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- [00:04]
Dr. Sanjay Gupta
Welcome to Paging Dr. Gupta. This is the place where I get to answer the questions that you've been wondering about straight from your everyday life. I love hearing from you. I get to hear your voices. I get to hear your stories, and of course, your real health questions. So Kira's back with us. Who do we have first?
- [00:21]
Kira
Hey, Sanjay. So we're starting off today with a great question and I think the timing is perfect since July is actually bone cancer awareness month. Here it is.
- [00:31]
Nancy
Hey, Dr. Gupta, I've got a cancer question. So I'm 77 years old. I live in California. Both my parents, raised in totally different environments, died from bone cancer. So I became concerned and wondered if I was prone to a bone cancer death. I read that cancer is a gene present in every person. And my understanding is that there are different triggers that activate the cancer gene. When I expressed my concern to three different doctors, all said, cancer doesn't work like that. So my question is then how does it work? Since I can't get a cancer screening without medical approval unless I have cancer, what can I do to be more proactive other than diet and exercise? Thank you so much. Have a great day.
- [01:18]
Caller
Bye.
- [01:18]
Nancy
Bye.
- [01:19]
Dr. Sanjay Gupta
Well, thank you so much for sending in this question. I have to say it makes a lot of sense that you're asking this. You've lost both parents to the same type of cancer, so I think it's natural to wonder what that might mean for you. And I'm going to dive into what you need to know around this in just a moment.
- [01:37]
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- [02:21]
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- [02:51]
Dr. Sanjay Gupta
Let'S start with how cancer actually works. You referenced something important. This idea that cancer is a gene present in every person and it somehow gets triggered or activated. That's a pretty common belief, but that's not quite how it works. First of all, cancer isn't a single gene. It's a group of diseases caused by changes or mutations in your DNA. So just to get some terms straight, DNA, deoxyribonucleic acid. That's the master blueprint for your life. Contains all the genetic instructions for your development, for your function. Now, genes are specific segments of DNA, and they are essentially the code for proteins. And then there's rna, which act as messengers carrying genetic information from DNA to the protein synthesis machinery inside your cells. So just make sure you understand all these different terms. DNA is the set of instructions that tells your cells what to do, how to grow, how to divide. Errors in the instructions can cause the cell to stop its normal function and become abnormal. Cancer is the development of abnormal cells and that divide uncontrollably and then have the ability to infiltrate and destroy healthy body tissue. Okay, so these are the important terms to sort of think about if you want to just rewind and play that section again so you make sure you understand what we're talking about here when it comes to genetics. Now, some of these cell changes or mutations are inherited, meaning that you're born with them. For example, a predisposition to breast or ovarian cancer. There's something known as the BRCA1 or BRCA2 gene. But sometimes these mutations happen over time due to aging, environmental exposure, Cigarette smoke, chemical sunburns, lifestyle factors. Sometimes they just happen by random chance. So while we all have genes that can mutate, that does not mean everyone has a cancer gene waiting to be triggered. Now, let's talk about bone cancer, Specifically, primary bone cancers. Those that start in the bone, they're actually quite rare in adults. How rare? They account for less than 1% of all cancers in the United States every year. More often, what people call bone cancer is actually a different cancer, like breast cancer or prostate cancer that has then spread or metastasized to the bones. So if both your parents had cancer in the bones. It's worth asking, is it primary bone cancer? Did it start there or did it spread there? Meaning is it metastatic? Those details matter a lot when thinking about your own risk. Now, there are some rare hereditary cancer syndromes that can increase the risk for certain bone cancers. There's something known as Li Fraumeni syndrome. In that case, you lose tumor suppression. Okay, so your body is constantly suppressing tumors. If you can't do that as well, certain tumors may be allowed to grow. There's also something known as hereditary retinoblastoma, and that can be associated with benign bone tumors, but these are very uncommon, and they usually show up earlier in life. Having said all that, most people will typically acquire the gene changes that lead to bone cancer during their life, rather than inheriting them from a parent. Or as I mentioned earlier, the bone cancer may be the result of metastatic disease, meaning it's coming from a different cancer. As a result of that, there's really not routine screening for bone cancer, unless you're having symptoms or if you have a really strong family history of a known hereditary cancer syndrome. If, after some digging, you find that your parents and possibly other relatives had similar cancers, and then it might be worth discussing genetic counseling with your doctor, maybe you have one of these rare syndromes. So to answer the main part of your question, what can you do if there's no standard screening test for bone cancer? Well, plenty, actually. New study from the American Cancer Society found that nearly 40% of cancer cases in adults 30 and over can be linked to modifiable lifestyle risk factors. I know this sounds boring, but, man, it really works. Smoking, that's still your biggest risk factor. Excess body weight, physical inactivity, poor diet, alcohol use, some infections like hpv. These are factors you can control every day. And here's another striking the number of deaths in the United States linked to preventable risks, nearly half. Okay. The number of deaths in the United States linked to preventable risks, Nearly half. So what should you do today? Talk to your doctor about genetic counseling. Again, if there's a strong family history, a counselor can help determine whether testing is appropriate. Keep up with screenings for other cancers. Recommended for your gender and your age group. Breast cancer, colon cancer, prostate cancer. Maintain a healthy weight. Stay physically active. Excess weight is now the second leading cause of preventable cancer in the United States, especially for endometrial cancer, liver cancer, and kidney cancers. Limit alcohol. Limit processed foods. Do wear your sunscreen when you're getting out in the sun, especially this time of year. And make it a point to get checked annually as well. Hope that helps. Now, Is taking a sleeping pill every night better or worse than waking up every hour? We'll dig into what the science says right after the break.
- [08:34]
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- [10:45]
Dr. Sanjay Gupta
Okay Kira, what do we have next?
- [10:47]
Kira
So Nancy sent us our next question and if you've ever dealt with waking up in the middle of the night and not being able to fall back asleep, you're going to want to hear the answer to this. Take a listen.
- [10:56]
Caller
Hi Sanjay, My name is Nancy from Southern California. My question to you is concerning sleep aids. I take a half a sleeping pill every night so I will sleep for more than four to five hours. I'm really excited when I wake up at 2am and can't get back to sleep and want to start my day but I know I can't because I'll be tired during the day. Is it worse to take a half a sleeping pill on a regular basis than to go back to sleep for an hour, wake up, go back to sleep for an hour, wake up and finally get out of bed after about 6 hours? Would love to hear the answer to that.
- [11:39]
Nancy
Thanks.
- [11:39]
Caller
Bye.
- [11:40]
Dr. Sanjay Gupta
Nancy, Great question. We decided to choose your question because we get a lot of questions in this same bucket. You're not alone. Millions of people have trouble staying asleep, not just falling asleep. Okay, These are not exactly the same thing. Some people can initiate sleep fine but keep waking up in the middle of the night. Other people really have difficulty falling asleep in the first place. CDC found that about 6% of American adults in use sleeping medications every single night and about 20% of us 1 in 5 take them at least occasionally. So your dilemma Take half a pill nightly versus endure something known as fragmented sleep. That's an important dilemma. So let's first address the issue about whether or not you should be cutting your pill in half in the first place. Coated pills or tablets that are slowly released in your body, like extended release, sustained release or long acting formulations, they should not be cut. Why? Because cutting interferes with the steady delivery of that medication over time. Capsules should not be split, crushed or opened unless specifically recommended by your healthcare provider. Pills or tablets that can be cut typically have a scored mark down the middle of the pill with a line or indentation. The reason I bring this up is because depending on the type of pill you're taking, cutting it could be the reason you're waking up at 2am you may not be getting the same extended release properties of the medication. So now assuming that part is okay, that that's not the problem, let's tackle the rest of your question starting with fragmented sleep. First, you mentioned when you don't take a sleeping pill, you wake up and fall back asleep for an hour here and there. Now, even if that adds up to six hours total, when your sleep keeps getting interrupted, your brain's probably not getting enough deep sleep or what is known as REM sleep. Those are the stages that really help you feel rested. So even if you do get six hours like that, it's probably going to make you feel unrefreshed or sort of dragging the next day. Now, what about taking that half pill every night? Here's where it gets tricky. It does depend on what you're taking. There are several different types of medications to help you sleep. There are short acting sleep aids like Ambien or Sonata. They're designed to help you fall asleep, but not necessarily stay asleep. Remember that other sleep aids are medium or long acting. They work because they stay in the body longer, but they can cause a hangover effect the next morning. And then there are medications that work in even different ways to help you get some sleep. You're definitely going to want to talk to your doctor to make sure you're taking the right type of medication for the type of insomnia that you have. Now, I do want to raise the concern about using any kind of sleep aid regularly. These medications can have short and long term side effects depending on the class of drugs. Even occasional use can cause dependence. That means your brain and body get used to it. What is known as rebound insomnia, where your sleep will actually get worse if you try and stop the medications. There can be other side effects like memory issues, daytime drowsiness, and in rare cases, people have even engaged in activities in their sleep. Things like eating, making phone calls, or even driving without knowing it. Older adults in particular should be careful because they are more susceptible to side effects and that could lead to falls, which can be really harmful. Now, I think because of a lot of warnings and uncertainties, people have increasingly turned to things like antihistamines or melatonin for help. But over the counter doesn't necessarily mean off the hook. Antihistamines like Benadryl can make you very groggy and dizzy and even confused the next day. Melatonin is a natural hormone, but remember, the supplement form is not FDA regulated, so doses can vary a lot. And more is not always better. There is a third option which a lot of people forget because it's not a quick fix. But it's something known as cognitive behavioral therapy for insomnia. This is often more effective than pills. And it's not just about sleep hygiene. Like, you know, cool bed and don't scroll before bed. Cbt Insomnia. Cbt. I can help retrain your brain to fall asleep and stay asleep. It can be done with a specialist, can even be done online now. So, Nancy, takeaway is this honestly both choices. Nightly pills or broken up sleep have downsides. You know that the best path, though, may be talking with your doctor about what's really waking you up at 2am could it be stress? Could it be a medical issue? Could it be sleep apnea? Keep in mind what I said about splitting the pills as well. That could be part of the problem. And then finally, if you're still having trouble, a sleep study or CBTI might give you some better answers, some better options, and some better rest. Look, don't just patch your sleep night to night. There are better, safer tools out there that can truly help you feel rested once again. Hope that helps. Thanks to everyone who sent in the questions. I say it all the time. It's true this show would not exist without you and I'm really glad you're part of it. If there's something health related you've been wondering, don't keep it to yourself. Share it, record a voice memo, email it to asksanjaynn.com or give us a call 470-396-0832 and leave a message. Thanks for listening. I'll be back next Tuesday. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sophia Sanchez, Kira Dehring and Madeline Thompson. Andrea Cain is our medical writer. Our senior producer is Dan Bloom. Amanda Seeley is our showrunner, Dan Dijiula is our technical director and the executive producer of CNN Audio is Steve Lichtai, with support from Jamis Andrest, John Dionora, Hailey Thomas, Alex Manasseri, Robert Mathers, Lainey Steinhart, Nicole Pesaru and Lisa Namorow. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Wendy Brundage.
- [18:10]
Sleep Number Ad
This CNN podcast is supported by Sleep Number when something's made for you, it simply fits. You feel special. That's the sensation of a Sleep Number Smart bed. You'll sleep comfortably, hot or cold, soft or firm, because it's personalized, scientifically made for you. The tech in a Sleep Number Smart bed automatically responds to your movements throughout the night, keeping you comfortable and, most importantly, sleeping soundly. Sleep too hot? The Klymit Series Smart beds cool up to 20 times faster than leading competitors. Getting great sleep is the journey of a lifetime and your Sleep number Smart Bed tracks the evolution and improvement of your sleep for you and your partner. It's designed to make each night's rest even better. Why choose a Sleep Number Smart bed? So you can choose your ideal comfort on either side. The only bed that lets you make each side firmer or softer whenever you like your Sleep Number setting. And now it's the Sleep Number 4th of July sale. Save over $600 on the Sleep Number P5 King Smart Bed, the lowest price of the season. Limited time, exclusively at a Sleep Number store near you. See store or sleepnumber.com for details.
- [19:14]
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