When’s Your Time to Die?

risk of dyingWhat are your chances of dying in the next 10 years?

Obviously there are some activities that may increase your risk  such as driving drunk and active military duty in a war zone, but how about getting winded after walking several blocks or having trouble pushing a chair across the room

Turns out the latter might be just as dangerous as the former.

Researchers at the University of San Francisco VA Medical Center have recently come up with a “mortality index” to predict when a person may die.  Marisa Cruz and her colleagues have developed a list of 12 questions that can help predict chances of dying within 10 years for patients aged 50 and older.  The researchers created the index by analyzing data on almost 20,000 Americans over 50 who took part in a national health survey in 1998. They tracked the participants for 10 years. Nearly 6,000 participants died during that time.

risk of dying 2While the test scores may satisfy people’s morbid curiosity, the researchers say their index wasn’t meant as guidance about how to alter your lifestyle.  Instead, it is mostly for use by doctors, to help them discuss the pros and cons of costly health screenings or medical procedures in patients who are unlikely to live 10 more years.

That said, we know that many of our readers are “simply dying” to take the test themselves – right now.

So without further ado…here’s how it works.

The 12 items on the mortality index are assigned points.  The fewer your total points the better odds of living.

  • Men automatically get 2 points. In addition, men and women ages 60 to 64 get 1 point; ages 70 to 74 get 3 points; and 85 or over get 7 points.
  • Two points each for: a current or previous cancer diagnosis, excluding minor skin cancers; lung disease limiting activity or requiring oxygen; congestive cardiac failure; smoking within the past 2 weeks; difficulty bathing; difficulty managing money because of health or memory problem; difficulty walking several blocks.
  • One point each for: diabetes or high blood sugar; difficulty pushing large objects, such as a heavy chair; being thin or normal weight.


The highest, or worst, score is  26, which equates to  a 95% chance of dying within 10 years. To get that, you’d have to be a man at least 85 years old with all the above conditions.
healthy young womanFor a score of zero, which correlates to a 3% chance of dying within 10 years, you’d have to be a woman of “normal weight” younger than 60 without any of those infirmities.

While it’s hardly surprising that a sick, older person would have a much higher chance of dying than someone younger why would being overweight be less risky than being of normal weight or slim?  One possible reason is that thinness in older age could be a sign of illness.

Dr. Stephan Fihn, a health quality measurement specialist with Veterans Affairs health services in Seattle, said the index seems valid and “methodologically sound.”
However, he adds that it is probably most accurate for the oldest patients, who don’t need a scientific crystal ball to figure out their days are numbered.

For fans of SRxA’s Word on Health, I’m pleased to report that my 10-year mortality index is zero. Let the blogging continue!

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A Pill to Prevent Skin Cancer?

Summer, it seems, has finally arrived.  And with it comes long lazy days at the beach, the pool… and, unfortunately, the associated risk of skin cancer.  To guard against this we all know to limit sun exposure, use high factor sunscreen and seek shade. But now it seems there’s one more thing we can do to help safeguard ourselves – take Advil!

Really?   Yes, it would appear so.  According to a case-control study published in the journal Cancer, the use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with reduced risk for skin cancer.

Using health registries, researchers identified 18,500 cases of skin cancer among adults in northern Denmark and matched them to population controls without skin cancer. Patients who had ever used NSAIDs (more than two prescriptions) had a 15% reduced risk for squamous cell carcinoma and a 13% reduced risk for malignant melanoma compared with those who had two or fewer prescriptions; especially when the drugs were taken for seven or more years or at a high intensity.

The risk reduction was seen in patients taking aspirin, NSAIDs, and COX-2 inhibitors, such as Celebrex.

Individuals who took NSAIDs did not appear to gain a generally reduced risk from developing basal cell carcinoma, although they had a 15% and 21% reduced risk of developing this kind of cancer on less-exposed sites (areas other than the head or neck) when taken long term or at a high intensity, respectively.

So how do NSAIDs do it?  The authors suggest that they reduce the risk of skin cancer by blocking COX enzymes, which are involved in the inhibition of apoptosis  and in stimulating angiogenesis. Or, in plain English, these anti-inflammatory drugs counteract the enzymes involved in the important steps of cancer development such as inhibition of cell death and suppression of the immune system.

Despite the positive results, lead author Sigrún Alba Johannesdóttir from Aarhus University Hospital cautions, “because there are also risks associated with the use of NSAIDs, we cannot give recommendations on NSAID use in general. It is up to the patient and his or her physician to balance benefits and harms associated with use of the medications.”

Nevertheless, when viewed alongside the study results fom earlier this year that showed patients who took aspirin daily for at least three years were 36% less likely to develop metastatic cancer and 15% less likely to die from the disease, this can only be good news.

Especially for people like me, who love the sun and can’t make it downstairs without a morning dose of diclofenac!

Taking on Tanorexia

If you were in the US last week, you’ll recall that you couldn’t turn on the TV or download a news story without being reminded of the latest in the saga of the “tanorexic” mom Patricia Krentcil.

In case you somehow missed this news, let me recap very briefly.  New Jersey native, 44 year old Krentcil, was accused of taking her 5-year-old daughter to a tanning booth after school officials noted the child’s severe sunburn.  She was then reported to social services, arrested and charged with second-degree child endangerment

Whatever the rights and wrongs of this case, and for the record we think they are mainly wrongs, one thing is clear – the leathery Mrs Krentcil has a serious addiction to tanning.

Most of us watching this train wreck of a story unfold, simply want to know why.  Why would someone do that to themselves? Why would you think this looks good? Why oh why?

Well, according to researchers at UT Southwestern Medical Center, people who frequently use tanning beds may be spurred by an addictive neurological reward-and-reinforcement trigger, They found that tanning produces endorphins – the brain the chemicals that provoke feelings of happiness.

This could explain why some people continue to use tanning beds despite the increased risk of developing skin cancer. About 120,000 new cases of melanoma are diagnosed in the U.S. each year. People younger than 30 who use a tanning bed 10 times a year have eight times the risk of developing malignant melanoma. And although public knowledge of these dangers has grown, so has the regular use of tanning beds.

While most people use tanning beds only occasionally, around 10% of indoor tanners use tanning beds for more than 20 hours a year and are motivated not only by their desire to improve appearance but also because it makes them feel relaxed.

To examine what lures frequent tanners to tanning beds,  researchers studied 14 people who used tanning beds 8 to 15 times a month. During tanning sessions on Mondays and Wednesdays, participants spent part of the time in a normal tanning bed and part of the time in a tanning bed that did not emit any UV radiation. The beds were equipped with special filters that made them appear indistinguishable. On Fridays, participants were offered the chance to use the tanning bed of their choice – either one bed for the whole session or a combination of the two. Although the tanning beds looked identical, frequent tanners were not fooled. Out of the 12 people who chose to tan on Fridays, all but one selected the UV-emitting bed for the entire session. What’s more, tanners felt more relaxed and less tense after using a UV tanning bed than they did after using a dummy tanning bed.

Using tanning beds has rewarding effects in the brain so people may feel compelled to persist in the behavior even though it’s bad for them,” said Dr. Bryon Adinoff, professor of psychiatry at the Veterans Affairs North Texas Health Care System.

Participants were also administered a compound that allowed scientists to measure brain blood flow while they were tanning.  What they found was that the brain activity and corresponding blood flow patterns were similar to those seen in people addicted to drugs and alcohol.

However, just as moderate drinkers can enjoy alcohol without being addicted, not all those who go to tanning salons are addicted to UV light.  As always, all things in moderation…except of course your comments on this post, which are, as always, very welcome!

Dying for a suntan this summer?

Half the battle in knowing how to properly protect yourself from skin cancer is being able to separate fact from fiction. Unfortunately, some myths about tanning and sun protection are deep rooted and could mislead people into thinking that tanning is safe – when, in reality, nothing could be further from the truth.

A new survey by the American Academy of Dermatology sets the record straight on some of the most common myths and what people believe to be true about tanning and sun protection.

The “Suntelligence: How Sun Smart is Your City?” online survey polled more than 7,000 adults nationwide to determine their knowledge, attitudes and behaviors toward tanning, sun protection and skin cancer detection.

“Our survey showed that despite our repeated warnings about the dangers of UV exposure and the importance of proper sun protection, many people could not correctly answer true/false statements on the subject,” said dermatologist Zoe D. Draelos, MD, FAAD, Duke University School of Medicine, Durham, N.C.

Examples of the myths included in the survey include:

  • Some types of ultraviolet (UV) rays are safe for your skin?
    • The survey found that only about one-third of respondents correctly answered false to this question.
  • Getting a base tan is a healthy way to protect skin from sun damage?
    • Less than half the respondents knew this statement was false.
  • It is smarter to tan indoors using a tanning bed?
    • 63% of respondents knew that this statement was false.
  • A sunscreen with a Sun Protection Factor (SPF) 30 provides twice the protection as an SPF 15?
    • Only 21% of respondents knew this statement was not true.  Contrary to popular belief, UVB protection from the sun’s burning rays does not actually increase proportionately with a designated SPF number. For example, an SPF of 30 screens 97 percent of UVB rays, whereas an SPF of 15 screens 93 percent of UVB rays, and an SPF of 2 screens 50 percent of UVB rays.

You can visit www.melanomamonday.org to take the Academy’s “Suntelligence” survey, as well as to find out how to perform a skin self-exam or find free skin cancer screenings in your area.