Pheochromocytoma

Pheochromocytoma is a rare tumor that usually starts in the cells of one of your adrenal glands. Although they are usually benign, pheochromocytomas often cause the adrenal gland to make too many hormones. This can lead to high blood pressure and cause symptoms such as :

• Headaches
• Sweating
• Pounding of the heart
• Being shaky
• Being extremely pale

Sometimes pheochromocytoma is part of another condition called multiple endocrine neoplasia syndrome (MEN). People with MEN often have other cancers and other problems involving hormones.

Doctors use lab tests and imaging tests to diagnose it. Surgery is the most common treatment. Other options include radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute

Pregnancy

You're going to have a baby! It's an exciting time, but it can also feel a bit overwhelming. You may have a lot of questions, including what you can do to give your baby a healthy start. Taking care of your health while you're pregnant will help your fetus develop into a healthy baby. To do that, it's important to:

• Have regular visits with your health care provider. During prenatal care visits your provider checks your health and carefully monitors your pregnancy until you deliver a healthy baby. And if there are any health problems, your provider can find them early. Getting treatment right away can cure many problems and prevent others.
• Eat healthy and drink plenty of water. Good nutrition during pregnancy includes eating a variety of:
  • Fruits
  • Vegetables
  • Whole grains
  • Lean meats or other protein sources
  • Low-fat dairy products
• Take prenatal vitamins. During pregnancy, you need higher amounts of certain vitamins and minerals, such as folic acid and iron.
• Be careful with medicines. Always check with your provider before you start or stop any medicine. This includes over-the-counter medicines and dietary or herbal supplements.
• Stay active. Physical activity can help you stay strong, feel and sleep better, and prepare your body for birth. Check with your provider about which types of activities are right for you.
• Avoid substances that could hurt your baby, including alcohol, drugs, and tobacco.

Your body will keep changing as your fetus develops until your baby is ready to be born. It can be hard to know whether a new symptom is normal or could be a sign of a problem. Check with your provider if something is bothering or worrying you.

Pregnancy and Nutrition

What is nutrition, and why is it important during pregnancy?

Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that it needs. Nutrients are substances in foods that our bodies need so they can function and grow. They include carbohydrates, fats, proteins, vitamins, minerals, and water.

When you're pregnant, nutrition is more important than ever. You need more of many important nutrients than you did before pregnancy. Making healthy food choices every day will help you give your baby what they need to develop. It will also help make sure that you and your baby gain a healthy amount of weight.

You need more folic acid, iron, calcium, and vitamin D than you did before pregnancy:

• Folic acid is a B vitamin that may help prevent neural tube defects.
  • Before pregnancy, you need 400 mcg (micrograms) per day.
  • During pregnancy and when breastfeeding, you need 600 mcg per day from foods and/or vitamins. It is hard to get this amount from foods alone, so you will most likely need to take a supplement that contains folic acid.
• Iron is important for your baby's growth and brain development. During pregnancy, the amount of blood in your body increases, so you need more iron for yourself and your growing baby. You should get 27 mg (milligrams) of iron a day.
• Calcium during pregnancy can reduce your risk of preeclampsia. It's a serious medical condition that causes a sudden increase in your blood pressure. Calcium also builds up your baby's bones and teeth.
• Pregnant adults should get 1,000 mg (milligrams) of calcium a day
• Pregnant teenagers (ages 14-18) need 1,300 mg of calcium a day
• Vitamin D helps the calcium to build your baby's bones and teeth. All women, pregnant or not, should be getting 600 IU (international units) of vitamin D per day.

Keep in mind that taking too much of a supplement can be harmful. For example, very high levels of vitamin A can cause birth defects. Only take vitamins and mineral supplements that your health care provider recommends.

You also need more protein when you are pregnant. Healthy sources of protein include beans, peas, eggs, lean meats, seafood, and unsalted nuts and seeds.

Getting enough fluids is another special nutritional concern during pregnancy. When you are pregnant, your body needs even more water to stay hydrated and support the life inside you. So it's important to drink enough fluids every day.

How much weight you should gain depends on your health and how much you weighed before pregnancy:

• If you were at a normal weight before pregnancy, you should gain about 25 to 35 pounds
• If you were underweight before pregnancy, you should gain more
• If you were overweight or had obesity before you became pregnant, you should gain less

Check with your provider to find out how much weight gain during pregnancy is healthy for you. You should gain the weight gradually during your pregnancy, with most of the weight gained in the last trimester.

How many calories you need depends on your weight gain goals. Your provider can tell you what your goal should be, based on things like your weight before pregnancy, your age, and how fast you gain weight. The general recommendations are:

• In the first trimester of pregnancy, you probably do not need extra calories
• In the second trimester, you usually need about 340 extra calories
• In the last trimester, you may need around 450 extra calories per day
• During the final weeks of pregnancy, you may not need extra calories

Keep in mind that not all calories are equal. You should eat healthy foods that are packed with nutrients - not "empty calories" such as those found in soft drinks, candies, and desserts.

During pregnancy, you should avoid:

• Alcohol. There is no known amount of alcohol that is safe for a woman to drink during pregnancy.
• Fish that may have high levels of mercury. Limit white (albacore) tuna to 6 ounces per week. Do not eat tilefish, shark, swordfish, marlin, orange roughy, or king mackerel.
• Foods that are more likely to contain germs that could cause foodborne illness, including
  • Refrigerated smoked seafood like whitefish, salmon, and mackerel
  • Undercooked meat, poultry, eggs, and seafood
  • Refrigerated meat spreads
  • Store-made salads, such as chicken, egg, or tuna salad
  • Unpasteurized or raw milk
  • Unpasteurized juices or cider
  • Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses
  • Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)
  • Raw cookie dough
  • Unwashed fruits and vegetables
• Too much caffeine. Drinking high amounts of caffeine may be harmful for your baby. For most people, it's best to limit caffeine to less than 200 mg per day during pregnancy. But first check with your provider about whether you should have caffeine at all.

Prostate Cancer

What is prostate cancer?

Cancer is a disease in which cells in the body grow out of control. Prostate cancer begins in the cells of the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

Prostate cancer is one of the most common types of cancer. It often grows very slowly. If it does not spread to other parts of the body, it may not cause serious problems. But sometimes prostate cancer can grow quickly and spread to other parts of the body. This kind of prostate cancer is serious.

Researchers don't know for sure what causes prostate cancer. They do know that it happens when there are changes in the genetic material (DNA).

Sometimes these genetic changes are inherited, meaning that you are born with them. There are also certain genetic changes that happen during your lifetime that can raise your risk of prostate cancer. But often the exact cause of these genetic changes is unknown.

Anyone who has a prostate can develop prostate cancer. But certain factors can make you more likely to develop it:

• Age. Your chance of developing prostate cancer increases as you get older. Prostate cancer is rare in people under age 50.
• Family health history. Your risk of prostate cancer is higher if you have a parent, sibling, or child who has or has had prostate cancer.
• Race. African Americans are more likely to get prostate cancer. They're also more likely to:
  • Get prostate cancer at a younger age.
  • Have more serious prostate cancer.
  • Die from prostate cancer.

Prostate cancer doesn't always cause symptoms, especially at first. If it does cause symptoms, they may include:

• Problems urinating (peeing), such as:
  • A urine stream that's weak, hard to start, or starts and stops
  • Suddenly needing to urinate right away
  • Urinating often, especially at night
  • Pain or burning when urinating
  • Blood in your urine or semen
• Pain in your lower back, hips, or pelvis that does not go away
• Painful ejaculation (the release of semen through the penis during orgasm)

But many of these symptoms may be from other common prostate problems that aren't cancer, such as an enlarged prostate.

You should discuss your prostate health with your health care provider if you:

• Have symptoms that could be prostate cancer
• Have a high risk for developing prostate cancer
• Had a screening test that suggests you could have prostate cancer

Tests which check for prostate cancer include:

• A digital rectal exam (DRE). In this exam, your provider feels your prostate for lumps or anything unusual by inserting a lubricated, gloved finger into your rectum.
• A prostate-specific antigen (PSA) blood test. A high PSA blood level may be a sign of prostate cancer. But many other things can cause high PSA levels, too.
• Imaging tests. These tests may use ultrasound or MRI to make pictures of your prostate.

If these tests show that you might have prostate cancer, the next step is usually a prostate biopsy. A biopsy is the only way to diagnose prostate cancer.

During a biopsy, a doctor uses a hollow needle to remove some prostate tissue. The tissue is studied under a microscope to look for cancer cells.

Your treatment options usually depend on your age, your general health, and how serious the cancer is. Your treatment may include one or more options:

• Observation,which is mostly used if you are older, your prostate cancer isn't likely to grow quickly, and you don't have symptoms or you have other medical conditions. Your doctor will keep checking on your cancer over time so to see whether you will need to start treatment for the cancer. There are two types of observation:
  • Watchful waiting means having little or no testing. If symptoms begin or change, you will get treatment to relieve them, but not to treat the cancer.
  • Active surveillance means having regular tests to see if your prostate cancer has changed. If the tests show the cancer is starting to grow or if you develop symptoms, then you will have treatment to try to cure the cancer.
• Surgery to remove your prostate gland may be an option if your cancer hasn't spread outside of your prostate.
• Radiation therapy uses high energy to kill cancer cells or prevent them from growing.
• Hormone therapy blocks cancer cells from getting the hormones they need to grow. It may include taking medicines or having surgery to remove the testicles.
• Chemotherapy uses medicines to kill cancer cells, slow their growth, or stop them from spreading. You might take the drugs by mouth, as an injection (shot), as a cream, or intravenously (by IV).
• Targeted therapy uses drugs or other substances that attack specific cancer cells. This treatment causes less harm to healthy cells than radiation therapy or chemotherapy.
• Immunotherapy helps your own immune system to fight cancer.

Making healthy lifestyle changes may help to prevent some prostate cancers. These changes include:

• Being at a healthy weight
• Quitting smoking
• Getting enough exercise
• Eating healthy foods

NIH: National Cancer Institute

Rickets

Rickets causes soft, weak bones in children. It usually occurs when they do not get enough vitamin D, which helps growing bones absorb the minerals calcium and phosphorous. It can also happen when calcium or phosphorus levels are too low.

Your child might not get enough vitamin D if he or she:

• Has dark skin
• Spends too little time outside
• Has on sunscreen all the time when out of doors
• Doesn't eat foods containing vitamin D because of lactose intolerance or a strict vegetarian diet
• Is breastfed without receiving vitamin D supplements
• Can't make or use vitamin D because of a medical disorder such as celiac disease

In addition to dietary rickets, children can get an inherited form of the disease. Symptoms include bone pain or tenderness, impaired growth, and deformities of the bones and teeth. Your child's doctor uses lab and imaging tests to make the diagnosis. Treatment is replacing the calcium, phosphorus, or vitamin D that are lacking in the diet. Rickets is rare in the United States.