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[ { "from": "human", "value": "Who is at risk for Low Vision??" }, { "from": "gpt", "value": "People age 60 and older, as well as African Americans and Hispanics over age 45, are at higher risk. African Americans and Hispanics are at higher risk for low vision because they are at higher risk for developing diabetes and diabetic retinopathy, and African Americans are at a higher risk for developing glaucoma." } ]

[ { "from": "human", "value": "What is (are) Low Vision?" }, { "from": "gpt", "value": "Many agencies and organizations in the community provide assistance and information to people who have low vision and to their families and caregivers. State agencies for the blind and visually impaired can make referrals to a variety of organizations that provide assistance. Such services include vision rehabilitation, recreation, counseling, and job training or placement. For assistance in finding agencies and organizations, contact: National Eye Institute National Institutes of Health 2020 Vision Place Bethesda, MD 20892-3655 Phone: 301-496-5248 E-mail: 2020@nei.nih.gov Website: http://www.nei.nih.gov/" } ]

[ { "from": "human", "value": "What is (are) COPD?" }, { "from": "gpt", "value": "Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The \"airways\" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band.\n- The walls between many of the air sacs are destroyed.\n- The walls of the airways become thick and inflamed or swollen.\n- Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else." } ]

[ { "from": "human", "value": "What causes COPD?" }, { "from": "gpt", "value": "Smoking Most cases of COPD develop over time, from breathing in fumes and other things that irritate the lungs. Some of the things that put you at risk for COPD include smoking, environmental exposure, and genetic factors. Cigarette smoking is the most common cause of COPD in the United States (either current or former smokers). Pipe, cigar, and other types of tobacco smoking can also cause COPD, especially if the smoke is inhaled. Environmental Exposure COPD can also occur in people who have had long-term exposure to things that can irritate your lungs, like chemical fumes, or dust from the environment or workplace. Heavy or long-term exposure to secondhand smoke or other air pollutants may also contribute to COPD even if you have never smoked or had long-term exposure to harmful pollutants. Secondhand smoke is smoke in the air from other people smoking. Genetic Factors In a small number of people, COPD is caused by a genetic condition known as alpha-1 antitrypsin, or AAT, deficiency. People who have this condition have low levels of alpha-1 antitrypsin (AAT)a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly. While very few people know if they have AAT deficiency, it is estimated that about 1 in every 1,600 people to about 1 in every 5,000 people have it. People with AAT deficiency can get COPD even if they have never smoked or had long-term exposure to harmful pollutants. Asthma Although uncommon, some people who have asthma can develop COPD. Asthma is a chronic (long-term) lung disease that inflames and narrows the airways. Treatment usually can reverse the inflammation and narrowing. However, if not, COPD can develop." } ]

[ { "from": "human", "value": "How to prevent COPD?" }, { "from": "gpt", "value": "If you have COPD, you can take these steps to prevent complications and control the disabling effects of the disease. - Quit smoking.\n- Avoid exposure to pollutants and lung irritants.\n- Take precautions against the flu.\n- Talk to your doctor about the flu and pneumonia vaccines.\n- See your doctor on a regular basis.\n- Follow your treatments for COPD exactly as your doctor prescribes. Quit smoking. Avoid exposure to pollutants and lung irritants. Take precautions against the flu. Talk to your doctor about the flu and pneumonia vaccines. See your doctor on a regular basis. Follow your treatments for COPD exactly as your doctor prescribes. Quit Smoking If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. Quitting can help prevent complications and slow the progress of the disease. It is also important to stay away from people who smoke and places where you know there will be smokers. To help you quit, there are many online resources and several new aids available from your doctor or health care provider. The National Cancer Institute (NCI) has information on smoking cessation. Visit SmokeFree.gov , or check out NCI's Clear Horizons, a quit smoking guide for people 50+. You can also visit The American Lung Association, or call 1-800-QUIT NOW (1-800-784-8669). Avoid Exposure to Pollutants and Lung Irritants Try to stay away from other things that could irritate your lungs, like dust and strong fumes. Stay indoors when the outside air quality is poor. You should also stay away from places where there might be cigarette smoke. Take Precautions Against the Flu The flu (influenza) can cause serious problems for people who have COPD. Do your best to avoid crowds during flu season. In addition to avoiding people with the flu, remembering to wash and sanitize your hands can be one of the best ways to guard against getting sick. Talk to Your Doctor About the Flu (influenza) and Pneumonia Vaccines Talk with your doctor about getting a yearly flu shot and whether and when you should get the pneumonia vaccine. Flu shots can reduce your risk of getting the flu, and the pneumonia vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. Both of these illnesses are major health risks for people who have COPD. See Your Doctor Regularly See your doctor or health care provider regularly even if you are feeling fine. Make a list of your breathing symptoms and think about any activities that you can no longer do because of shortness of breath. Be sure to bring a list of all the medicines you are taking to each office visit. Follow Your Treatments Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms." } ]

[ { "from": "human", "value": "What are the symptoms of COPD?" }, { "from": "gpt", "value": "Common Symptoms The most common symptoms of COPD are \n-a cough that does not go away\n- coughing up lots of sputum (mucus). a cough that does not go away coughing up lots of sputum (mucus). These symptoms often start years before the flow of air in and out of the lungs is reduced. Not everyone who has a cough and sputum goes on to develop COPD. Other common symptoms of COPD include \n-shortness of breath while doing activities you used to be able to do\n-wheezing (a whistling sound when you breathe)\n- tightness in the chest. shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. Getting a Diagnosis Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. If your doctor thinks you may have COPD, he or she will examine you, listen to your lungs, and ask you questions about your medical history, and what lung irritants you may have been around for long periods of time. The Spirometry Test To confirm a diagnosis of COPD, your doctor will use a breathing test called spirometry. The test is easy and painless and shows how much air you can breathe out and measures how fast you can breathe it out. In a spirometry test, you breathe hard into a large hose connected to a machine called a spirometer. When you breathe out, the spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Determining COPD Severity Based on this test, your doctor can determine if you have COPD and how severe it is. There are four levels of severity for COPD: - people at risk for COPD\n- people with mild COPD\n- people with moderate COPD\n- people with severe COPD. people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. People at risk for developing COPD have a normal breathing test and mild symptoms such as chronic cough and sputum (mucus) production. People with mild COPD have mild breathing limitation. Symptoms may include a chronic cough and sputum (mucus) production. At this stage, you may not be aware that airflow in your lungs is reduced. People with moderate COPD have a breathing test that shows worsening airflow blockages. Symptoms may be worse than with mild COPD and you may experience shortness of breath while working hard, walking fast, or doing brisk activity. At this stage, you would seek medical attention. People with severe COPD have a breathing test that shows severe limitation of the airflow. People with severe COPD will be short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, quality of life is impaired and worsening symptoms may be life-threatening. Other Tests Other tests are used to rule out other causes of the symptoms. - Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. \n-A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. - An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy." } ]

[ { "from": "human", "value": "What is (are) COPD?" }, { "from": "gpt", "value": "Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out." } ]

[ { "from": "human", "value": "What causes COPD?" }, { "from": "gpt", "value": "COPD is a disease that slowly worsens over time, especially if you continue to smoke. If you have COPD, you are more likely to have lung infections, which can be fatal. If the lungs are severely damaged, the heart may be affected. A person with COPD dies when the lungs and heart are unable to function and get oxygen to the body's organs and tissues, or when a complication, such as a severe infection, occurs. Treatment for COPD may help prevent complications, prolong life, and improve a person's quality of life." } ]

[ { "from": "human", "value": "What causes COPD?" }, { "from": "gpt", "value": "Cigarette smoking is the most common cause of COPD. Most people with COPD are smokers or have been smokers in the past. Breathing in other fumes and dusts over long periods of time can also lead to COPD. Pipe, cigar, and other types of tobacco smoking can cause COPD, especially if the smoke is inhaled. Exposure to secondhand smoke can play a role in causing COPD. Most people with COPD are at least 40 years old or around middle age when symptoms start." } ]

[ { "from": "human", "value": "What are the symptoms of COPD?" }, { "from": "gpt", "value": "The most common symptoms of COPD are a cough that does not go away and coughing up a lot of sputum (mucus). These symptoms may occur years before lung damage has reduced the flow of air in and out of the lungs. Other symptoms of COPD include shortness of breath, especially with exercise; wheezing (a whistling sound when you breathe); and tightness in the chest." } ]

[ { "from": "human", "value": "How to diagnose COPD?" }, { "from": "gpt", "value": "To confirm a COPD diagnosis, a doctor will use a breathing test called spirometry. The test is easy and painless. It shows how well the lungs are working. The spirometer measures how much air the lungs can hold and how fast air is blown out of the lungs. Other tests, such as bronchodilator reversibility testing, a chest X-ray, and arterial blood gas test, may be ordered." } ]

[ { "from": "human", "value": "What are the treatments for COPD?" }, { "from": "gpt", "value": "Treatment for COPD can be different for each person and is based on whether symptoms are mild, moderate or severe. Treatments include medication, pulmonary or lung rehabilitation, oxygen treatment, and surgery. There are also treatments to manage complications or a sudden onset of symptoms." } ]

[ { "from": "human", "value": "How to diagnose COPD?" }, { "from": "gpt", "value": "If you have not been exercising regularly, you should get the advice of your doctor before starting. The symptoms of COPD are different for each person. People with mild COPD may not have much difficulty walking or exercising. As the symptoms of COPD get worse over time, a person may have more difficulty with walking and exercising. You should talk to your doctor about exercising and whether you would benefit from a pulmonary or lung rehabilitation program." } ]

[ { "from": "human", "value": "How to prevent COPD?" }, { "from": "gpt", "value": "If you smoke, the most important thing you can do to prevent more lung damage is to stop smoking. It is also important to stay away from people who smoke and places where you know there will be smokers. Avoid exposure to pollutants like dust, fumes, and poor air quality, and take precautions to prevent flu and pneumonia. Following your doctor's instructions with medications and rehabilitative treatment can help alleviate COPD symptoms and control the disabling effects of the disease." } ]

[ { "from": "human", "value": "What are the treatments for COPD?" }, { "from": "gpt", "value": "Bronchodilators and inhaled steroids are two medications used to treat COPD. Bronchodilators work by relaxing the muscles around the airways, opening them and making it easier to breathe. People with mild COPD take bronchodilators using an inhaler only when needed. Those with moderate or severe COPD may need more regular treatment. Inhaled steroids also are used for people with moderate or severe COPD in order to reduce swelling in the airways." } ]

[ { "from": "human", "value": "What are the symptoms of COPD?" }, { "from": "gpt", "value": "Call your doctor right away if your symptoms worsen suddenly. People with COPD may have symptoms that suddenly get worse. When this happens, you have a much harder time catching your breath. Symptoms that worsen suddenly can include sudden chest tightness, more coughing, a change in your sputum (mucus), or fever. Your doctor will look at things that may be causing these sudden symptoms. Sometimes the symptoms are caused by a lung infection." } ]

[ { "from": "human", "value": "What is (are) COPD?" }, { "from": "gpt", "value": "More information on COPD is available at: What is COPD? and at the Learn More, Breathe Better Campaign For information on quitting smoking, visit http://www.surgeongeneral.gov/tobacco/ or Smokefree.gov. For information on the H1N1 flu and COPD, go to The Centers for Disease Control and Prevention." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Age-related macular degeneration, also known as AMD, is an eye disease that affects the macula, a part of the retina. The retina sends light from the eye to the brain, and the macula allows you to see fine detail. AMD Blurs Central Vision AMD blurs the sharp central vision you need for straight-ahead activities such as reading, sewing, and driving. AMD causes no pain. How AMD Progresses In some cases, AMD advances so slowly that people notice little change in their vision. In others, the disease progresses faster and may lead to a loss of vision in both eyes. AMD is a common eye condition among people age 50 and older. It is a leading cause of vision loss in older adults. Two Forms of AMD There are two forms of age-related macular degeneration -- dry and wet." } ]

[ { "from": "human", "value": "Who is at risk for Age-related Macular Degeneration??" }, { "from": "gpt", "value": "Risk Increases With Age AMD is most common in older people, but it can occur during middle age. The risk increases with age. Other Risk Factors Other risk factors include - Smoking\n- Obesity\n- Race. Whites are much more likely to lose vision from AMD than African-Americans.\n- Family history. People with a family history of AMD are at higher risk of getting the disease.\n- Gender. Women appear to be at greater risk than men. Smoking Obesity Race. Whites are much more likely to lose vision from AMD than African-Americans. Family history. People with a family history of AMD are at higher risk of getting the disease. Gender. Women appear to be at greater risk than men." } ]

[ { "from": "human", "value": "What are the symptoms of Age-related Macular Degeneration?" }, { "from": "gpt", "value": "AMD is detected during a comprehensive eye exam that includes a visual acuity test, a dilated eye exam, and tonometry. Tests for AMD - The visual acuity test is an eye chart test that measures how well you see at various distances.\n- In the dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Then, your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours.\n- With tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. The visual acuity test is an eye chart test that measures how well you see at various distances. In the dilated eye exam, drops are placed in your eyes to widen, or dilate, the pupils. Then, your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of AMD and other eye problems. After the exam, your close-up vision may remain blurred for several hours. With tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. Your eye care professional also may do other tests to learn more about the structure and health of your eye. The Amsler Grid During an eye exam, you may be asked to look at an Amsler grid, shown here. You will cover one eye and stare at a black dot in the center of the grid. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. You may notice that some of the lines are missing. These may be signs of AMD. Because dry AMD can turn into wet AMD at any time, you should get an Amsler grid from your eye care professional. You could then use the grid every day to evaluate your vision for signs of wet AMD. The Fluorescein Angiogram Test If your eye care professional believes you need treatment for wet AMD, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your eye. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment." } ]

[ { "from": "human", "value": "What are the treatments for Age-related Macular Degeneration?" }, { "from": "gpt", "value": "If You Have Advanced AMD Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage. The National Eye Institute's Age-Related Eye Disease Study found that taking certain vitamins and minerals may reduce the risk of developing advanced AMD. Wet AMD can be treated with laser surgery, photodynamic therapy, and injections into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment. Laser Surgery Laser surgery uses a laser to destroy the fragile, leaky blood vessels. Only a small percentage of people with wet AMD can be treated with laser surgery. Laser surgery is performed in a doctor's office or eye clinic. The risk of new blood vessels developing after laser treatment is high. Repeated treatments may be necessary. In some cases, vision loss may progress despite repeated treatments. Photodynamic Therapy With photodynamic therapy, a drug called verteporfin is injected into your arm. It travels throughout the body, including the new blood vessels in your eye. The drug tends to stick to the surface of new blood vessels. Next, the doctor shines a light into your eye for about 90 seconds. The light activates the drug. The activated drug destroys the new blood vessels and leads to a slower rate of vision decline. Unlike laser surgery, verteporfin does not destroy surrounding healthy tissue. Because the drug is activated by light, you must avoid exposing your skin or eyes to direct sunlight or bright indoor light for five days after treatment. Photodynamic therapy is relatively painless. It takes about 20 minutes and can be performed in a doctor's office. Photodynamic therapy slows the rate of vision loss. It does not stop vision loss or restore vision in eyes already damaged by advanced AMD. Treatment results often are temporary. You may need to be treated again. Drug Treatment for Wet AMD Wet AMD can now be treated with new drugs that are injected into the eye (anti-VEGF therapy). Abnormally high levels of a specific growth factor occur in eyes with wet AMD and promote the growth of abnormal new blood vessels. This drug treatment blocks the effects of the growth factor. You will need multiple injections that may be given as often as monthly. The eye is numbed before each injection. After the injection, you will remain in the doctor's office for a while and your eye will be monitored. This drug treatment can help slow down vision loss from AMD and in some cases improve sight. If You Have Low VisionIf you have lost some sight from AMD, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Many community organizations and agencies offer information about low vision counseling and training and other special services for people with visual impairments. Research on AMD The National Eye Institute is conducting and supporting a number of studies to learn more about AMD. For example, scientists are - studying the possibility of transplanting healthy cells into a diseased retina\n- evaluating families with a history of AMD to understand genetic and hereditary factors that may cause the disease\n- looking at certain anti-inflammatory treatments for the wet form of AMD studying the possibility of transplanting healthy cells into a diseased retina evaluating families with a history of AMD to understand genetic and hereditary factors that may cause the disease looking at certain anti-inflammatory treatments for the wet form of AMD This research should provide better ways to detect, treat, and prevent vision loss in people with AMD." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Age-related macular degeneration, or AMD, is a disease that blurs the sharp, central vision you need for straight-ahead activities such as reading, sewing, and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. AMD causes no pain." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. With wet AMD, loss of central vision can occur quickly. Wet AMD is considered to be advanced AMD and is more severe than the dry form." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision. Over time, as less of the macula functions, central vision in the affected eye can be lost. If you have vision loss from dry AMD in one eye only, you may not notice any changes in your overall vision. With the other eye seeing clearly, you can still drive, read, and see fine details. You may notice changes in your vision only if AMD affects both eyes. If you experience blurry vision, see an eye care professional for a comprehensive dilated eye exam." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Dry AMD has three stages -- early AMD, intermediate AMD, and advanced dry AMD. All of these may occur in one or both eyes. People with early dry AMD have either several small drusen or a few medium-sized drusen. Drusen are yellow deposits under the retina which often are found in people over age 50. People with early AMD have no symptoms and no vision loss. People with intermediate dry AMD have either many medium-sized drusen or one or more large drusen. Some people see a blurred spot in the center of their vision. More light may be needed for reading and other tasks. In addition to drusen, people with advanced dry AMD have a breakdown of light-sensitive cells and supporting tissue in the macula. This breakdown can cause a blurred spot in the center of your vision. Over time, the blurred spot may get bigger and darker, taking more of your central vision. You may have difficulty reading or recognizing faces until they are very close to you." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Drusen are yellow deposits under the retina. They often are found in people over age 50. Your eye care professional can detect drusen during a comprehensive dilated eye exam." } ]

[ { "from": "human", "value": "What causes Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Drusen alone do not usually cause vision loss. In fact, scientists are unclear about the connection between drusen and AMD. They do know that an increase in the size or number of drusen raises a person's risk of developing either advanced dry AMD or wet AMD. These changes can cause serious vision loss." } ]

[ { "from": "human", "value": "What are the symptoms of Age-related Macular Degeneration?" }, { "from": "gpt", "value": "An early symptom of wet AMD is that straight lines appear wavy. If you notice this condition or other changes to your vision, contact your eye care professional at once. You need a comprehensive dilated eye exam." } ]

[ { "from": "human", "value": "What are the symptoms of Age-related Macular Degeneration?" }, { "from": "gpt", "value": "The most common symptom of dry AMD is slightly blurred vision. You may have difficulty recognizing faces. You may need more light for reading and other tasks. Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected. One of the most common early signs of dry AMD is drusen. Drusen are yellow deposits under the retina. They often are found in people over age 50. Your eye care professional can detect drusen during a comprehensive dilated eye exam." } ]

[ { "from": "human", "value": "Who is at risk for Age-related Macular Degeneration??" }, { "from": "gpt", "value": "AMD is most common in older people, but it can occur during middle age. The risk increases with age. Other risk factors include smoking, obesity, white race, family history of AMD, and female gender." } ]

[ { "from": "human", "value": "What are the treatments for Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Once dry AMD reaches the advanced stage, no form of treatment can prevent vision loss. However, treatment can delay and possibly prevent intermediate AMD from progressing to the advanced stage, in which vision loss occurs." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "The AREDS formulation is a combination of antioxidants and zinc that is named for a study conducted by The National Eye Institute called the Age-Related Eye Disease Study, or AREDS. This study found that taking a specific high-dose formulation of antioxidants and zinc significantly reduced the risk of advanced AMD and its associated vision loss. Slowing AMD's progression from the intermediate stage to the advanced stage will save many people's vision." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "The daily amounts used by the study researchers were 500 milligrams of vitamin C, 400 International Units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide, and 2 milligrams of copper as cupric oxide. Copper was added to the AREDS formulation containing zinc to prevent copper deficiency anemia, a condition associated with high levels of zinc intake." } ]

[ { "from": "human", "value": "How to prevent Age-related Macular Degeneration?" }, { "from": "gpt", "value": "There is no reason for those diagnosed with early stage AMD to take the AREDS formulation. The study did not find that the formulation helped those with early stage AMD. If you have early stage AMD, a comprehensive dilated eye exam every year can help determine if the disease is progressing. If early stage AMD progresses to the intermediate stage, discuss taking the formulation with your doctor." } ]

[ { "from": "human", "value": "What are the treatments for Age-related Macular Degeneration?" }, { "from": "gpt", "value": "Wet AMD can be treated with laser surgery, photodynamic therapy, and drugs that are injected into the eye. None of these treatments is a cure for wet AMD. The disease and loss of vision may progress despite treatment." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Age-related Macular Degeneration?" }, { "from": "gpt", "value": "The National Eye Institute scientists are - studying the possibility of transplanting healthy cells into a diseased retina\n- evaluating families with a history of AMD to understand genetic and hereditary factors that may cause the disease\n- looking at certain anti-inflammatory treatments for the wet form of AMD. studying the possibility of transplanting healthy cells into a diseased retina evaluating families with a history of AMD to understand genetic and hereditary factors that may cause the disease looking at certain anti-inflammatory treatments for the wet form of AMD. This research should provide better ways to detect, treat, and prevent vision loss in people with AMD." } ]

[ { "from": "human", "value": "What is (are) Age-related Macular Degeneration?" }, { "from": "gpt", "value": "National Eye Institute National Institutes of Health 2020 Vision Place Bethesda, MD 20892-3655 301-496-5248 E-mail: 2020@nei.nih.gov www.nei.nih.gov Association for Macular Diseases 210 East 64th Street, 8th Floor New York, NY 10021-7471 212-605-3719 Foundation Fighting Blindness Executive Plaza 1, Suite 800 11435 Cronhill Drive Owings Mill, MD 21117-2220 1-888-394-3937 410-785-1414 Macular Degeneration Partnership 6222 Wilshire Boulevard, Suite 260 Los Angeles, CA 90048 1-888-430-9898 310-623-4466 www.amd.org" } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "Can Cause Vision Loss, Blindness Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina in the back of the eye. A healthy retina is necessary for good vision. If you have diabetic retinopathy, at first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. Four Stages The four stages of diabetic retinopathy are - mild nonproliferative retinopathy\n- moderate nonproliferative retinopathy\n- severe nonproliferative retinopathy\n- proliferative retinopathy. mild nonproliferative retinopathy moderate nonproliferative retinopathy severe nonproliferative retinopathy proliferative retinopathy. The first stage is mild nonproliferative retinopathy. At this earliest stage, there are small areas of balloon-like swelling in the retina's tiny blood vessels. The second stage is moderate nonproliferative retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked. The third stage is severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas send signals to the body to grow new blood vessels for nourishment. The fourth stage is proliferative retinopathy. At this advanced stage, the signals sent by the retina for nourishment cause the growth of new blood vessels. These new blood vessels are abnormal and fragile. The new blood vessels grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result. Other Diabetic Eye Diseases In addition to diabetic retinopathy, other diabetic eye diseases that people with diabetes may face are cataract and glaucoma. See this graphic for a quick overview of diabetic eye disease, including how many people it affects, whos at risk, what to do if you have it, and how to learn more." } ]

[ { "from": "human", "value": "What causes Diabetic Retinopathy?" }, { "from": "gpt", "value": "Who Is at Risk? All people with diabetes -- both type 1 and type 2 -- are at risk for diabetic retinopathy. People with diabetes are also at increased risk for cataract and glaucoma. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. How Vision Loss Occurs Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. Macular edema can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. Macular edema can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema. Have Dilated Eye Exams The National Eye Institute (NEI) urges everyone with diabetes to have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an eye exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. Watch an animation to see what a comprehensive dilated eye exam includes." } ]

[ { "from": "human", "value": "What are the symptoms of Diabetic Retinopathy?" }, { "from": "gpt", "value": "Diabetic retinopathy often has no early warning signs. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year to detect the disease before it causes damage to your vision. Vision Changes May Indicate Bleeding In the early stages of diabetic retinopathy, you may not notice any changes in your vision. But if diabetic retinopathy reaches its final stage, proliferative retinopathy, bleeding can occur. If this happens, at first, you will see a few specks of blood, or spots, floating in your vision. If spots occur, see your eye care professional as soon as possible. Early Treatment is Important You may need treatment before more serious bleeding or hemorrhages occur causing vision loss or possibly blindness. Hemorrhages tend to happen more than once, often during sleep. See how to find an eye care professional. Here is a list of questions to ask your eye care professional. Sometimes the spots clear without treatment, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be successful. Detection Diabetic retinopathy and macular edema are detected during a comprehensive eye exam that includes a visual acuity test, dilated eye exam, and tonometry. A visual acuity test is an eye chart test that measures how well you see at various distances. During the dilated eye exam, your eye care professional checks your retina for early signs of the disease, including - leaking blood vessels\n- retinal swelling such as macular edema\n- pale, fatty deposits on the retina -- signs of leaking blood vessels\n- damaged nerve tissue leaking blood vessels retinal swelling such as macular edema pale, fatty deposits on the retina -- signs of leaking blood vessels damaged nerve tissue Watch an animation showing what a comprehensive dilated eye exam involves. With tonometry, an instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test. If your eye care professional believes you need treatment for macular edema, he or she may suggest a fluorescein angiogram. In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment." } ]

[ { "from": "human", "value": "What are the treatments for Diabetic Retinopathy?" }, { "from": "gpt", "value": "Preventing Disease Progression During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Treatment for Macular Edema Research found that that prompt treatment of macular edema with anti-VEGF drugs, with or without laser treatment, resulted in better vision than laser treatment alone or steroid injections. When injected into the eye, these drugs reduce fluid leakage and interfere with the growth of new blood vessels in the retina. In some cases, focal laser treatment is used along with the eye injections. Your doctor places up to several hundred small laser burns in the areas of the retina around the macula that are leaking. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed. Treatment for Diabetic Retinopathy Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding. Learn more about laser treatment. Vitrectomy If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye. Scatter laser treatment and vitrectomy are effective in treating proliferative retinopathy and in reducing vision loss. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight. Learn more about a vitrectomy. Have Dilated Eye Exams The National Eye Institute (NEI) urges everyone with diabetes to have a comprehensive dilated eye exam at least once a year. If you have diabetic retinopathy, you may need an exam more often. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. Watch an animation to see what a comprehensive dilated eye exam includes. Research The National Eye Institute, or NEI, is conducting and supporting research that seeks better ways to detect, treat, and prevent vision loss in people with diabetes. This research is conducted through studies in the laboratory and with patients. For example, researchers are studying drugs for the treatment of proliferative retinopathy that may reduce the need for laser surgery. A major study has shown that better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery." } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. If you have diabetic retinopathy, at first you may notice no changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes. See this graphic for a quick overview of diabetic eye disease, including how many people it affects, whos at risk, what to do if you have it, and how to learn more." } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "The four stages of diabetic retinopathy are - mild nonproliferative retinopathy\n- moderate nonproliferative retinopathy\n- severe nonproliferative retinopathy\n- proliferative retinopathy mild nonproliferative retinopathy moderate nonproliferative retinopathy severe nonproliferative retinopathy proliferative retinopathy Nonproliferative retinopathy. At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels. Moderate nonproliferative retinopathy. As the disease progresses, some blood vessels that nourish the retina are blocked. Severe nonproliferative retinopathy. Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment. Proliferative retinopathy. At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye." } ]

[ { "from": "human", "value": "Who is at risk for Diabetic Retinopathy??" }, { "from": "gpt", "value": "All people with diabetes -- both type 1 and type 2 -- are at risk for diabetic retinopathy. People with diabetes are also at increased risk for cataract and glaucoma. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year. Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy. If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. See how to find an eye care professional." } ]

[ { "from": "human", "value": "What causes Diabetic Retinopathy?" }, { "from": "gpt", "value": "Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema." } ]

[ { "from": "human", "value": "What are the symptoms of Diabetic Retinopathy?" }, { "from": "gpt", "value": "Diabetic retinopathy often has no early warning signs. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year. Learn more about a comprehensive dilated eye exam." } ]

[ { "from": "human", "value": "What are the symptoms of Diabetic Retinopathy?" }, { "from": "gpt", "value": "At first, you will see a few specks of blood, or spots, \"floating\" in your vision. If spots occur, see your eye care professional as soon as possible. You may need treatment before more serious bleeding or hemorrhaging occurs. Hemorrhages tend to happen more than once, often during sleep. Sometimes, the spots clear without treatment, and you will see better. However, bleeding can reoccur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs. If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be effective." } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "In this test, a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment." } ]

[ { "from": "human", "value": "What are the treatments for Diabetic Retinopathy?" }, { "from": "gpt", "value": "Research found that that prompt treatment of macular edema with anti-VEGF drugs, with or without laser treatment, resulted in better vision than laser treatment alone or steroid injections. When injected into the eye, these drugs reduce fluid leakage and interfere with the growth of new blood vessels in the retina. In some cases, focal laser treatment is used along with the eye injections. Your doctor places up to several hundred small laser burns in the areas of the retina around the macula that are leaking. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed." } ]

[ { "from": "human", "value": "What are the treatments for Diabetic Retinopathy?" }, { "from": "gpt", "value": "During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol. Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye." } ]

[ { "from": "human", "value": "What are the treatments for Diabetic Retinopathy?" }, { "from": "gpt", "value": "Both focal and scatter laser treatment are performed in your doctor's office or eye clinic. Before the surgery, your doctor will dilate your pupil and apply drops to numb the eye. The area behind your eye also may be numbed to prevent discomfort. The lights in the office will be dim. As you sit facing the laser machine, your doctor will hold a special lens to your eye. During the procedure, you may see flashes of light. These flashes eventually may create a stinging sensation that can be uncomfortable. You will need someone to drive you home after surgery. Because your pupil will remain dilated for a few hours, you should bring a pair of sunglasses. For the rest of the day, your vision will probably be a little blurry. If your eye hurts, your doctor can suggest treatment." } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "If you have a lot of blood in the center of the eye, or vitreous gel, you may need a vitrectomy to restore your sight. If you need vitrectomies in both eyes, they are usually done several weeks apart. A vitrectomy is performed under either local or general anesthesia. Your doctor makes a tiny incision in your eye. Next, a small instrument is used to remove the vitreous gel that is clouded with blood. The vitreous gel is replaced with a salt solution. Because the vitreous gel is mostly water, you will notice no change between the salt solution and the original vitreous gel." } ]

[ { "from": "human", "value": "What are the treatments for Diabetic Retinopathy?" }, { "from": "gpt", "value": "Yes. Both treatments are very effective in reducing vision loss. People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. Although both treatments have high success rates, they do not cure diabetic retinopathy. Once you have proliferative retinopathy, you always will be at risk for new bleeding. You may need treatment more than once to protect your sight." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Diabetic Retinopathy?" }, { "from": "gpt", "value": "The National Eye Institute, or NEI, is conducting and supporting research that seeks better ways to detect, treat, and prevent vision loss in people with diabetes. This research is conducted through studies in the laboratory and with patients. For example, researchers are studying drugs for the treatment of proliferative retinopathy that may reduce the need for laser surgery." } ]

[ { "from": "human", "value": "What to do for Diabetic Retinopathy?" }, { "from": "gpt", "value": "If you have diabetes, get a comprehensive dilated eye exam at least once a year. Proliferative retinopathy can develop without symptoms. If it gets to this advanced stage, you are at high risk for vision loss or even blindness. Macular edema can develop without symptoms at any of the four stages of diabetic retinopathy. You can develop both proliferative retinopathy and macular edema and still see fine. However, you are at high risk for vision loss. Your eye care professional can tell if you have macular edema or any stage of diabetic retinopathy. Whether or not you have symptoms, early detection and timely treatment can prevent vision loss. See this glossary for basic terms about diabetic retinopathy." } ]

[ { "from": "human", "value": "What is (are) Diabetic Retinopathy?" }, { "from": "gpt", "value": "National Eye Institute National Institutes of Health 2020 Vision Place Bethesda, MD 20892-3655 301-496-5248 E-mail: 2020@nei.nih.gov www.nei.nih.gov Find eye health organizations that address diabetic eye disease." } ]

[ { "from": "human", "value": "What is (are) Depression?" }, { "from": "gpt", "value": "Everyone feels blue or sad now and then, but these feelings don't usually last long and pass within a couple of days. When a person has depression, it interferes with daily life and normal functioning, and causes pain for both the person with depression and those who care about him or her. Doctors call this condition \"depressive disorder,\" or \"clinical depression.\" Depression in Older Adults Important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness. For instance, the death of a loved one, moving from work into retirement, or dealing with a serious illness can leave people feeling sad or anxious. After a period of adjustment, many older adults can regain their emotional balance, but others do not and may develop depression. Depression is a common problem among older adults, but it is NOT a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more physical ailments. However, when older adults do suffer from depression, it may be overlooked because they may be less willing to talk about feelings of sadness or grief, or they may show different, less obvious symptoms, and doctors may be less likely to suspect or spot it. Sometimes it can be difficult to distinguish grief from major depression. Grief after loss of a loved one is a normal reaction to the loss and generally does not require professional mental health treatment. However, grief that lasts for a very long time following a loss may require treatment. Test Depression and Suicide Though it is widely believed that suicide more often affects young people, suicide is a serious problem among older adults, too particularly among older men and depression is usually a major contributing factor. Adults 65 and older have a suicide rate that is higher than the rate for the national population, but there are some major differences between older men and women. While suicide rates for older women are somewhat lower than those for young and middle-aged women, rates among men 75 and older are higher than those for younger men. In fact, white men age 85 and older have the highest suicide rate in the United States. Types of Depression There are several types of depression. The most common types are major depressive disorder and dysthymic disorder. - Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, concentrate, eat, and enjoy activities he or she once liked. Major depression prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.\n- Dysthymic disorder, also called dysthymia, is a less severe but more long-lasting form of depression. Dysthymia is characterized by symptoms lasting two years or longer that keep a person from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetime. Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, concentrate, eat, and enjoy activities he or she once liked. Major depression prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life. Dysthymic disorder, also called dysthymia, is a less severe but more long-lasting form of depression. Dysthymia is characterized by symptoms lasting two years or longer that keep a person from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetime. Other types of depression include subsyndromal depression, psychotic depression. and bipolar depression. - Subsyndromal depression is common among older adults. It includes less severe but clear symptoms of depression that fall short of being major depression or dysthymia. Having subsyndromal depression may increase a person's risk of developing major depression.\n- Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).\n- Bipolar depression, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression). Subsyndromal depression is common among older adults. It includes less severe but clear symptoms of depression that fall short of being major depression or dysthymia. Having subsyndromal depression may increase a person's risk of developing major depression. Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Bipolar depression, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression)." } ]

[ { "from": "human", "value": "What causes Depression?" }, { "from": "gpt", "value": "Several lines of research have shown that depressive illnesses are disorders of the brain. But the exact causes for these illnesses are not yet clear and are still being studied. Changes in the Brain Imaging technologies show that the brains of people with depression look different or are working differently than those who do not have the illness. The areas of the brain that control moods, thinking, sleep, appetite, and behavior appear not to be functioning well. The scans also show very high or very low levels of important brain chemicals. But these images do not reveal WHY the depression has occurred. Many Possible Causes In general, there is no one cause or risk factor for depression. It most likely results from many factors, such as family history, life experiences, and environment. Older adults with depression may have had it when they were younger, or they may have a family history of the illness. They may also be going through difficult life events, such as losing a loved one, a difficult relationship with a family member or friend, or financial troubles. For older adults who experience depression for the first time later in life, other factors may be at play. Depression may be related to changes that occur in the brain and body as a person ages. For example, some older adults who are at risk for illnesses such as heart disease or stroke may have hardening and inflammation of the blood vessels, and blood may not be able to flow normally to the body's organs, including the brain. Over time, this blood vessel disease and restricted blood flow can damage nearby brain tissue and harm the nerve connections that help different parts of the brain communicate with each other. If this happens, an older adult with no family history of depression may develop what some doctors call \"vascular depression.\" Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease. This type of depression can appear in the early stages of these diseases, before many symptoms appear. Depression Can Occur With Other Illnesses Depression can also co-occur with other serious medical illnesses such as diabetes, cancer, and Parkinson's disease. Depression can make these conditions worse, and vice versa. Sometimes, medications taken for these illnesses may cause side effects that contribute to depression. Because many older adults face these illnesses along with various social and economic difficulties, some health care professionals may wrongly conclude that these problems are the cause of the depression -- an opinion often shared by patients themselves. All these factors can cause depression to go undiagnosed or untreated in older people. Yet, treating the depression will help an older adult better manage other conditions he or she may have." } ]

[ { "from": "human", "value": "What are the symptoms of Depression?" }, { "from": "gpt", "value": "Common Symptoms There are many symptoms associated with depression, and some will vary depending on the individual. However, some of the most common symptoms are listed below. If you have several of these symptoms for more than two weeks, you may have depression. - feeling nervous or emotionally \"empty\"\n- feelings of excessive guilt or worthlessness\n- tiredness or a \"slowed down\" feeling\n- restlessness and irritability\n- feeling like life is not worth living\n- sleep problems, including trouble getting to sleep, wakefulness in the middle of the night, or sleeping too much\n- eating more or less than usual, usually with unplanned weight gain or loss\n- having persistent headaches, stomach-aches or other chronic pain that does not go away when treated\n- loss of interest in once pleasurable activities, including sex\n- frequent crying\n- difficulty focusing, remembering or making decisions\n- thoughts of death or suicide, or a suicide attempt feeling nervous or emotionally \"empty\" feelings of excessive guilt or worthlessness tiredness or a \"slowed down\" feeling restlessness and irritability feeling like life is not worth living sleep problems, including trouble getting to sleep, wakefulness in the middle of the night, or sleeping too much eating more or less than usual, usually with unplanned weight gain or loss having persistent headaches, stomach-aches or other chronic pain that does not go away when treated loss of interest in once pleasurable activities, including sex frequent crying difficulty focusing, remembering or making decisions thoughts of death or suicide, or a suicide attempt Is it Depression or Something Else? The first step to getting appropriate treatment is to visit a doctor. Certain medications taken for other medical conditions, vitamin B12 deficiency, some viruses, or a thyroid disorder can cause symptoms similar to depression. If an older adult is taking several medications for other conditions and is depressed, seeing a doctor is especially important. A doctor can rule out medications or another medical condition as the cause of the depression by doing a complete physical exam, interview, and lab tests. If these other factors can be ruled out, he or she may refer you to a mental health professional, such as a psychologist, counselor, social worker, or psychiatrist. Some doctors called geriatric psychiatrists and clinical geropsychologists are specially trained to treat depression and other mental illnesses in older adults. The doctor or mental health professional will ask about the history of your symptoms, such as when they started, how long they have lasted, their severity, whether they have occurred before, and if so, whether they were treated and how. He or she will then diagnose the depression and work with you to choose the most appropriate treatment." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Depression?" }, { "from": "gpt", "value": "Treating Older Adults Studies show that the majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy or a combination of both. In addition, research has indicated that treating depression in older adults often improves the outcomes of co-existing medical conditions. Some research has also suggested that the risk for developing depression in people who have had a stroke may be reduced if they receive preventative treatment with an antidepressant or talk therapy. Special Considerations However, there are some special considerations that doctors must take into account when treating older adults. The commonly prescribed medications for depression may not work well for some older adults because they may interact unfavorably with other medications being taken for other conditions. Some older adults with depression may also have some problems thinking clearly, and these individuals often respond poorly to the drugs. Which Form of Treatment Is Most Effective? Many older adults prefer to get counseling or psychotherapy for depression rather than add more medications to those they are already taking for other conditions. Research suggests that for older adults, psychotherapy is just as likely to be an effective first treatment for depression as taking an antidepressant. There is a great deal of evidence indicating that cognitive-behavioral therapy (CBT), including a version called problem solving therapy, may be an especially useful type of psychotherapy for treating older adults and improving their quality of life. However, a practical issue to consider when deciding on treatment is that it may be harder for many older people to find or be able to travel to meetings with a well-trained psychotherapist than to get a prescription for antidepressant medication from their primary care doctor. Also, some research suggests that treatment with medication may be more effective if the depression is quite severe or if the older adult is coping with other serious illnesses. Overall, research has suggested that, when possible, a combination of medication and psychotherapy treatment is likely to be most effective in treating depression in older adults and, in particular, for reducing the number of new episodes. Late-Life Depression is Often Undiagnosed Despite progress in treatment research, late-life depression often goes undiagnosed or is inadequately treated in older adults. In fact, several studies have found that up to 75 percent of older adults who die by suicide had visited their primary care doctors within one month of their deaths. Collaborative or comprehensive care may lead to better treatment results. Collaborative Care The Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT) offered antidepressant medication and/or psychotherapy to depressed older adults, along with a \"care manager\" -- a social worker, nurse or psychologist -- who monitored their symptoms, side effects of medication, and progress. The study found that those participants who had case-managed care got better more quickly, had longer periods without depression, and in general responded better to treatment than those who did not have case-managed care. Another study called the Improving Mood: Promoting Access to Collaborative Treatment (IMPACT) trial also found that collaborative care was more effective than usual care, and was less expensive over the long run as well. Improving Diagnosis of Depression Several studies are looking at ways to help older adults get better access to depression treatment. One is developing and testing an education and intervention program to help primary care clinics and providers identify and treat late-life depression. Another study found that depressed older adults who had a \"care manager\" monitor their symptoms, side effects, and progress got better more quickly -- and stayed better longer -- than those who did not have case-managed care. Still other projects are investigating ways of improving older adults engagement in and ability to follow treatment plans for depression. Researchers are also looking at ways to \n-better understand the relationship between other medical illnesses and depression\n- integrate treatment for depression with treatments for other medical conditions a person may have\n- produce a quicker response to treatment\n- develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies)\n- help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. better understand the relationship between other medical illnesses and depression integrate treatment for depression with treatments for other medical conditions a person may have produce a quicker response to treatment develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. Findings from these and other studies will provide important information for doctors to treat late-life depression. In a Crisis? Get Help! If you are in a crisis... If you are thinking about harming yourself or attempting suicide, tell someone who can help immediately. - Call your doctor.\n- Call 911 for emergency services.\n- Go to the nearest hospital emergency room.\n- Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to be connected to a trained counselor at a suicide crisis center nearest you. Call your doctor. Call 911 for emergency services. Go to the nearest hospital emergency room. Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to be connected to a trained counselor at a suicide crisis center nearest you." } ]

[ { "from": "human", "value": "What is (are) Depression?" }, { "from": "gpt", "value": "Depression is more than just feeling blue or sad. It is an illness. When you have depression, it interferes with daily life and normal functioning, and causes pain for both you and those who care about you." } ]

[ { "from": "human", "value": "What is (are) Depression?" }, { "from": "gpt", "value": "Major depressive disorder, also called major depression or clinical depression, is characterized by a combination of symptoms that interfere with your ability to work, sleep, concentrate, eat, and enjoy activities you once liked. Major depression keeps a person from functioning normally. Dysthymic disorder, or dysthymia, is a less severe but sometimes more long-lasting form of depression. It is characterized by symptoms lasting two years or longer that keep you from functioning normally or feeling well. Subsyndromal depression, affecting many older adults, includes real symptoms of depression that are less severe than major depression or dysthymia. Having sybsydromal depression may increase your risk of developing major depression. Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Bipolar depression also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changesfrom extreme highs (e.g., mania) to extreme lows (e.g., depression)." } ]

[ { "from": "human", "value": "Who is at risk for Depression??" }, { "from": "gpt", "value": "The risk factors for depression are family history, life experiences, and environment. If you have depression, you may have experienced it when you were younger, and may have a family history of the illness. You may also be going through difficult life events, such as physical or psychological trauma, losing a loved one, a difficult relationship with a family member or friend, or financial troubles. Any of these stressful experiences can lead to depression. For older adults who experience depression for the first time later in life, other factors may be at play. Depression may be related to changes that occur in the brain and body as a person ages. For example, some older adults who are at risk for illnesses such as heart disease or stroke may have hardening and inflammation of the blood vessels, and blood may not be able to flow normally to the body's organs, including the brain. Over time, this blood vessel disease and restricted blood flow can damage nearby brain tissue and harm the nerve connections that help different parts of the brain communicate with each other. If this happens, an older adult with no family history of depression may develop what some doctors call \"vascular depression.\" Older adults may also experience depression as a result of brain changes caused by illnesses such as Alzheimers disease or Parkinsons disease. This type of depression can appear in the early stages of these diseases, before many symptoms appear." } ]

[ { "from": "human", "value": "What are the symptoms of Depression?" }, { "from": "gpt", "value": "Symptoms of depression often vary depending upon the person. Common symptoms include - feeling nervous or emotionally empty\n- tiredness or a \"slowed down\" feeling\n- feeling guilty or worthless\n- restlessness and irritability\n- feeling like life is not worth living\n- sleep problems such as insomnia, oversleeping or wakefulness in the middle of the night\n- eating more or less than usual, usually with unplanned weight gain or loss\n- having persistent headaches, stomach-aches or other chronic pain that does not go away when treated\n- loss of interest in once pleasurable activities\n- frequent crying\n- difficulty focusing, remembering or making decisions\n- thoughts of death or suicide. feeling nervous or emotionally empty tiredness or a \"slowed down\" feeling feeling guilty or worthless restlessness and irritability feeling like life is not worth living sleep problems such as insomnia, oversleeping or wakefulness in the middle of the night eating more or less than usual, usually with unplanned weight gain or loss having persistent headaches, stomach-aches or other chronic pain that does not go away when treated loss of interest in once pleasurable activities frequent crying difficulty focusing, remembering or making decisions thoughts of death or suicide." } ]

[ { "from": "human", "value": "What are the treatments for Depression?" }, { "from": "gpt", "value": "Medications called antidepressants work to normalize brain chemicals called neurotransmitters, notably serotonin, norepinephrine, and dopamine. Scientists studying depression have found that these chemicals, and possibly others, are involved in regulating mood, but they are unsure of exactly how they work. Newer Antidepressants. The newest and most popular types of antidepressant medications are called selective serotonin reuptake inhibitors (SSRIs). They include fluoxetine (Prozac), citalopram (Celexa) and several others. Similar to SSRIs are serotonin and norepinephrine reuptake inhibitors (SNRIs) and include venlafaxine (Effexor) and duloxetine (Cymbalta). Another newer antidepressant bupropion (Wellbutrin) is neither an SSRI nor an SNRI but is popular as well. Older Antidepressants. Older antidepressants, called tricyclics and monoamine oxidase inhibitors (MAOIs), are still used sometimes, too. However, these older antidepressants are not as popular as the newer ones because they tend to have more side effects. However, medications affect everyone differently so talk with your doctor to decide which type is best for you. Practical Considerations. People taking MAOIs must follow strict food and medicine restrictions to avoid potentially serious interactions. If you take an MAOI, your doctor should give you a complete list of foods, medicines, and substances to avoid. MAOIs can also react with SSRIs to produce a serious condition called \"serotonin syndrome,\" which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life threatening conditions. MAOIs should not be taken with SSRIs. Caution is required when combining any serotonergic medication (not just MAOIs) with SSRIs. For example, in 2006 the FDA issued specific warnings against using triptans that are commonly-prescribed to treat migraine headaches together with SSRIs or SNRIs. Using these medications together can cause serotonin syndrome." } ]

[ { "from": "human", "value": "What are the treatments for Depression?" }, { "from": "gpt", "value": "A bushy, wild-growing plant with yellow flowers, St John's wort has been used for centuries in many folk and herbal remedies. It is commonly used in Europe to treat mild depression, and it is a top-seller in the United States as well. In a study funded by the National Institutes of Health, the herb was found to be no more effective than a placebo (sugar pill) in treating adults suffering from major depression. Other research has shown that St. John's wort can interact unfavorably with other drugs. The herb interferes with certain drugs used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. Because of these potential interactions, older adults should always consult with their doctors before taking any herbal supplement. Another product sold as a dietary supplement, S-adenosyl methionine (SAMe), has shown promise in controlled trials as helpful when added to an SSRI antidepressant that is only partially effective." } ]

[ { "from": "human", "value": "What are the treatments for Depression?" }, { "from": "gpt", "value": "Several studies are looking at ways to help older adults get better access to depression treatment. One is developing and testing an education and intervention program to help primary care clinics and providers identify and treat late-life depression. Another study found that depressed older adults who had a \"care manager\" monitor their symptoms, side effects, and progress got better more quickly -- and stayed better longer -- than those who did not have case-managed care. Still other projects are investigating ways of improving older adults engagement in and ability to follow treatment plans for depression. Researchers are also looking at ways to \n-better understand the relationship between other medical illnesses and depression\n- integrate treatment for depression with treatments for other medical conditions a person may have\n- produce a quicker response to treatment\n- develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies)\n- help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression. better understand the relationship between other medical illnesses and depression integrate treatment for depression with treatments for other medical conditions a person may have produce a quicker response to treatment develop new methods for delivering treatment to those who are homebound, unable to move around without assistance, or who live in rural areas. (e.g., via use of telephonic or internet-assisted therapies) help prevent depression by keeping it from developing or recurring in those at risk or by preventing those with milder symptoms from progressing to more severe episodes of depression." } ]

[ { "from": "human", "value": "What is (are) Problems with Smell?" }, { "from": "gpt", "value": "Our sense of smell helps us enjoy life. We delight in the aromas of our favorite foods or the fragrance of flowers. Our sense of smell also is a warning system, alerting us to danger signals such as a gas leak, spoiled food, or a fire. Any loss in our sense of smell can have a negative effect on our quality of life. It also can be a sign of more serious health problems. Aging and Smell Loss Problems with smell increase as people get older, and they are more common in men than women. In one study, nearly one-quarter of men ages 6069 had a smell disorder, while about 11 percent of women in that age range reported a problem. Many older people are not even aware that they have a problem with their sense of smell because the changes occur gradually over several years. They may not even notice that they are experiencing a loss of smell until there is an incident in which they don't detect food that has spoiled or the presence of dangerous smoke. How Our Sense of Smell Works The sense of smell, or olfaction, is part of our chemical sensing system, along with the sense of taste. Normal smell occurs when odors around us, like the fragrance of flowers or the smell of baking bread, stimulate the specialized sensory cells, called olfactory sensory cells. Olfactory sensory cells are located in a small patch of tissue high inside the nose. Odors reach the olfactory sensory cells in two pathways. The first pathway is by inhaling, or sniffing, through your nose. When people think about smell, they generally think of this pathway. The second pathway is less familiar. It is a channel that connects the roof of the throat region to the nose. When we chew our food, aromas are released that access olfactory sensory cells through this channel. If you are congested due to a head cold or sinus infection, this channel is blocked, which temporarily affects your ability to appreciate the flavors of food. Types of Smell Disorders People who experience smell disorders either have a decrease in their ability to smell or changes in the way they perceive odors. Total smell loss is relatively rare, but a decrease in the sense of smell occurs more often, especially in older adults. A decreased sense of smell may be temporary and treatable with medication. There are several types of smell disorders depending on how the sense of smell is affected. \n-Some people have hyposmia, which occurs when their ability to detect certain odors is reduced.\n- Other people can't detect odor at all, which is called anosmia.\n- Sometimes a loss of smell can be accompanied by a change in the perception of odors. This type of smell disorder is called dysosmia. Familiar odors may become distorted, or an odor that usually smells pleasant instead smells foul.\n- Still others may perceive a smell that isn't present at all, which is called phantosmia.\n- Smell loss due to aging is called presbyosmia. Some people have hyposmia, which occurs when their ability to detect certain odors is reduced. Other people can't detect odor at all, which is called anosmia. Sometimes a loss of smell can be accompanied by a change in the perception of odors. This type of smell disorder is called dysosmia. Familiar odors may become distorted, or an odor that usually smells pleasant instead smells foul. Still others may perceive a smell that isn't present at all, which is called phantosmia. Smell loss due to aging is called presbyosmia. Smell Loss May Signal Other Conditions Problems with our chemical senses may be a sign of other serious health conditions. A smell disorder can be an early sign of Parkinsons disease, Alzheimers disease, or multiple sclerosis. It can also be related to other medical conditions, such as obesity, diabetes, hypertension, and malnutrition. Getting a diagnosis early will help an individual deal better with the underlying condition or disease. Smell and Taste Smell and taste are closely linked in the brain, but are actually distinct sensory systems. True tastes are detected by taste buds on the tongue and the roof of the mouth, as well as in the throat region, and are limited to sweet, salty, sour, bitter, savory and perhaps a few other sensations. The loss of smell is much more common than the loss of taste, and many people mistakenly believe they have a problem with taste, when they are really experiencing a problem with their sense of smell. A loss in taste or smell is diagnosed by your doctor using special taste and smell tests. Smell Loss and Eating Habits When smell is impaired, people usually have problems appreciating the subtle flavors of food, and say that food is less enjoyable. Some people change their eating habits. Some may eat too little and lose weight while others may eat too much and gain weight. Either way, there may be a long-term impact on one's overall health. Loss of smell may also cause us to eat too much sugar or salt to make our food taste better. This can be a problem for people with certain medical conditions, such as diabetes or high blood pressure. In severe cases, loss of smell can lead to depression. Hazards of Smell Loss Research shows that people with a total or partial loss of smell are almost twice as likely as people with normal smell to have certain kinds of accidents. The most common types of accidents in order of frequency involve - cooking\n- eating or drinking spoiled foods or toxic substances\n- failing to detect gas leaks or fires cooking eating or drinking spoiled foods or toxic substances failing to detect gas leaks or fires If you think you have a problem with your sense of smell, see your doctor." } ]

[ { "from": "human", "value": "What causes Problems with Smell?" }, { "from": "gpt", "value": "Problems with smell happen for many reasons, some clearer than others. Loss of smell may be permanent or temporary, depending on the cause. Effects of Aging As with vision and hearing, people gradually lose their ability to smell as they get older. Smell that declines with age is called presbyosmia and is not preventable. Age is only one of the many reasons that problems with smell can occur. Most people who develop a problem with smell have recently had an illness or injury. Common Causes The common causes of smell disorders are \n-sinus and upper respiratory infections\n- aging\n- smoking\n- nasal polyps\n- head injury\n- allergies\n- hormonal disturbances\n- dental problems\n- exposure to certain chemicals\n- numerous medications\n- radiation for treatment of head and neck cancers\n- diseases of the nervous system. sinus and upper respiratory infections aging smoking nasal polyps head injury allergies hormonal disturbances dental problems exposure to certain chemicals numerous medications radiation for treatment of head and neck cancers diseases of the nervous system. Sinus and Upper Respiratory Infections. The most common causes of smell problems are the common cold and chronic nasal or sinus infection. Respiratory infections such as the flu can lead to smell disorders. Swollen sinuses and nasal passages often result in problems with smell because the odors in the air do not have good access to the olfactory sensory cells. These conditions may cause total or partial loss of smell. The problem usually diminishes or goes away when the underlying medical condition clears up. Aging. Problems with smell become more common as people get older. A person's sense of smell generally declines when he or she is over 60. Smoking. Tobacco smoking is the most concentrated form of pollution that most people are exposed to. It impairs the ability to identify and enjoy odors. Nasal Polyps. Loss of smell can be caused by nasal polyps, which are small, non-cancerous growths in the nose or sinuses that can block the ability of odors to reach olfactory sensory cells high up in the nose. In rare cases, benign non-malignant tumors grow on the olfactory nerves leading to the brain, causing a loss of smell. Previous surgery or trauma to the head can impair your sense of smell because the olfactory nerves may be cut, blocked, or physically damaged. Automobile accidents are among the most frequent causes of trauma to the face and head. Allergies. If your smell disorder is caused by allergies and seasonal nasal congestion, you should avoid allergens, such as ragweed, grasses, and pet dander. Exposure to Certain Chemicals. Sometimes exposure to certain chemicals, such as insecticides and solvents, can permanently damage the sense of smell. Medications. If you are taking certain medicines, you may notice a change in your ability to smell. Certain medications, including some common antibiotics and antihistamines, can cause problems with smell. The sense of smell usually returns to normal when you stop taking the medicine. Radiation Treatment. People with head and neck cancers who receive radiation treatment to the nose and mouth regions commonly experience problems with their sense of smell and taste as an unfortunate side effect. Older people who have lost their larynx or voice box commonly complain of poor ability to smell and taste. Diseases of the Nervous System. Sometimes a problem with smell can be a sign of a more serious health problem. This might include diseases of the nervous system, such as Parkinson's disease or Alzheimer's disease. Loss of smell may be the first sign that something is wrong. Check with your doctor if you've been experiencing a problem with your sense of smell for a while. You may be able to prevent or get early treatment for a more serious health problem." } ]

[ { "from": "human", "value": "What are the symptoms of Problems with Smell?" }, { "from": "gpt", "value": "A Reduced Sense of Smell There are several types of smell disorders depending on how the sense of smell is affected. People who have smell disorders experience either a loss in their ability to smell or changes in the way they perceive odors. Some people have hyposmia, which occurs when their ability to detect certain odors is reduced. This smell disorder is common in people who have upper respiratory infections or nasal congestion. This is usually temporary and goes away when the infection clears up. If You Can't Detect Odor at All Other people can't detect odor at all, which is called anosmia. This type of smell disorder is sometimes the result of head trauma in the nose region, usually from an automobile accident or chronic nasal or sinus infections. It can sometimes be caused by aging. In rare cases, anosmia is inherited. If Your Sense of Smell Is Distorted Sometimes a loss of smell can be accompanied by a change in the perception of odors. This type of smell disorder is called dysosmia. Familiar odors may become distorted, or an odor that usually smells pleasant instead smells foul. Sometimes people with this type of smell disorder also experience headaches, dizziness, shortness of breath, or anxiety. Still others may perceive a smell that isn't present at all, which is called phantosmia. Questions To Ask Yourself If you think you have a problem with your sense of smell, try to identify and record the circumstances at the time you first noticed the problem. Ask yourself the following questions: - When did I first become aware of it?\n- Did I have a cold or the flu?\n- Did I have a head injury?\n- Was I exposed to air pollutants, pollens, pet dander, or dust to which I might be allergic?\n- Is this a recurring problem?\n- Does it come at any special time, like during the hay fever season? When did I first become aware of it? Did I have a cold or the flu? Did I have a head injury? Was I exposed to air pollutants, pollens, pet dander, or dust to which I might be allergic? Is this a recurring problem? Does it come at any special time, like during the hay fever season? Bring this information with you when you visit your physician. Also, be prepared to tell him or her about your general health and any medications you are taking. Talking With Your Doctor Diagnosis by a doctor is important to identify and treat the underlying cause of a potential smell disorder. Your doctor may refer you to an otolaryngologist, a specialist in diseases of the ear, nose, and throat. An accurate assessment of a smell disorder will include, among other things, - a physical examination of the ears, nose, and throat\n- a review of your health history, such as exposure to toxic chemicals or injury, and\n- a smell test supervised by a health care professional. a physical examination of the ears, nose, and throat a review of your health history, such as exposure to toxic chemicals or injury, and a smell test supervised by a health care professional. Tests for Smell Disorders Some tests measure the smallest amount of odor you can detect. You also may receive a \"scratch and sniff\" test to determine how well you can identify various odors from a list of possibilities. In this test, the odor is embedded in a circular pad on a piece of paper and released when scratched. In this way, doctors can determine whether a person has a decreased ability to smell (hyposmia), the inability to detect any odors (anosmia), or another kind of smell disorder. In some cases, your doctor may need to perform a nasal examination with a nasal endoscope, an instrument that illuminates and magnifies the areas of the nose where the problem may exist. This test can help identify the area and extent of the problem and help your doctor select the right treatment. If your doctor suspects that upper regions of the nose and nasal sinuses that can't be seen by an endoscope are involved, he or she may order a specialized X-ray procedure, usually a CT scan, to look further into the nose and sinuses. When to See the Doctor If you think you have a smell disorder, see your doctor. Diagnosis of a smell disorder is important because once the cause is found, your doctor may be able to treat your smell disorder. Many types of smell problems are reversible, but if they are not, counseling and self-help techniques may help you cope." } ]

[ { "from": "human", "value": "What are the treatments for Problems with Smell?" }, { "from": "gpt", "value": "Relief is Possible Although there is no treatment for presbyosmia -- loss of smell due to aging -- relief from smell disorders is possible for many older people. Depending on the cause of your problem with smell, your doctor may be able to treat it or suggest ways to cope with it. Recovering the Ability To Smell Some people recover their ability to smell when they recover from the illness causing their loss of smell. Some people recover their sense of smell spontaneously, for no obvious reason. Other common causes of smell loss, such as the common cold or seasonal allergies, are usually temporary. Smell is regained by waiting for the illness to run its course. In some cases, nasal obstructions, such as polyps, can be removed to restore airflow through the nasal passages and restore the sense of smell. If your smell disorder cant be successfully treated, you might want to seek counseling to help you adjust. Ask About Your Medications Sometimes a certain medication causes a smell disorder, and improvement occurs when the medicine causing the problem is stopped or changed. If you take medications, ask your doctor if they can affect your sense of smell. If so, ask if you could substitute other medications or reduce the dose. Your doctor will work with you to get the medicine you need while trying to reduce unwanted side effects. Medications That May Help Your doctor may suggest oral steroid medications such as prednisone, which is usually used for a short period of time, or topical steroid sprays, which can be used for longer periods of time. Antibiotics are also used to treat nasal infections. The effectiveness of both steroids and antibiotics depends greatly on the severity and duration of the nasal swelling or infection. Often relief is temporary. Occasionally, the sense of smell returns to normal on its own without any treatment. Steps You Can Take If you have a problem with smell, there are some things you can do. - Wait it out. If you have had a cold with a stuffy nose, chances are in a few days your sense of smell will return. However, you should not wait to see your doctor if you think something more serious has caused your loss of smell or you have had the problem for a while. Loss of smell can sometimes mean a more serious condition exists. Wait it out. If you have had a cold with a stuffy nose, chances are in a few days your sense of smell will return. However, you should not wait to see your doctor if you think something more serious has caused your loss of smell or you have had the problem for a while. Loss of smell can sometimes mean a more serious condition exists. - Sweat it out. If your nose is stuffed up from a cold, sometimes mild exercise or the steam from a hot shower may open up your nasal passages. Sweat it out. If your nose is stuffed up from a cold, sometimes mild exercise or the steam from a hot shower may open up your nasal passages. - Stop smoking. Smoking causes long-term damage to your sense of smell. If you quit smoking, you may notice some improvement. To get free help quitting, visit www.Smokefree.gov Stop smoking. Smoking causes long-term damage to your sense of smell. If you quit smoking, you may notice some improvement. To get free help quitting, visit www.Smokefree.gov - Check with your doctor. If your sense of smell seems to have disappeared or changed, or if you've noticed the problem for a while, see your doctor for help. Sometimes, especially with a sinus infection, taking antibiotics for a short period of time may remedy the problem. If there is a blockage or you have a chronic sinus condition, outpatient surgery may be called for. Check with your doctor. If your sense of smell seems to have disappeared or changed, or if you've noticed the problem for a while, see your doctor for help. Sometimes, especially with a sinus infection, taking antibiotics for a short period of time may remedy the problem. If there is a blockage or you have a chronic sinus condition, outpatient surgery may be called for. If Your Smell Loss Is Permanent If you do not regain your sense of smell, there are things you should do to ensure your safety. Take extra precautions to avoid eating food that may have spoiled. If you live with other people, ask them to smell the food to make sure it is fresh. People who live alone should discard food if there is a chance it is spoiled. Other home safety measures include installing smoke alarms and gas detectors. For those who wish to have additional help, there may be support groups in your area. These are often associated with smell and taste clinics in medical school hospitals. Some online bulletin boards also allow people with smell disorders to share their experiences. Not all people with smell disorders will regain their sense of smell, but most can learn to live with it. Ongoing Research The National Institute on Deafness and Other Communication Disorders (NIDCD) supports basic and clinical investigations of smell and taste disorders at its laboratories in Bethesda, Md. and at universities and chemosensory research centers across the country. These chemosensory scientists are exploring how to \n-promote the regeneration of sensory nerve cells\n- understand the effects of the environment (such as gasoline fumes, chemicals, and extremes of humidity and temperature) on smell and taste\n- prevent the effects of aging on smell and taste\n- develop new diagnostic tests for taste and smell disorders\n- understand associations between smell disorders and changes in diet and food preferences in the elderly or among people with chronic illnesses. promote the regeneration of sensory nerve cells understand the effects of the environment (such as gasoline fumes, chemicals, and extremes of humidity and temperature) on smell and taste prevent the effects of aging on smell and taste develop new diagnostic tests for taste and smell disorders understand associations between smell disorders and changes in diet and food preferences in the elderly or among people with chronic illnesses." } ]

[ { "from": "human", "value": "What is (are) Problems with Smell?" }, { "from": "gpt", "value": "Smell is part of our chemical sensing system. Our sense of smell is the ability to detect odors in our environment through our nose, like the fragrance of flowers or the smell of baking bread. Smell is also the ability to detect food odors or aromas released in our mouths when we chew, which then flow from the roof of the throat region to the nose. Congestion blocks this flow and impacts our appreciation of the flavor of food." } ]

[ { "from": "human", "value": "What are the symptoms of Problems with Smell?" }, { "from": "gpt", "value": "People who experience smell disorders either have a decrease in their ability to smell or changes in the way they perceive odors. Total smell loss is relatively rare, but a decrease in the sense of smell occurs more often, especially in older adults. There are several types of smell disorders depending on how the sense of smell is affected. - Some people have hyposmia, which occurs when their ability to detect certain odors is reduced.\n- Other people can't detect odor at all, which is called anosmia.\n- Sometimes a loss of smell can be accompanied by a change in the perception of odors. This type of smell disorder is called dysosmia. Familiar odors may become distorted, or an odor that usually smells pleasant instead smells foul.\n- Still others may perceive a smell that isn't present at all, which is called phantosmia.\n- Smell loss due to aging is called presbyosmia. Some people have hyposmia, which occurs when their ability to detect certain odors is reduced. Other people can't detect odor at all, which is called anosmia. Sometimes a loss of smell can be accompanied by a change in the perception of odors. This type of smell disorder is called dysosmia. Familiar odors may become distorted, or an odor that usually smells pleasant instead smells foul. Still others may perceive a smell that isn't present at all, which is called phantosmia. Smell loss due to aging is called presbyosmia." } ]

[ { "from": "human", "value": "What causes Problems with Smell?" }, { "from": "gpt", "value": "Most people who have a problem with smell have recently had an illness or injury. The most common causes are upper respiratory infections, such as the common cold, and chronic sinus or nasal disease. Other common causes are \n-aging\n- smoking\n- nasal polyps\n- head injury\n- allergens such as ragweed, grasses, and pet dander\n- hormonal disturbances\n- dental problems\n- exposure to certain chemicals such as insecticides or solvents\n- medications such as antibiotics or antihistamines\n- radiation for treatment of head and neck cancers\n- diseases of the nervous system such as Parkinsons disease or Alzheimers disease. aging smoking nasal polyps head injury allergens such as ragweed, grasses, and pet dander hormonal disturbances dental problems exposure to certain chemicals such as insecticides or solvents medications such as antibiotics or antihistamines radiation for treatment of head and neck cancers diseases of the nervous system such as Parkinsons disease or Alzheimers disease." } ]

[ { "from": "human", "value": "How to prevent Problems with Smell?" }, { "from": "gpt", "value": "Problems with smell that occur with aging are not preventable. However, you can protect yourself against other causes of smell loss with these steps. - Treat Sinus and Nasal Conditions. Swollen sinuses and nasal passages may cause total or partial loss of smell. Your doctor may prescribe an antibiotic or anti-inflammatory drug to reduce nasal swelling from chronic sinus infections, a major cause of smell loss. Treat Sinus and Nasal Conditions. Swollen sinuses and nasal passages may cause total or partial loss of smell. Your doctor may prescribe an antibiotic or anti-inflammatory drug to reduce nasal swelling from chronic sinus infections, a major cause of smell loss. \n-Prevent Upper Respiratory Infections. Colds and respiratory infections such as the flu can lead to smell disorders. Wash your hands frequently, especially during the winter months, and get a flu shot every year. For more information about the flu vaccine, visit Key Facts About Seasonal Flu Vaccine Prevent Upper Respiratory Infections. Colds and respiratory infections such as the flu can lead to smell disorders. Wash your hands frequently, especially during the winter months, and get a flu shot every year. For more information about the flu vaccine, visit Key Facts About Seasonal Flu Vaccine - Avoid Allergens. Keep away from allergens such as ragweed, grasses, and pet dander that can cause seasonal allergies or nasal congestion. Avoid Allergens. Keep away from allergens such as ragweed, grasses, and pet dander that can cause seasonal allergies or nasal congestion. - Avoid Head Injuries. Previous surgery or trauma to the head can impair your sense of smell because the olfactory nerves may be cut, blocked, or physically damaged. Always wear seatbelts when riding in a car and a helmet when bicycling. Avoid Head Injuries. Previous surgery or trauma to the head can impair your sense of smell because the olfactory nerves may be cut, blocked, or physically damaged. Always wear seatbelts when riding in a car and a helmet when bicycling. - Avoid Exposure to Toxic Chemicals. Avoid contact with chemicals that might cause smell problems such as paints, insecticides, and solvents, or wear a respirator if you cannot avoid contact. Avoid Exposure to Toxic Chemicals. Avoid contact with chemicals that might cause smell problems such as paints, insecticides, and solvents, or wear a respirator if you cannot avoid contact. - Review Your Medications. If you are taking medications such as antibiotics or antihistamines and notice a change in your sense of smell, talk to your doctor. You may be able to adjust or change your medicine to one that will not cause a problem with smell. Review Your Medications. If you are taking medications such as antibiotics or antihistamines and notice a change in your sense of smell, talk to your doctor. You may be able to adjust or change your medicine to one that will not cause a problem with smell. - Dont Smoke. It impairs the ability to identify and enjoy odors. For free help to quit smoking, visit www.Smokefree.gov Dont Smoke. It impairs the ability to identify and enjoy odors. For free help to quit smoking, visit www.Smokefree.gov\n-Treat Nasal Polyps If Necessary. If you have nasal polyps, having them removed may restore smell. Treat Nasal Polyps If Necessary. If you have nasal polyps, having them removed may restore smell. \n-Treat Other Conditions. If you have diabetes, thyroid abnormalities, certain vitamin deficiencies, or are malnourished and you experience a loss of smell or taste, tell your doctor. In some cases, when the condition that is causing the problem with smell is treated, the sense of smell returns. Treat Other Conditions. If you have diabetes, thyroid abnormalities, certain vitamin deficiencies, or are malnourished and you experience a loss of smell or taste, tell your doctor. In some cases, when the condition that is causing the problem with smell is treated, the sense of smell returns." } ]

[ { "from": "human", "value": "What causes Problems with Smell?" }, { "from": "gpt", "value": "In rare cases, certain medicines such as antibiotics or antihistamines may cause a change in your ability to smell. If you are taking these medications and notice a change in your sense of smell, talk to your doctor. You may be able to adjust or change your medicine to one that will not cause a problem with smell." } ]

[ { "from": "human", "value": "How to diagnose Problems with Smell?" }, { "from": "gpt", "value": "Scientists have developed tests to determine the nature and extent of a person's smell disorder. Tests measure the smallest amount of odor patients can detect as well as how accurately a person can identify different smells. An easily administered \"scratch and sniff\" test allows a person to scratch pieces of paper treated to release different odors, sniff them, and try to identify each odor from a list of possibilities. In this way, doctors can determine whether a person has a decreased ability to smell (hyposmia), the inability to detect any odors (anosmia), or another kind of smell disorder. In some cases, your doctor may need to perform a nasal examination with a nasal endoscope, an instrument that illuminates and magnifies the areas of the nose where the problem may exist. This test can help identify the area and extent of the problem and help your doctor select the right treatment. If your doctor suspects that upper regions of the nose and nasal sinuses that can't be seen by an endoscope are involved, he or she may order a specialized X-ray procedure, usually a CT scan, to look further into the nose and sinuses." } ]

[ { "from": "human", "value": "What are the treatments for Problems with Smell?" }, { "from": "gpt", "value": "Depending on the cause of your smell disorder, your doctor may be able to treat your problem or suggest ways to cope with it. If a certain medication is the cause of the disorder, ask your doctor if you could substitute other medications or reduce the dose. Your doctor will work with you to get the medicine you need while trying to reduce unwanted side effects. Some patients with respiratory infections or allergies regain their sense of smell when the illness or condition is over. Often, correcting a general medical problem also can restore the sense of smell. For patients with nasal obstructions, such as polyps, or other inflammatory conditions of the nose or sinuses, medical treatments or surgery can restore the sense of smell. Occasionally, the sense of smell returns to normal on its own, without any treatment. Your doctor may suggest oral steroid medications such as prednisone, which is usually used for a short period of time, or topical steroid sprays, which can be used for longer periods of time. Antibiotics are also used to treat nasal infections. The effectiveness of both steroids and antibiotics depends greatly on the severity and duration of the nasal swelling or infection. Often relief is temporary." } ]

[ { "from": "human", "value": "What is (are) Problems with Smell?" }, { "from": "gpt", "value": "You can help your doctor make a diagnosis by writing down important information about your problem beforehand and giving the information to your doctor during your visit. Write down answers to the following questions. - When did I first become aware of the problem?\n- Did I have a cold or the flu?\n- Did I have a head injury?\n- Was I exposed to air pollutants, pollen, pet dander, or dust to which I might be allergic?\n- Is this a recurring problem?\n- Does it come at any special time, such as during the hay fever season? When did I first become aware of the problem? Did I have a cold or the flu? Did I have a head injury? Was I exposed to air pollutants, pollen, pet dander, or dust to which I might be allergic? Is this a recurring problem? Does it come at any special time, such as during the hay fever season?" } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Problems with Smell?" }, { "from": "gpt", "value": "The National Institute on Deafness and Other Communication Disorders (NIDCD) supports basic and clinical investigations of smell and taste disorders at its laboratories in Bethesda, Md. and at universities and chemosensory research centers across the country. These chemosensory scientists are exploring how to - promote the regeneration of sensory nerve cells\n- understand the effects of the environment (such as gasoline fumes, chemicals, and extremes of humidity and temperature) on smell and taste\n- prevent the effects of aging on smell and taste\n- develop new diagnostic tests for taste and smell disorders\n- understand associations between smell disorders and changes in diet and food preferences in the elderly or among people with chronic illnesses. promote the regeneration of sensory nerve cells understand the effects of the environment (such as gasoline fumes, chemicals, and extremes of humidity and temperature) on smell and taste prevent the effects of aging on smell and taste develop new diagnostic tests for taste and smell disorders understand associations between smell disorders and changes in diet and food preferences in the elderly or among people with chronic illnesses." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "How Tumors Form The body is made up of many types of cells. Normally, cells grow, divide and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Breast cancer occurs when malignant tumors form in the breast tissue. Who Gets Breast Cancer? Breast cancer is one of the most common cancers in American women. It is most common among women between the ages of 45-85. (Watch the video to learn more about breast cancer survival rates. To enlarge the videos appearing on this page, click the brackets in the lower right-hand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Men can get breast cancer too, although they account for only 1 percent of all reported cases. Read more about breast cancer in men. When Breast Cancer Spreads When cancer grows in breast tissue and spreads outside the breast, cancer cells are often found in the lymph nodes under the arm. If the cancer has reached these nodes, it means that cancer cells may have spread, or metastasized, to other parts of the body. When cancer spreads from its original location in the breast to another part of the body such as the brain, it is called metastatic breast cancer, not brain cancer. Doctors sometimes call this \"distant\" disease. Learn about different kinds of breast cancer. Breast Cancer is Not Contagious Breast cancer is not contagious. A woman cannot \"catch\" breast cancer from other women who have the disease. Also, breast cancer is not caused by an injury to the breast. Most women who develop breast cancer do not have any known risk factors or a history of the disease in their families. Treating and Surviving Breast Cancer Today, more women are surviving breast cancer than ever before. Nearly three million women are breast cancer survivors. (Watch the video to hear a woman discuss surviving breast cancer.) There are several ways to treat breast cancer, but all treatments work best when the disease is found early. As a matter of fact, when it is caught in its earliest stage, 98.5 percent of women with the disease are alive five years later. Every day researchers are working to find new and better ways to detect and treat cancer. Many studies of new approaches for women with breast cancer are under way. With early detection, and prompt and appropriate treatment, the outlook for women with breast cancer can be positive. To learn more about what happens after treatment, see Surviving Cancer." } ]

[ { "from": "human", "value": "Who is at risk for Breast Cancer??" }, { "from": "gpt", "value": "Some women develop breast cancer and others do not, and the risk factors for the disease vary. Breast cancer may affect younger women, but three-fourths of all breast cancers occur in women between the ages of 45 to 85. In Situ and Invasive Breast Cancer Researchers often talk about breast cancer in two ways: in situ and invasive. In situ refers to cancer that has not spread beyond its site of origin. Invasive applies to cancer that has spread to the tissue around it. This chart shows what the approximate chances are of a woman getting invasive breast cancer in her lifetime. Risk Factors Risk factors are conditions or agents that increase a person's chances of getting a disease. Here are the most common risk factors for breast cancer. \n-Older age. The risk of breast cancer in a 70 year old woman is about 10 times that of a 30 year old woman, but risk decreases after age 85. Older age. The risk of breast cancer in a 70 year old woman is about 10 times that of a 30 year old woman, but risk decreases after age 85. - Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. - Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. - Never being pregnant or having your first child in your mid-30s or later. Never being pregnant or having your first child in your mid-30s or later. - Early menstruation. Having your first menstrual period before age 12. Early menstruation. Having your first menstrual period before age 12. - Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. \n-Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. - Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. - Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. - Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. - Gaining weight after menopause, especially after natural menopause and/or after age 60. Gaining weight after menopause, especially after natural menopause and/or after age 60. - Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. - Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma. Five percent to 10 percent of all breast cancers are thought to be inherited. Get information about the BRCA1 and BRCA2 genetic mutations and testing for them. Warning Signs When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. \n-a lump or thickening in or near the breast or in the underarm area\n- a change in the size or shape of the breast\n- a dimple or puckering in the skin of the breast\n-a nipple turned inward into the breast\n-fluid, other than breast milk, from the nipple, especially if it's bloody\n- scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple)\n- dimples in the breast that look like the skin of an orange. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast a dimple or puckering in the skin of the breast a nipple turned inward into the breast fluid, other than breast milk, from the nipple, especially if it's bloody scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) dimples in the breast that look like the skin of an orange. Don't Ignore Symptoms You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible. Some women believe that as they age, health problems are due to \"growing older.\" Because of this myth, many illnesses go undiagnosed and untreated. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Talk to your doctor." } ]

[ { "from": "human", "value": "Who is at risk for Breast Cancer??" }, { "from": "gpt", "value": "What Is Cancer Prevention? Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer. When studying ways to prevent cancer, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor. Anything that decreases your chance of developing cancer is called a cancer protective factor. Risk Factors Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including - changing lifestyle or eating habits\n- avoiding things known to cause cancer\n- taking medicine to treat a precancerous condition or to keep cancer from starting. changing lifestyle or eating habits avoiding things known to cause cancer taking medicine to treat a precancerous condition or to keep cancer from starting. (For more on risk factors, see the chapter on \"Risk Factors.\") Here are protective factors for breast cancer. Less Exposure to Estrogen Decreasing the length of time a woman's breast tissue is exposed to estrogen may help lower her risk of developing breast cancer. Exposure to estrogen is reduced in the following ways. \n-Early pregnancy. Estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35.\n-Breast-feeding. Estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.\n-Surgical removal of the ovaries. The ovaries make estrogen. The amount of estrogen made by the body can be greatly reduced by removing one or both ovaries. Also, drugs may be taken to lower the amount of estrogen made by the ovaries.\n-Late menstruation. Menstrual periods that start at age 14 or older decreases the number of years the breast tissue is exposed to estrogen.\n- Early menopause. The fewer years a woman menstruates, the shorter the time her breast tissue is exposed to estrogen. Early pregnancy. Estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding. Estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed. Surgical removal of the ovaries. The ovaries make estrogen. The amount of estrogen made by the body can be greatly reduced by removing one or both ovaries. Also, drugs may be taken to lower the amount of estrogen made by the ovaries. Late menstruation. Menstrual periods that start at age 14 or older decreases the number of years the breast tissue is exposed to estrogen. Early menopause. The fewer years a woman menstruates, the shorter the time her breast tissue is exposed to estrogen. Exercise Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight. Learn more about the benefits of exercise for older adults. For exercises tailored to older adults, visit Go4Life, the exercise and physical activity campaign from the National Institute on Aging (NIA) at NIH. Estrogen-only Hormone Therapy After Hysterectomy Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy. Learn about menopausal hormone therapy and cancer. Selective Estrogen Receptor Modulators (SERMs) Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (SERMs). SERMs act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues. Treatment with tamoxifen or raloxifene lowers the risk of breast cancer in postmenopausal women. Tamoxifen also lowers the risk of breast cancer in high-risk premenopausal women. With either drug, the reduced risk lasts for several years after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene. Prophylactic Mastectomy Some women who have a high risk of breast cancer may choose to have a prophylactic mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision. Learn more about surgery to reduce the risk of breast cancer. Prophylactic Oophorectomy Premenopausal women who have a high risk of breast cancer due to certain changes in the BRCA1 and BRCA2 genes may choose to have a prophylactic oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Prophylactic oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density. Unclear As Risk Factors It is not clear whether the following affect the risk of breast cancer. - Oral contraceptives. Taking oral contraceptives (\"the pill\") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Some oral contraceptives contain estrogen. Progestin-only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer.\n- Environment. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer. Oral contraceptives. Taking oral contraceptives (\"the pill\") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Some oral contraceptives contain estrogen. Progestin-only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. Environment. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer. For More Information Clinical trials are taking place in many parts of the country. Information about clinical trials can be found at http://www.cancer.gov/clinicaltrials on the website of the National Cancer Institute (NCI). Check NCI's list of cancer clinical trials for breast cancer prevention trials that are now accepting patients." } ]

[ { "from": "human", "value": "How to diagnose Breast Cancer?" }, { "from": "gpt", "value": "Most cancers in their early, most treatable stages do not cause any symptoms. That is why it's important to have regular tests to check for cancer long before you might notice anything wrong. Detecting Breast Cancer Through Screening When breast cancer is found early, it is more likely to be treated successfully. Checking for cancer in a person who does not have any symptoms is called screening. Screening tests for breast cancer include, among others, clinical breast exams and mammograms. Recent studies have shown that ultrasound and MRI's may also be useful complementary screening tools, particularly in women with mammograms that are not definitive. During a clinical breast exam, the doctor or other health care professional checks the breasts and underarms for lumps or other changes that could be a sign of breast cancer. A mammogram is a special x-ray of the breast that often can detect cancers that are too small for a woman or her doctor to feel. Who Should Have a Mammography? Several studies show that mammography screening has reduced the number of deaths from breast cancer. However, some other studies have not shown a clear benefit from mammography. Scientists are continuing to examine the level of benefit that mammography can produce. The U.S. Preventive Services Task Force (USPSTF) recommends a screening mammography for women 50-74 years every two years. Learn more about the USPSTF mammography recommendations here. Between 5 and 10 percent of mammogram results are abnormal and require more testing. Most of these follow-up tests confirm that no cancer was present. Worried about the cost of a mammogram? Learn about free and low-cost screenings. (Centers for Disease Control and Prevention) How Biopsies are Performed If needed, the most common follow-up test a doctor will recommend is called a biopsy. This is a procedure where a small amount of fluid or tissue is removed from the breast to make a diagnosis. A doctor might perform fine needle aspiration, a needle or core biopsy, or a surgical biopsy. - With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab.\n- For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous.\n- In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells. With fine needle aspiration, doctors numb the area and use a thin needle to remove fluid and/or cells from a breast lump. If the fluid is clear, it may not need to be checked out by a lab. For a needle biopsy, sometimes called a core biopsy, doctors use a needle to remove tissue from an area that looks suspicious on a mammogram but cannot be felt. This tissue goes to a lab where a pathologist examines it to see if any of the cells are cancerous. In a surgical biopsy, a surgeon removes a sample of a lump or suspicious area. Sometimes it is necessary to remove the entire lump or suspicious area, plus an area of healthy tissue around the edges. The tissue then goes to a lab where a pathologist examines it under a microscope to check for cancer cells. Another type of surgical biopsy that removes less breast tissue is called an image-guided needle breast biopsy, or stereotactic biopsy. Eighty percent of U.S. women who have a surgical breast biopsy do not have cancer. However, women who have breast biopsies are at higher risk of developing breast cancer than women who have never had a breast biopsy. Other Detection Methods Magnetic resonance imaging, or MRI, and ultrasound are two other techniques which, as supplements to standard mammography, might help detect breast cancer with greater accuracy. Genetic Detection The most comprehensive study to date of gene mutations in breast cancer, published in September 2012, confirmed that there are four primary subtypes of breast cancer, each with its own biology. The four groups are called intrinsic subtypes of breast cancer and include HER2-enriched (HER2E), Luminal A (LumA), Luminal B (LumB) and Basal-like. The outlook for survival is different for each of these subtypes of breast cancer. Researchers found that one subtype, Basal-like breast cancer, shares many genetic features with a form of ovarian cancer, and that both may respond similarly to drugs that reduce tumor growth or target DNA repair. The authors hope that discovery of these mutations will be an important step in the effort to improve therapies for breast cancer. For the time being, there are no genetic tests that are commercially available based solely on these findings. Soon, however, knowing extensively which breast cancer gene mutations a woman has should help guide precision treatment." } ]

[ { "from": "human", "value": "What are the treatments for Breast Cancer?" }, { "from": "gpt", "value": "There are many treatment options for women with breast cancer. The choice of treatment depends on your age and general health, the stage of the cancer, whether or not it has spread beyond the breast, and other factors. If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better outcomes. Working With a Team of Specialists People with cancer often are treated by a team of specialists. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist who is a specialist in cancer treatment, a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. (Watch the video about this breast cancer survivor's treatment. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Clinical Trials for Breast Cancer Some breast cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Women with breast cancer who are interested in taking part in a clinical trial should talk to their doctor. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. See a list of the current clinical trials on breast cancer." } ]

[ { "from": "human", "value": "What are the treatments for Breast Cancer?" }, { "from": "gpt", "value": "There are a number of treatments for breast cancer, but the ones women choose most often -- alone or in combination -- are surgery, hormone therapy, radiation therapy, and chemotherapy. What Standard Treatments Do Here is what the standard cancer treatments are designed to do. - Surgery takes out the cancer and some surrounding tissue.\n- Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow.\n- Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue.\n-Chemotherapy uses anti-cancer drugs to kill most cancer cells. Surgery takes out the cancer and some surrounding tissue. Hormone therapy keeps cancer cells from getting most of the hormones they need to survive and grow. Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors and some surrounding tissue. Chemotherapy uses anti-cancer drugs to kill most cancer cells. Treatment for breast cancer may involve local or whole body therapy. Doctors use local therapies, such as surgery or radiation, to remove or destroy breast cancer in a specific area. Whole body, or systemic, treatments like chemotherapy, hormonal, or biological therapies are used to destroy or control cancer throughout the body. Some patients have both kinds of treatment. Treating Early-Stage Breast Cancer If you have early-stage breast cancer, one common treatment available to you is a lumpectomy combined with radiation therapy. A lumpectomy is surgery that preserves a woman's breast. In a lumpectomy, the surgeon removes only the tumor and a small amount of the surrounding tissue. The survival rate for a woman who has this therapy plus radiation is similar to that for a woman who chooses a radical mastectomy, which is complete removal of a breast. If Cancer Has Spread Locally If you have breast cancer that has spread locally -- just to other parts of the breast -- your treatment may involve a combination of chemotherapy and surgery. Doctors usually first shrink the tumor with chemotherapy and then remove it through surgery. Shrinking the tumor before surgery may allow a woman to avoid a mastectomy and keep her breast. In the past, doctors would remove a lot of lymph nodes near breast tumors to see if the cancer had spread. Some doctors also use a method called sentinel node biopsy. Using a dye or radioactive tracer, surgeons locate the first or sentinel lymph node closest to the tumor, and remove only that node to see if the cancer has spread. If Cancer Has Spread Beyond the Breast If the breast cancer has spread to other parts of the body, such as the lung or bone, you might receive chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. Radiation therapy may also be useful to control tumors in other parts of the body. Get more information about treatment options for breast cancer and for recurrent breast cancer." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Breast Cancer?" }, { "from": "gpt", "value": "New Technologies Several new technologies offer hope for making future treatment easier for women with breast cancer. - Using a special tool, doctors can today insert a miniature camera through the nipple and into a milk duct in the breast to examine the area for cancer. Using a special tool, doctors can today insert a miniature camera through the nipple and into a milk duct in the breast to examine the area for cancer. - Researchers are testing another technique to help women who have undergone weeks of conventional radiation therapy. Using a small catheter -- a tube with a balloon tip -- doctors can deliver tiny radioactive beads to a place on the breast where cancer tissue has been removed. This can reduce the therapy time to a matter of days. Researchers are testing another technique to help women who have undergone weeks of conventional radiation therapy. Using a small catheter -- a tube with a balloon tip -- doctors can deliver tiny radioactive beads to a place on the breast where cancer tissue has been removed. This can reduce the therapy time to a matter of days. New Drug Combination Therapies New drug therapies and combination therapies continue to evolve. - A mix of drugs may increase the length of time you will live or the length of time you will live without cancer. It may someday prove useful for some women with localized breast cancer after they have had surgery. A mix of drugs may increase the length of time you will live or the length of time you will live without cancer. It may someday prove useful for some women with localized breast cancer after they have had surgery. - New research shows women with early-stage breast cancer who took the drug letrozole, an aromatase inhibitor, after they completed five years of tamoxifen therapy significantly reduced their risk of breast cancer recurrence. New research shows women with early-stage breast cancer who took the drug letrozole, an aromatase inhibitor, after they completed five years of tamoxifen therapy significantly reduced their risk of breast cancer recurrence. Treating HER2-Positive Breast Cancer Herceptin is a drug commonly used to treat women who have a certain type of breast cancer. This drug slows or stops the growth of cancer cells by blocking HER2, a protein found on the surface of some types of breast cancer cells. Approximately 20 to 25 percent of breast cancers produce too much HER2. These \"HER2 positive\" tumors tend to grow faster and are generally more likely to return than tumors that do not overproduce HER2. Results from clinical trials show that those patients with early-stage HER2 positive breast cancer who received Herceptin in combination with chemotherapy had a 52 percent decrease in risk in the cancer returning compared with patients who received chemotherapy treatment alone. Cancer treatments like chemotherapy can be systemic, meaning they affect whole tissues, organs, or the entire body. Herceptin, however, was the first drug used to target only a specific molecule involved in breast cancer. Another drug, Tykerb, was approved by the U.S. Food and Drug Administration for use for treatment of HER2-positive breast cancer. Because of the availability of these two drugs, an international trial called ALTTO was designed to determine if one drug is more effective, safer, and if taking the drugs separately, in tandem order, or together is better. Unfortunately, the results, released in 2014, showed that taking two HER2-targeted agents together was no better than taking one alone in improving survival. The TAILORx Trial In an attempt to further specialize breast cancer treatment, The Trial Assigning Individualized Options for Treatment, or TAILORx, enrolled 10,000 women to examine whether appropriate treatment can be assigned based on genes that are frequently associated with risk of recurrence of breast cancer. The goal of TAILORx is important because the majority of women with early-stage breast cancer are advised to receive chemotherapy in addition to radiation and hormonal therapy, yet research has not demonstrated that chemotherapy benefits all of them equally. TAILORx seeks to examine many of a woman's genes simultaneously and use this information in choosing a treatment course, thus sparing women unnecessary treatment if chemotherapy is not likely to be of substantial benefit to them." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy. Sometimes, however, the process goes wrong. Cells become abnormal and form more cells in an uncontrolled way. These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "Breast cancer occurs when a malignant tumor forms in the breast tissue. The cancer can be found in the breast itself or in the ducts and lymph nodes that surround the breast." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "When cancer spreads from its original location in the breast to another part of the body such as the brain, it is called metastatic breast cancer, not brain cancer. Doctors sometimes call this \"distant\" disease." } ]

[ { "from": "human", "value": "Who is at risk for Breast Cancer??" }, { "from": "gpt", "value": "Did You Know: Breast Cancer Statistics? Breast cancer is one of the most common cancers in American women. It is most common among women between the ages of 45-85. Today, more women are surviving breast cancer than ever before. Over two million women are breast cancer survivors. Men can get breast cancer too, although they account for only one percent of all reported cases. Read more about breast cancer in men." } ]

[ { "from": "human", "value": "What are the symptoms of Breast Cancer?" }, { "from": "gpt", "value": "When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. \n-a lump or thickening in or near the breast or in the underarm area\n- a change in the size or shape of the breast\n- a dimple or puckering in the skin of the breast\n-a nipple turned inward into the breast\n-fluid, other than breast milk, from the nipple, especially if it's bloody\n- scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple)\n- dimples in the breast that look like the skin of an orange. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast a dimple or puckering in the skin of the breast a nipple turned inward into the breast fluid, other than breast milk, from the nipple, especially if it's bloody scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple) dimples in the breast that look like the skin of an orange. Don't Ignore Symptoms You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible. Some women believe that as they age, health problems are due to \"growing older.\" Because of this myth, many illnesses go undiagnosed and untreated. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Talk to your doctor." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "One definition of cure is being alive and free of breast cancer for 5 years. If the cancer is found early, a woman's chances of survival are better. In fact, nearly 98 percent of women who discover their breast cancer when it is near the site of origin and still small in size are alive 5 years later. However, women whose cancer is diagnosed at a late stage, after it has spread to other parts of the body, have only a 23.3 percent chance of surviving 5 years. To learn more about what happens after treatment, see Surviving Cancer." } ]

[ { "from": "human", "value": "Who is at risk for Breast Cancer??" }, { "from": "gpt", "value": "Risk factors are conditions or agents that increase a person's chances of getting a disease. Here are the most common risk factors for breast cancer. - Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter.\n- Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.\n- Never being pregnant or having your first child in your mid-30s or later.\n- Early menstruation. Having your first menstrual period before age 12.\n-Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density.\n-Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer.\n- Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.\n- Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.\n- Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.\n- Gaining weight after menopause, especially after natural menopause and/or after age 60.\n- Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease.\n- Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma.Five percent to 10 percent of all breast cancers are thought to be inherited.Personal and family history. A personal history of breast cancer or breast cancer among one or more of your close relatives, such as a sister, mother, or daughter. Estrogen levels in the body. High estrogen levels over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating. Never being pregnant or having your first child in your mid-30s or later. Early menstruation. Having your first menstrual period before age 12. Breast density. Women with very dense breasts have a higher risk of breast cancer than women with low or normal breast density. Combination hormone replacement therapy/Hormone therapy. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy. (HRT) or hormone therapy (HT). Combination HRT/HT is estrogen combined with progestin. This type of HRT/HT can increase the risk of breast cancer. Exposure to radiation. Radiation therapy to the chest for the treatment of cancer can increase the risk of breast cancer, starting 10 years after treatment. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast. Obesity. Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy. Alcohol. Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises. Gaining weight after menopause, especially after natural menopause and/or after age 60. Race. White women are at greater risk than black women. However, black women diagnosed with breast cancer are more likely to die of the disease. Inherited gene changes. Women who have inherited certain changes in the genes named BRCA1 and BRCA2 have a higher risk of breast cancer, ovarian cancer and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors. Men who have inherited certain changes in the BRCA2 gene have a higher risk of breast, prostate and pancreatic cancers, and lymphoma.Five percent to 10 percent of all breast cancers are thought to be inherited. Get information about the BRCA1 and BRCA2 genetic mutations and testing for them. This chart shows what the approximate chances are of a woman getting invasive breast cancer in her lifetime." } ]

[ { "from": "human", "value": "How to prevent Breast Cancer?" }, { "from": "gpt", "value": "When studying ways to prevent breast cancer, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor. Anything that decreases your chance of developing cancer is called a cancer protective factor. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including - changing lifestyle or eating habits\n- avoiding things known to cause cancer\n- taking medicine to treat a precancerous condition or to keep cancer from starting. changing lifestyle or eating habits avoiding things known to cause cancer taking medicine to treat a precancerous condition or to keep cancer from starting." } ]

[ { "from": "human", "value": "What are the symptoms of Breast Cancer?" }, { "from": "gpt", "value": "When breast cancer first develops, there may be no symptoms at all. But as the cancer grows, it can cause changes that women should watch for. You can help safeguard your health by learning the following warning signs of breast cancer. - a lump or thickening in or near the breast or in the underarm area\n- a change in the size or shape of the breast\n- ridges or pitting of the breast; the skin looks like the skin of an orange\n- a change in the way the skin of the breast, areola, or nipple looks or feels; for example, it may be warm, swollen, red, or scaly\n- nipple discharge or tenderness, or the nipple is pulled back or inverted into the breast. a lump or thickening in or near the breast or in the underarm area a change in the size or shape of the breast ridges or pitting of the breast; the skin looks like the skin of an orange a change in the way the skin of the breast, areola, or nipple looks or feels; for example, it may be warm, swollen, red, or scaly nipple discharge or tenderness, or the nipple is pulled back or inverted into the breast. You should see your doctor about any symptoms like these. Most often, they are not cancer, but it's important to check with the doctor so that any problems can be diagnosed and treated as early as possible." } ]

[ { "from": "human", "value": "What is (are) Breast Cancer?" }, { "from": "gpt", "value": "A mammogram can often detect breast changes in women who have no signs of breast cancer. Often, it can find a breast lump before it can be felt. If the results indicate that cancer might be present, your doctor will advise you to have a follow-up test called a biopsy." } ]

[ { "from": "human", "value": "Who is at risk for Breast Cancer??" }, { "from": "gpt", "value": "The risks of breast cancer screening tests include the following. - Finding breast cancer may not improve health or help a woman live longer. Screening may not help you if you have fast-growing breast cancer or if it has already spread to other places in your body. Also, some breast cancers found on a screening mammogram may never cause symptoms or become life-threatening. Finding these cancers is called overdiagnosis. Finding breast cancer may not improve health or help a woman live longer. Screening may not help you if you have fast-growing breast cancer or if it has already spread to other places in your body. Also, some breast cancers found on a screening mammogram may never cause symptoms or become life-threatening. Finding these cancers is called overdiagnosis. - False-negative test results can occur. Screening test results may appear to be normal even though breast cancer is present. A woman who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms. False-negative test results can occur. Screening test results may appear to be normal even though breast cancer is present. A woman who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if she has symptoms. - False-positive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isnt) is usually followed by more tests (such as biopsy), which also have risks. False-positive test results can occur. Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isnt) is usually followed by more tests (such as biopsy), which also have risks. - Anxiety from additional testing may result from false positive results. In one study, women who had a false-positive screening mammogram followed by more testing reported feeling anxiety 3 months later, even though cancer was not diagnosed. However, several studies show that women who feel anxiety after false-positive test results are more likely to schedule regular breast screening exams in the future. Anxiety from additional testing may result from false positive results. In one study, women who had a false-positive screening mammogram followed by more testing reported feeling anxiety 3 months later, even though cancer was not diagnosed. However, several studies show that women who feel anxiety after false-positive test results are more likely to schedule regular breast screening exams in the future. - Mammograms expose the breast to radiation. Being exposed to radiation is a risk factor for breast cancer. The risk of breast cancer from radiation exposure is higher in women who received radiation before age 30 and at high doses. For women older than 40 years, the benefits of an annual screening mammogram may be greater than the risks from radiation exposure. Mammograms expose the breast to radiation. Being exposed to radiation is a risk factor for breast cancer. The risk of breast cancer from radiation exposure is higher in women who received radiation before age 30 and at high doses. For women older than 40 years, the benefits of an annual screening mammogram may be greater than the risks from radiation exposure. - There may be pain or discomfort during a mammogram. During a mammogram, the breast is placed between 2 plates that are pressed together. Pressing the breast helps to get a better x-ray of the breast. Some women have pain or discomfort during a mammogram. There may be pain or discomfort during a mammogram. During a mammogram, the breast is placed between 2 plates that are pressed together. Pressing the breast helps to get a better x-ray of the breast. Some women have pain or discomfort during a mammogram. Some women worry about radiation exposure, but the risk of any harm from a mammogram is actually quite small. The doses of radiation used are very low and considered safe. The exact amount of radiation used during a mammogram will depend on several factors. For instance, breasts that are large or dense will require higher doses to get a clear image. Learn more about the risks of breast cancer screening." } ]

[ { "from": "human", "value": "What are the treatments for Breast Cancer?" }, { "from": "gpt", "value": "You can seek conventional treatment from a specialized cancer doctor, called an oncologist. The oncologist will usually assemble a team of specialists to guide your therapy. Besides the oncologist, the team may include a surgeon, a radiation oncologist who is a specialist in radiation therapy, and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. You might also be eligible to enroll in a clinical trial to receive treatment that conventional therapies may not offer." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Breast Cancer?" }, { "from": "gpt", "value": "Clinical trials are research studies on people to find out whether a new drug or treatment is both safe and effective. New therapies are tested on people only after laboratory and animal studies show promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible. Clinical trials are taking place in many parts of the country. Information about clinical trials can be found at http://www.cancer.gov/clinicaltrials on the website of the National Cancer Institute (NCI). Check NCI's list of cancer clinical trials for breast cancer prevention trials that are now accepting patients." } ]