Health News. Lots of resources and medical information

The question the reader will ask at this point is ‘Given all this epidemiological study, do we know the causes of cancer?’ Broadly the answer is ‘yes’ in many circumstances and for many cancers, and the opportunities for prevention that this understanding generates are there to be taken. We do not always know how the factors that have been identified by the epidemiological studies discussed in this chapter link up to what is being learned in the laboratories of the molecular biologists. This connection is being made rapidly and will be increasingly clear by the end of the century. Epidemiology has been very successful in discovering or confirming which features of our lives in the Western world can be now identified as causes of cancer. Sunlight. Ultraviolet irradiation from the sun is the main cause of skin cancers, including melanoma. Alcohol. Alcohol contributes to cancers of the upper digestive tract, particularly in combination with smoking. It probably also contributes to cancers of the liver, mainly, but perhaps not exclusively, through causing cirrhosis of the liver. There is little doubt that advice on the avoidance of heavy drinking is sound if we wish to reduce cancer risk as well as the other risks with which drinking is associated.Occupations. Cancer epidemiology really began with Percival Pott and his chimney-sweeps, and, for many researchers, creating a safe workplace and eliminating risks is a central purpose of epidemiological studies. Chemical dyes and asbestos have been identified as causes of cancer and eliminated in the workplace, but constant vigilance is still in order. New and stringent regulations permitting only limited exposure to substances hazardous to health arc now in force in many Western European countries, and their extension to Eastern Europe represents a significant financial, political and medical challenge.Environmental Pollution. Most of the factors that are hazardous in the workplace arc found in lower concentrations in the general environment and may well contribute to cancer risk. Atmospheric pollution probably plays only a limited role in lung cancer, but asbestos in the general environment has undoubtedly contributed to the level of risk.*33\194\4*

A few words are in order on behalf of older children in an alcoholic family. In many cases, children’s problems are related to stress in the parents. Children may easily become weapons in parental battles. With alcoholism, children may think their behavior is the cause of the drinking. A child needs to be told that this is not the case. In instances where the counselor knows that physical or severe emotional abuse has occurred, child welfare authorities must be notified. In working with the family, additional parenting persons may be brought into the picture. Going to a nursery school or day-care center may help the child from a chaotic home.What cannot be emphasized too strongly is that children not be “forgotten” or left out of treatment. Sometimes parents consider a child too young to understand, or feel the children need to be “protected.” What this can easily lead to is the child’s feeling even more isolated, vulnerable, and frightened. Children in family sessions tend to define an appropriate level of participation for themselves. Sometimes the presence of children is problematic for adults not because they won’t understand, but because of their uncanny ability to see things exactly as they are: for example, without self-consciousness the child may say what the rest are only hinting at, or may ask the most provocative questions. Along the same line, while a parent is actively drinking, the inevitable concerns and questions of the child must be addressed. Children may not need all the details, but pretense by adults that everything is okay is destructive. When initially involving the family, consider the children’s needs in building a treatment plan. Many child welfare agencies or mental health centers conduct group sessions for children around issues of concern to children, such as a death in the family, divorce, or alcoholism. Usually these groups are set up for children of roughly the same age, and run for a set period, such as 6 weeks. The goal is to provide basic information, support, and the chance to express feelings the child is uncomfortable with or cannot bring up at home. The subliminal message of such groups is that the parents’ problems are not the child’s fault, and talking about it is okay. In family sessions you can make that message clear, too. You can provide time for the child to ask questions and also provide children with pamphlets that may be helpful for them.Occasionally a child may seem to be “doing well.” In fact, the child may reject efforts by others to be involved in alcohol discussions or treatment efforts. If the alcoholic parent is actively drinking, the resistance on the child’s part may be part of the child’s way of coping. Seeing you may be perceived by the child as taking sides; it may force the child to look at things he is trying to pretend are not there. (Resistance also may surface to joining the family treatment when the alcoholic has become sober, for many of the same reasons.) Listen to the child’s objections for clues to the child’s concerns. Feel free to seek advice from a child therapist if you feel you are in danger of getting in over your head. What is important here is not to let a child’s assertion that “everything is fine” pass without some question.*133\331\2*

The dental problems common to all adults—diseases of the teeth and of the supporting structures of the teeth—seem to occur more frequently and more severely in people with HIV infection. See your dentist regularly. Floss and brush your teeth assiduously. Tell your dentist about your HIV infection: people who are prone to dental problems should probably see the dentist more frequently, and the dentist may change some of his or her normal recommendations. Some dentists may also wish to take additional precautions while working in your mouth, even though the standard recommendation is that all people receiving any kind of medical and dental care should be treated as though they have HIV infection.     Get Exercise-Aerobic exercise programs are widely advocated as a way of staying healthy and of preventing cardiovascular disease. Whether exercise is similarly helpful to people with HIV infection is unknown. Most people who exercise regularly, however, feel better both physically and emotionally. There is no reason for a person with HIV infection to avoid regular exercise as long as fatigue or other symptoms do not prevent it.
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