Awareness and understanding play an important role in keeping women healthy and helping them to avoid some of the top risks to their health. Discover how you can keep a closer eye on your own health.
Awareness and understanding of major health threats can go a long way to keeping women healthy. But staying ahead of some of the most dangerous conditions requires a good dose of vigilance, too.
According to the federal Centers for Disease Control and Prevention (CDC), the top causes of death among adult American women include heart disease, stroke, cancer, chronic lower respiratory disease, Alzheimer’s disease and unintentional injuries. A closer look at the top three health threats helps to pinpoint both the reasons and the need for a woman to pay close attention to her health.
Threat No. 1: Heart Disease
Heart disease is the leading cause of death among both men and women. One in every four Americans will die as the result of some form of heart disease. The sad news is that, although women once were in the minority of this statistic, they now appear to be equally as vulnerable as men.
Dr. Elizabeth Retzer, an interventional cardiologist with Centegra Physician Care, in McHenry County, says women age 55 and above should be concerned about the potential for developing heart disease. But, she adds, younger women also are being diagnosed with a broad spectrum of heart-related conditions.
“We are becoming increasingly concerned about this segment of the population that has been diagnosed with coronary disease who believed they were too young,” she says. “They think of it as a disease of people in their 50s, 60s or 70s. Because of risk factors such as smoking, diabetes, high blood pressure, high cholesterol and family history, we are seeing heart disease in men and women of all ages.”
One of the problems with women and heart disease is that they frequently have atypical symptoms not normally associated with heart attacks or developing heart disease.
“While women can experience the same symptoms we traditionally associate with coronary disease, such as the ‘elephant on my chest’ pressure,” Retzer adds, “they can also feel other symptoms such as shortness of breath, a sudden lower exercise tolerance and extreme fatigue. In addition to chest pain, women can alternatively present with pain in their necks, backs, shoulders or jaws, which, along with nausea and stomach upset, they mistake for heartburn.”
Retzer says women are often reluctant to complain to their doctors about these symptoms because they fear being embarrassed.
“Women come into our clinic wanting to dismiss their symptoms as something else,” Retzer says. “We would much rather you present with symptoms that turn out not to be caused by the heart than to miss those symptoms that are. Women should never be afraid to ask or seek help. To put it bluntly, sugarcoating the symptoms doesn’t help anyone. Finding out they don’t have heart disease is a huge relief to both the patient and physician. Finding out if they do is the first step to appropriate treatment.”
Women don’t necessarily need to see a cardiologist until after their primary physician suspects heart disease, Retzer says, but it’s important to seek care when suspicions arise.
Once a physician is involved, testing can be ordered to determine what type of heart problem may exist, and whether this condition involves valve disease, blocked arteries, electrical disorders, or dysfunctions of the squeezing function of the heart itself.
“If testing or physical exam is abnormal, the next steps can include ultrasounds, stress tests and angiograms to pinpoint the cause of their abnormality,” Retzer says.
Ultrasounds can identify tight or leaky valves, as well as problems with the squeezing or relaxing functions of the heart.
“In an angiogram, iodine-based contrast is injected into the arteries and we can see if there is a blockage,” she says. “In most cases, blockages can be fixed immediately, at the time of the initial procedure, with a stent.”
Severely blocked arteries and malfunctioning heart valves also can be surgically repaired with bypass and replacement operations, respectively.
“The good news is that technology is advancing by leaps and bounds,” Retzer says. “While surgical techniques remain the mainstay of therapy, non-surgical, catheter-based and minimally invasive methodologies are improving constantly and at a fantastic rate.”
Following these procedures, patients will need long-term medication management and cardiology follow-up. Patients with coronary disease may need to take medications indefinitely to stabilize blockages and keep stents or bypass grafts open.
Patients with metal valve replacements need to take blood thinners, while those with tissue valve replacements are not required to do so. Metal valves can last between 15 and 30 years, while tissue valves can have a shorter lifespan. Which type of valve a patient receives will ultimately depend on the reason the replacement is needed, the patient’s other medical conditions, and the type and site of the valve needing replacement.
When evaluating a potential cardiac patient, a physician may also diagnose congestive heart failure, a broad term for a multitude of heart conditions that can include damaged or dead heart muscle, weak or ineffective pumping action, or impaired relaxation of the heart.
“Congestive heart failure is diagnosed when the heart is unable to keep up with the blood flow demands of the rest of the body, and can be caused by various underlying conditions,” Retzer says. “Medications to improve heart muscle strength and remove excess body fluid are the primary treatment options. Patients with progressive congestive heart failure are often seen in specialty clinics where their individual conditions can be assessed and treated appropriately.”
Retzer encourages women who are at risk for heart disease to see a physician if they suspect something’s amiss.
“The most important idea is that we are focused sharply on why heart disease in women gets missed and not promptly treated,” Retzer says. “It’s vital to recognize the signs and react appropriately in order to save lives and ensure a better quality of life for women of all ages.”
The Danger of Strokes
Strokes occur when something blocks the flow of oxygenated blood to the brain, causing tissue damage and killing vital brain cells. When women reach the age of 45, they hit a statistical marker after which the risk of stroke increases. Most women don’t even think about the possibility of stroke until they are much older. As they experience menopause and lose the protective effects of estrogen, risk of both heart disease and stroke increases proportionately.
Researchers at the Mayo Clinic report that one-third of strokes occur in women younger than 65. African-American and Hispanic women are more susceptible than are white women. Family and personal histories also play a part.
At Northwest Community Hospital in Arlington Heights, vascular surgeon Dr. Sapan Desai identifies two kinds of strokes: permanent strokes that can cause lasting problems and mini strokes, called a transient ischemic attack (TIA) which last less than 24 hours. Stroke can cause muscle weakness, loss of sensation, slurred speech, blindness and other major brain damage.
“Strokes and heart attacks have this similarity, that some event causes vital cells to die from lack of blood flow,” Desai says. “One of the primary causes is blockage to the carotid and vertebral arteries that carry blood from the heart through the neck to the brain. If these become too constricted or totally blocked, the blood supply is cut off.”
Desai explains that plaque buildup in these arteries can slow the flow of blood. When a clot or piece of plaque obstructs the arteries or moves through the arteries to lodge in the brain, strokes can occur.
“Some patients have significant blockage in these arteries,” he says. “At certain levels, it becomes necessary to open them up again, much like a plumber cleans clogged pipes. It’s a relatively simple, straightforward operation that patients normally tolerate well.”
In other cases, Desai says, adverse conditions within the heart itself can cause strokes, particularly with atrial fibrillation (A-fib). The abnormal heartbeat that signifies A-Fib interrupts the consistent blood flow and can precipitate a stroke due to clot formation.
“Medications can help control A-fib, as can a pacemaker,” Desai says. “For more severe cases, surgery may be necessary to ablate the nerve ends, scarring them and blocking the stimulation that creates A-fib.”
Stroke may also be connected with peripheral artery disease (PAD), a condition in which the veins and arteries in the legs, and less commonly in the arms, become blocked and restrict smooth blood flow.
“Medications may help to alleviate this or the blood vessels can be cleaned out as is done with the arteries in the neck,” Desai says. “In cases when the blood vessels are severely blocked, we can do bypass surgery just as is done with the heart when those arteries are blocked beyond treatment with stenting.”
Desai says women can improve their odds of avoiding strokes by following the common-sense advice of medical professionals.
“If you are smoking, stop immediately,” he stresses. “Regular exercise is important, as is losing weight and maintaining an appropriate weight. Diet is vital as well. Eating a healthy, low-fat diet helps prevent strokes and so many other diseases. So, too, does reducing the amount of alcohol you consume.”
Desai also recommends that women see their primary physicians regularly and monitor their blood pressure and cholesterol levels.
“Women will benefit from taking a statin to control cholesterol and blood pressure-lowering medication as needed,” he says. “Also, a baby aspirin daily can help by reducing the chances of clotting.”
Many women are unaware of the signs of a stroke and thus delay seeking care until damage has already been done. These may be signs of a stroke: sudden weakness or numbness in the arms, legs or face, particularly if it occurs on one side of the body; confusion, difficulty understanding what people are saying or experiencing trouble speaking; loss of coordination, balance or an inability to walk.
Treating Lung Cancer
Some cancers have longer survivor rates and improved cure rates, but lung cancer remains an ever-present threat to women.
The CDC reports that lung cancer is the leading cause of cancer death, and the second most commonly diagnosed cancer (excluding skin cancer), among men and women in the United States.
The good news is that the incidence of lung cancer is declining nationwide for both men and women. Dr. Bryan Macrie, a radiation oncologist with Presence Saint Joseph Hospital in Elgin, says the bad news, however, is that the number of new cases among women is declining at a slower rate than for men. Women’s rates declined only 1.9 percent per year, while men’s rates declined 3 percent per year between 2008 and 2012.
“Even with the decline, lung cancer remains a major public health issue facing both men and women,” Macrie says. “Fundamentally, smoking is the No. 1 risk factor for developing lung cancer in both men and women. It’s not entirely known why women are lagging in the decline, though greater emphasis on smoking prevention and cessation for women by their providers may be warranted.”
Lung cancer can be caused by environmental exposures, but the CDC reports that 80 to 90 percent of lung cancers are attributed to cigarette smoking and secondhand smoke. Macrie points out that nonsmoking women still are vulnerable to lung cancer, with one of the reasons being a speculative link to the effects of estrogen.
“Although the linkage remains controversial, there are data suggesting a greater incidence of lung cancers among women who receive estrogen as part of hormone replacement therapy,” he says. “Lung cancer is more common in nonsmoking women than in men who don’t smoke.”
Women who don’t smoke are more likely than their male counterparts to develop a specific sub-type of lung cancer called an adenocaricinoma that may also exhibit a specific gene mutation, Macrie says.
“This mutation occurs in a gene that codes for a receptor called epidermal growth factor receptor (EGFR) that is normally found on the surface of tumor cells,” he explains. “But in its mutated state, it can cause uncontrolled cell growth and development. Women with EGFR-mutated lung cancers tend to develop their cancer at a younger age than those who have smoking-associated lung cancers that do not share the same mutation.”
Lung cancer treatment follows pretty much the same pattern for men as for women, but Macrie points out that women often do better than men while under treatment.
“It’s possible that women may be more compliant patients and follow medical advice better than men, on the whole,” he says. “One other advantage is that women are more likely to be diagnosed at earlier stages because they seek medical care more regularly, and abnormalities are therefore detected sooner.”
Macrie says lung cancer is treated with surgery, chemotherapy and radiation with the course of treatment designed to meet the patient’s specific needs.
“Surgery may be the first line of treatment if the patient has earlier-stage lung cancer,” he says. “For those whose cancer is more advanced or who have other health conditions that may make surgery too risky, we begin chemotherapy and radiation customized specifically to their particular needs.”
When a woman is a smoker, Macrie says, she may have also developed cardiopulmonary conditions such as congestive obstructive pulmonary disease (COPD), which would complicate lung cancer treatment. In this type of patient, Macrie says, surgery may not be possible due to insufficient pulmonary reserve. Instead, targeted radiation and aggressive chemotherapy are used to combat the cancer.
“Once the treatment is completed, women tend to have better survival outcomes,” he says. “This is true with respect to response rates to second-line treatment in the event the cancer recurs. Lung cancer is a stubborn disease that is difficult to treat, at best.”
The experts at Presence Saint Joseph Hospital’s Meadows Regional Cancer Care Center focus on prevention, diagnosis and treatment of cancers. In their pursuit of improved diagnostics, one recently introduced program to screen men and women who have a long-term smoking habit aims to detect new cancers at an earlier time point, when they’re far more curable.
“These high-risk patients are given surveillance CT scans in an effort to catch lung cancer at earlier stages,” Macrie says. “Major insurance companies are covering these procedures as research shows that they reduce lung cancer mortality and are therefore a proactive way of reducing health care costs. I strongly recommend that women who smoke talk to their primary physicians about eligibility in this program.”
Medical professionals agree that much remains to be done in the advancement of prevention, diagnosis, treatment and support for women not only with cardiac, stroke and lung cancer but with other illnesses as well. The key to success hinges on public awareness and education as well as the continued promotion of sound health practices and constant vigilance.
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