One in two of us will have a cancer diagnosis in our lifetime and cancer is the leading cause of death in Ireland, but there is a lot we can do to help prevent this outcome.

While prevention is clearly important, everyone is at risk of developing cancer. Detecting cancer early gives the best opportunity for a good outcome if we are diagnosed. So what can we do to help ensure the best outcome?

Looking out for signs and symptoms 

It is important to be aware of your body and if you notice any unusual change in how your body works, talk to your doctor. The chances are it will not be cancer but getting it checked is not a waste of anyone’s time, and it could even save your life.

Some of the signs you should check with a doctor:

• A lump or swelling
• Bleeding that is not normal for you
• Unexplained weight loss or prolonged tiredness or fatigue
• Pain that does not go away after three or more weeks
• A persistent cough, changes in your voice, hoarseness that lasts longer than three weeks or feeling short of breath (most especially if you smoke)
• A sore or bruise that does not heal
• Difficulty swallowing, ongoing indigestion or heartburn
• A mouth or tongue ulcer present for three weeks or more
• A change in your bowel or bladder habits, persistent bloating, constipation, diarrhoea or problems passing urine for more than three weeks
• A new mole or change in shape, size or colour to an existing mole
• Any change in your breast- many breast cancers, especially in younger women do not present as a ‘lump’

Together the person and their cancer team can weigh the benefits and risks of each cancer treatment to determine which is best for them.

Getting treatment and support

Cancer treatment is a complex process that differs from person to person and we are fortunate that our cancer doctors and healthcare professionals have world-class training. On diagnosis, the person will meet with their oncology team (cancer team) and an individualised treatment plan will be devised.

Treatment options depend on several factors, such as the type and stage of cancer, person’s general health and preferences. Together the person and their cancer team can weigh the benefits and risks of each cancer treatment to determine which is best for them.  

Receiving a cancer diagnosis is a very worrying time. It is normal to feel overwhelmed and confused. Talking with your doctor/cancer team and learning all you can about your diagnosis and your treatment options can help. The Irish Cancer Society provides a range of supports for anyone impacted by cancer, be they patient or family members.

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What are CBD products, how are they made and are they all the same? An Irish grower and producer explains the differences. 

Cannabidiol (CBD) oil or hemp oil all come from the hemp plant. The hemp plant is extremely versatile and useful in a number of sectors including textiles and personal health. The plant naturally contains more than 100 cannabinoids, notably cannabidiol (CBD), but despite this, not all oils are the same.

Mark Canavan, co-founder of Greenheart CBD explains: “Most oils on the market are produced using chemical extraction or made up from concentrates, but at Greenheart we keep our product fully natural and extract in a natural process known as cold pressed extraction.”

How the process works

The company uses a ‘seed to shelf’ production process that starts in the fields of Wicklow and provides full traceability to the end consumer. 

“We grow hemp under licence, using strains permitted in the EU and scan the fields daily using AI-enhanced drones, which relay details about the health and stage of growth, this allows us to identify any problems and harvest crops at the optimum time,” says Canavan. The company plans to introduce larger drones that allow for soil testing, weeding and the spray application of organic fertiliser or plant nutritional products and have partnered with Zenadrone.

Greenheart has also partnered with UNIPHAR, Ireland’s largest pharmacy distributor allowing Greenheart products to be readily available in pharmacies nationwide.

Greenheart CBD has committed itself to making a difference in today’s world with a unique and original approach to helping farmers climb from the poverty trap.

A new cryptocurrency

Canavan shares a new development the company are working on, “We are a very forward-thinking company and due to the evolution that is occurring in the financial sector, we decided to get involved in the crypto currency space and create a decentralised platform for farmers looking to get into hemp production and improve their quality of life through our new currency ‘CBD’.

“We embarked on this project in 2019 and got our token launched on Pancake Swap in May 2021. We have ambitious plans to grow the community and value of our currency by implementing the various targets we have set on our roadmap.”

Liam Robertson, chief executive of Alphabit Fund says, “Greenheart CBD has committed itself to making a difference in today’s world with a unique and original approach to helping farmers climb from the poverty trap.” 

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A new lifestyle campaign has been launched to encourage men in Ireland to review their lifestyles and make important changes to improve their heart health. 

One in four men in Ireland die from heart disease and stroke. Men are nearly three times more likely than women to die young from these issues – but the good news is that 80% of those deaths are preventable through healthy lifestyles.

The older you get, the higher your risk – and so it is important that men, particularly those in their 40s and 50s, take stock of and Reboot their lifestyles by identifying what simple changes they can make now to benefit their heart health into the future.

Reviewing your lifestyle

A new survey has found that more than one in four men do not consider the health of their heart a priority, despite the fact that men are at an increased risk of dying early from heart disease and stroke compared to women.

The Irish Heart Foundation has launched a new campaign which aims to encourage men in Ireland to review their lifestyles and make important changes to improve their heart health.

The campaign is supported by Rugby Players Ireland and the Irish Heart Foundation was delighted to get the help of a number of former Ireland internationals – Tommy Bowe, Malcolm O’Kelly, Peter Stringer and Paul Wallace to launch the campaign.

In the past five years, two of the players’ friends and former teammates, Anthony ‘Axel’ Foley and Gary Halpin, passed away suddenly due to heart issues at the ages of just 42 and 55.

CSO data shows that 999 men died of a heart attack in 2020, compared to 642 women.

Taking control of your health

The former players have come together with the Irish Heart Foundation to encourage men of all backgrounds and fitness levels to take control of their health and ‘Reboot their Lives’ this September.

CSO data shows that 999 men died of a heart attack in 2020, compared to 642 women. In the same year, in the 45 to 54 age group, 217 men died of heart disease and stroke compared to only 75 women. The campaign calls on men to sign up on the Irish Heart Foundation website where they can access heart health information, assess their lifestyle through a quiz and download a helpful booklet with lots of tips to Reboot.

The campaign is being supported by the HSE as part of their delivery on Healthy Ireland, the national framework to support health and wellbeing in Ireland.

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From wearable devices to voice-activated medical assistants, the digital sphere is teeming with breakthroughs that can make a difference for the world’s growing incidence of noncommunicable diseases (NCDs). 

If, as the saying goes, “our health is our wealth,” then we must invest in digital healthcare for everyone to tackle the world’s leading killer, cardiovascular disease (CVD). More than 18 million deaths occur annually from CVD, many of them in low- to middle-income countries. Digital healthcare is not a salve for all health woes, but it can widen or narrow the existing gap in accessible and affordable healthcare. 

If a positive outcome of the pandemic exists, it could be the wider uptake of digital tools as an additional aid in healthcare.

Being ‘well-connected’

‘Well-connected’ in the usual sense may imply special treatment or favours; in our digital world, it is all about equity. Indeed, increasingly, to be well is affected by our ability to be connected via some technological means, encompassing tools from a basic landline to hand-held heart monitoring devices.

Wearable devices include smartwatches and more sophisticated tools that read the wearer’s data via embedded microchips and sensors. Other examples include hand-held or chest-applied electrocardiogram (ECG) devices attached to smartphones that can record heart rhythm and help diagnose irregular heartbeat when it involves, for instance, atrial fibrillation, which can have serious consequences, such as stroke. In some cases, they can even take images from the heart using ultrasound technology. 

Smartphone cameras can be used to monitor blood pressure and connecting pharmacies on a common mobile platform has aided their participation in patient management. In 2019, the wearables market grew by 89% before seeing a decrease in 2020.

A chance for damage control

It is estimated that in least developed countries (LDCs), 17% of the rural population has no mobile coverage, with only a 2G network covering 19% of the rural population.

The road to an even playing field must entail investment, infrastructure, education and privacy protocols. Weaving digital literacy into education efforts will increase comfort levels for patients and health workers who might not be used to technology as a health resource.  

If a positive outcome of the pandemic exists, it could be the wider uptake of digital tools as an additional aid in healthcare. The biggest winner could be within reach: that all means, digital or traditional, are accessible to the most vulnerable and in need. Our future is an opportunity to do damage control, to correct past mistakes of unequal access to affordable care and save many a beating heart.

#UseHeart

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Three years ago, Adam Kavanagh, 24, was diagnosed with type 1 diabetes. He had no idea that his symptoms were that of diabetes. However, diabetes did not stop him from being one of the top Irish 200m sprinters.

Q: Have you had any symptoms of type 1 diabetes before getting diagnosed?

At first, I thought it was a kidney infection. I was working in the United States and I remember that I was drinking a lot of water. As a result, I was visiting the toilet very frequently. When I arrived at Dublin airport, my parents said that I lost weight. I remember I was weak, but I didn’t connect the dots yet – just went straight to a music festival and started a new job.

The first six months were tough – I had to embed myself in a new routine – insulin, blood checks and diet.

Q: As a busy 21 year old, it must have been a tough beginning at a new job?

Yes, I had to take a day off first week and see my GP. My doctor checked my urine and that’s how I found out I have type 1 diabetes – there was a lot of glucose in it. The first six months were tough – I had to embed myself in a new routine – insulin, blood checks and diet. It took me a year to get used to this new routine.

Q. You are a sports person. You play football and you compete at a high level as a 200m sprinter. How diabetes diagnosis affected your sports life?

I took it easy – I took a break from competitive sport for nine months, but then I got back on track and I am still improving. I am an Irish 200m sprinter currently ranked in the top 25 in the country.

I am already a member and contributor to the Diabetes Football Community in the UK, I play for UCD & the Irish Diabetic Futsal team. I am hoping to enhance the sports and diabetes topic in Ireland. It is a great empowerment and motivation to effectively control your diabetes, so you can compete at the highest levels. Diabetes does not have to stop your passion!

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Migraine is a complex neurological disorder which is underrated by many. It is the most common primary headache disorder presenting to doctors and the more chronic forms can be very disabling.

There are approximately one million migraine sufferers in Ireland, some having a couple of migraine attacks every decade and others experiencing multiple attacks each week. The peak migraine prevalence for women is between ages 15-49. The lifetime prevalence is 42% in females¹ . From a monetary perspective, it directly costs the Irish economy at least €252 million per year². Migraine is therefore a cause of significant societal burden, both medically and financially. Unfortunately, it is often misdiagnosed, underdiagnosed and undertreated.” says Dr Martin Ruttledge, Consultant Neurologist at Beaumont Hospital. This is not just in Ireland, but it is a worldwide problem.

Dr Ruttledge, Dr Mary Kearney and Ms Esther Tomkins co-authored The ICGP Migraine Quick Reference Guide (QRG) in 2019, a “teaching manual” developed to help primary care doctors and other community Health Care Professionals (HCP) to better understand migraine, and to facilitate better diagnosis and management in primary care.

Keeping a diary of symptoms

Some patients can experience relatively few migraine attacks throughout their life, while the average patient can experience one to two attacks per month. In addition, approximately 10% of all patients suffer weekly attacks. The authors of the above ICGP document recommend that patients should keep a headache diary, documenting frequency of attacks and medication taken.

There are approximately one million migraine sufferers in Ireland.

The diary should also document associated symptoms, duration and severity of each attack, together with possible trigger factors such as female hormone fluctuations, weather or skipping meals. The authors suggest that when a patient visits their GP with recurring headaches, they should be advised to keep a detailed headache diary. This usually provides very useful clinical information and can help confirm the diagnosis.

Dr Ruttledge concludes: “It’s all about just sitting and talking to the patients, taking their medical history and explaining the condition in straightforward language.” However, it takes time and investment to develop Headache Specialists. More training for doctors and specialist headache nurses is a must for Ireland going forward.

References
[1] Frederick IO, Qiu C, Enquobahrie DA, Aurora SK, Peterlin BL, Gelaye B, et al. Lifetime prevalence and correlates of migraine among women in a pacific northwest pregnancy cohort study. Headache 2014 Apr; 54(4):675-685. 
[2] Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z. Migraine is first cause of disability in under 50s: will health politicians now take notice? J Headache Pain 2018 Feb 21; 19(1):17-018-0846-2. 

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It is estimated that around a quarter of a million people in Ireland are currently diagnosed with glaucoma. It is a serious, progressive eye disease, which left untreated, can lead to blindness. 

Glaucoma is a serious, progressive group of eye diseases, which left untreated, can lead to blindness. It can be difficult to detect without an eye test – most types of glaucoma have no symptoms. Glaucoma is sometimes caused by an increase in pressure in the fluid in the eye when the fluid cannot drain adequately.

Glaucoma is a serious, progressive group of eye diseases, which left untreated, can lead to blindness.

Lifelong glaucoma management

Damage to the optic nerve is permanent and irreversible, so it is very important to lower the fluid pressure in the eye. Once diagnosed, the most common treatment is prescription eye drops, which will help to either reduce the fluid production or increase the drainage of fluid from the eye. These eye drops need to be applied up to three times a day, every day for the rest of your life, so perseverance can become challenging, limiting the efficacy of the treatment.

Innovations in medical implants

An international study has shown 72% of patients who were treated with iStent inject® no longer need to take glaucoma medication after 12 months¹. ² 

The device comprises of microscopic 0.36mm stents which are implanted into the eye. When in place, they aren’t visible to the human eye. The stents work by helping to restore the eye’s natural fluid outflow, thus reducing ocular pressure³.

The surgery is elegant and can be carried out at the same time as cataract surgery, or during a separate procedure, usually under local anaesthetic by an ophthalmologist. iStent inject® has an excellent safety profile and is performed by eye surgeons while you are awake. There are a significant number of studies that show its efficacy and safety².

Today the original iStent® and iStent inject® have been implanted in over 700,000 eyes around the world, with more and more patients who have glaucoma benefit from the procedure every day.

Trabecular micro-bypass surgery, namely iStent implantation, can be a good alternative treatment.

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As one of the groups most vulnerable to serious illness from COVID-19, the pandemic has been an anxious and challenging time for people with COPD.   

COPD (chronic obstructive pulmonary disease) is a common, treatable lung condition. It is a chronic disease, so it will never go away, but there are many things that people can do to manage it, in order to enjoy the best possible quality of life.

COPD is an umbrella term for emphysema and bronchitis and is mainly due to exposure to harmful particles or gases that are inhaled, causing abnormalities to the airways and within the lungs.

COPD in Ireland

COPD remains a serious problem for people in Ireland and for our health system. The HSE’s NHQRS Annual Report 2020 estimates that 380,000 people are living with the disease yet only 110,000 are diagnosed. It states that at least 1,500 patients die each year of COPD and over 15,000 patients are admitted to hospital with it. The OECD reported that Ireland has the highest hospitalisation rate for COPD in 2017, the latest year for which international data is available.

Persistent symptoms such as a cough, phlegm and difficulty in breathing can be an indication of COPD.

Causes of COPD

Smoking is the most common cause of COPD but prolonged exposure to air pollution, such as environmental toxins, fumes and dust, is also a risk factor. This means that the disease is largely preventable by never smoking and/or avoiding long term exposure to harmful fumes, dust or gases. However, some people with an existing illness such as chronic asthma may be more prone to developing COPD, while others may be pre-disposed to it due to a hereditary lung condition known as Alpha-1 antitrypsin deficiency.

Persistent symptoms such as a cough, phlegm and difficulty in breathing can be an indication of COPD. People over the age of 35 who have these symptoms, who are or have been smokers or who have a family history of the disease, should ask their GP for a COPD health check.

Help is at hand

Those living with COPD often experience social isolation, lack of mobility, reduced independence, frequent hospital admissions and mental health issues. People with COPD were identified as one of the groups most at risk of serious illness if they catch COVID-19 – this means the last 18 months have been a particularly anxious and challenging time for many.

Greater awareness of signs and symptoms of COPD and increased access to supports in the community for detecting and managing the condition are critically important.

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We all know that we can feel tension and anxiety in the “pit of our stomach” but also happiness and excitement. Now there is the science out there to prove it too. 

The gut microbiome is made up of trillions of live microbes living in the human intestine. It contains at least 150 times more genes than the human genome. It is a complex ecosystem with amazing diversity. It consists of bacteria, viruses, fungi and yeasts. They live symbiotically with us, metabolising foods, processing vitamins, and supporting our immune system.

The gut-brain axis is a two way communication system between the brain and the enteric nervous system.

The gut-brain axis

The gut-brain axis is a two way communication system between the brain and the enteric nervous system (ENS). The ENS is an integrated circuit of 100 million neurons embedded in the lining of your gastrointestinal tract. It coordinates the digestive process devoid of input from the brain, earning it the name of the “second brain”. 

How the microbiome interacts with the ENS and the brain was proposed in the landmark study by Nobuyuki Sudo and colleagues. They discovered that germ-free mice, which are born without any bacteria, had an impaired stress response. Sudo then gave the germ free mice healthy gut microbes and showed that the mice developed a normal stress response. The experiment demonstrated how gut bacteria can affect behaviour.

Further research on the mechanism was proposed by John Cryan and Ted Dinan at University College Cork. They demonstrated a combination of ways the axis communicates including hormones, microbial metabolites, neurotransmitters and immunological factors. When these are released from the gut, they send signals to the brain. To describe bacteria which affects the brain and mood, the team coined the term psychobiotic. 

Ways to balance your microbiome

Eat fibre rich foods: Short-chain fatty acids (SCFA) are produced from microbial fermentation of fibre and appear to have an anti-inflammatory affect and are a source of energy for your colon cells. Eating fibre-rich foods, such as fruit and vegetables promotes their formation. 

Good news, wine and chocolate are good for you, in moderation: Dark chocolate i.e. 70% cocoa, red wine, coffee and tea all contain polyphenol which our microbiome metabolise into bioactive metabolites. These can help to control bodyweight by inhibiting appetite and improving lipid metabolism.

Eat fermented foods: A new study from researchers at Stanford School of Medicine demonstrated that eating foods such as yogurt, kefir, fermented vegetables and kombucha tea led to an increase in overall microbial diversity.

Therapies such as cognitive-behavioural therapy (CBT) involve relaxation techniques and cognitive restructuring, teaching people to challenge negative thoughts and manage stress better. 

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Of all people living with diabetes in Ireland, 10% have to continuously take insulin just to survive. They also have to be educated to self-manage diabetes to prevent diabetes-related complications and live long and healthy lives.

Type 1 diabetes is an autoimmune condition: the body stops producing the hormone called insulin that is essential to survive for reasons we still do not understand. Living with diabetes requires daily decisions around medication doses, including estimating and delivering insulin, checking blood glucose levels and avoiding low and high blood glucose levels. 

High glucose levels (hyperglycaemia) occur as an effect of insufficient insulin levels and can be caused by many factors: food, stress, other medicines etc. Low glucose levels (hypoglycaemia) on the other hand, can be a result of an insulin overdose, that can occur after miscalculating food and carbohydrate intake, exercise, increased activity etc. There are dozens of factors that can influence glucose levels – with only a few controllable. 

If well controlled, diabetes does not have to be a barrier to living a normal, active, and healthy life.

Living with type 1 diabetes

Living with diabetes requires attention and effort 365 days a year and 24 hours a day – there is no break from it. One of the ways living with diabetes has improved, and the burden of all these daily tasks has been reduced, has been the advances in technology. Glucose monitoring allows the checking of glucose levels and patterns by only connecting a reader (i.e. a reader or a mobile phone) to a sensor attached to one’s body.

More advanced, continuous glucose monitors have alarms and alert when glucose is rising or falling. The vast majority of people with diabetes (PwD) in Ireland use insulin pens and take 3-4 (or more) injections a day. Those on insulin pumps can just programme insulin dose by clicking the buttons and deliver it via infusion set, which is attached to a body and replaced every 2-3 days. The minority of those living with condition in Ireland use advanced technological support, despite the fact it is reimbursed. 

Just control what you can

If well controlled, diabetes does not have to be a barrier to living a normal, active, and healthy life. PwD can do anything – just have to maintain their safety. Appropriate diabetes management saves lives and protects from long-term complications (same as in type 2 diabetes), it also minimises the risk of severe complications: severe hypoglycaemia and diabetes ketoacidosis (DKA). 

DKA is life-threatening, thus should be recognised quickly. It frequently occurs at the time of diabetes diagnosis. To avoid DKA, we should all be aware of type 1 diabetes symptoms: T for thirst increased, E for energy reduced, S for sudden weight loss, and T for toilet trips, which are very frequent. 

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