Rx for Readers: Reduce the risks!
A healthy lifestyle can minimize the chance of cancer recurrence and heart disease.
Human heart Photo: Thinkstock/Imagebank
I am a 64-year-old woman who has recovered from breast cancer. I am grateful,
but I am nervous because I read recently that the most common cause of mortality
in breast cancer survivors is heart disease. Do chemotherapy and other cancer
therapies increase the risk of cardiovascular disease? Is there any other
connection? I am somewhat overweight but not obese. Besides losing some weight,
what else can I do? Why didn’t my oncologist tell me that I had this risk?
Prof. Nathan Cherny, senior oncologist and director of the cancer
pain and palliative medicine service at Jerusalem’s Shaare Zedek Medical Center,
Everyone dies of something. Yes, it is true that if your cancer doesn’t
recur (which it probably will not) and you do not succumb to bad drivers,
terror, war or dementia, the most common cause of death in the Western world,
including Israel, is heart disease or stroke.
Indeed, for all persons who
are have a relatively low risk of dying of cancer and for people who never get
cancer, the most common cause of death is cardiovascular or cerebro-vascular. It
is not that the treatments of the disease have made a major increase in risk.
(There are some very minor changes in risk associated with left-chest-wall
radiotherapy, doxorubicin chemotherapy or Herceptin.) Rather, when you factor in
not dying from the disease that has been cured, this is what awaits all of us as
The good news is that for most cancer survivors, the actuarial
curves for overall survival (how long we live) start to approach those of the
“never-ill-withcancer” about five to 10 years after treatment, when the risk of
dying of cancer starts to become very small.
Everyone – cancer survivors
as well – can reduce their risk of heart disease by not smoking, controlling
blood pressure and cholesterol and – probably most important – getting regular
exercise. For survivors of breast cancer like yourself, healthy diet and regular
exercise also reduce the risk of cancer recurrence.
Thus, a healthy
lifestyle has a double advantage.
So if you are not yet doing it, get
into a routine of 30 minutes to an hour of moderate exercise at least three
times per week; get your blood pressure and cholesterol checked; eat fish,
vegetables and fruit for fiber and antioxidants; and keep the steak and lamb for
infrequent special events. Finally, celebrate in being able to be a
I have more than once bought shoes or sneakers that seem to fit
properly, yet after wearing them several times my big toe (usually the left one)
begins to get black and blue. What could be the reason for this? I can’t buy a
larger size, since the shoes are really too big. I wear orthotics because of
high arches and always put in the orthotics when I try on the
L.F., via email
Dr. Cobi Lidor, an orthopedist with special
expertise in feet at Assuta Medical Center’s Basil Heights Medical Center, a
subsidiary of Maccabi Health Services, replies:
When this problem occurs, it is
best to go quickly to a foot specialist so the problem can be diagnosed. You
didn’t indicate what your weight and height are. The heavier and taller you are,
the riskier it is. I can’t tell from your question if you wear proper stockings
or socks. If you don’t, friction could be causing the problem. It is best to
purchase soft shoes that are flat or near-flat with round toes so they will not
press on your feet and they will be more comfortable.
Buy shoes that are
half a centimeter longer than your foot.
But the most important thing is
never to buy shoes at the start of the day. Buy them at the end of the day, when
your feet are somewhat swollen. If you are buying new shoes for a special event
like a wedding, don’t buy a pair very soon before but weeks before. This gives
you a chance to try them out and make sure they are comfortable before the
event. If they are not comfortable, you have time to buy different
Also, when you go to the shoe store, don’t just put on shoes, look
at them in the mirror and buy what looks good.
Walk around as much as you
can in the shoes so you can really feel if they fit and are
I am a 25-year-old woman, and I love the pointy platform
high heels that are sold today because they are fashionable and make me look
sexy. But I know they are not good for me. For example, they gave me an ingrown
toenail and an infection on one foot recently. Do you have any advice for having
healthy feet even if I wear these shoes from time to time?
P.T., Tel Aviv
Lidor answers this question as well:
Many of the women’s shoes sold today are a
disaster for healthy feet, including platforms and incredibly high heels that
stretch the Achilles tendon and squeeze the toes and put a lot of pressure on
They also put women at risk for falls. As an orthopedist, I cannot
endorse wearing these at all. If you suffer from wearing them, you
But if you refuse to budge and wear them only for special
occasions, there are some things you can consider: You should wear clean
stockings; if they are dirty, bacteria and fungus could enter the toes and get
under the nails, which should be cut straight across. Don’t wear tight
Make sure your feet are soft and clean.
Soak your feet
for a short time in lukewarm, soapy water and dry them carefully, including
between the toes. You can also apply moisturizer. Try very hard to limit the
time you wear high-heeled shoes.
Pressure from the shoe on your toes can
prevent the nails from growing properly and cause an infection. Infected ingrown
toenails (medically known as onychocryptosis) are not only unpleasant but can
also be dangerous. In diabetics who do not have normal feeling in the
extremities, untreated infections could turn into serious complications and even
Rx for Readers welcomes queries from readers about
medical problems. Experts will answer those we find most interesting. Write Rx
for Readers, The Jerusalem Post, POB 81, Jerusalem 91000; fax your question to
Judy Siegel-Itzkovich at (02) 538-9527; or email it to email@example.com, giving
your initials, age and place of residence.