caucasians to have P.A.D. If you have P.A.D., your risk of coronary artery disease, heart attack, stroke, and transient ischemic attack ("mini-stroke") is much higher than in people without P.A.D. If you have coronary artery disease, you have a 1 in 3 chance of having blocked leg arteries. Although P.A.D. is serious, it is treatable. If you have the disease, it's important to see your doctor regularly and treat the underlying atherosclerosis. Other Names for Peripheral Arterial Disease - Atherosclerotic peripheral arterial disease - Claudication (klaw-dih-KA-shen) - Hardening of the arteries - Leg cramps from poor circulation - Peripheral vascular disease - Poor circulation - Vascular disease Atherosclerotic peripheral arterial disease Claudication (klaw-dih-KA-shen) Hardening of the arteries Leg cramps from poor circulation Peripheral vascular disease Poor circulation Vascular disease
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