Q: I’m a 20-year-old guy. My sister got the HPV shot. Do I need one too?
HPV is the human papillomavirus, a family of more than 100 commonly found viruses. Infection with HPV may have no clinical symptoms and the body can clear itself of HPV infection in many cases.
Some HPV infections are transmitted through sexual contact and can cause genital or anal warts. Two types of HPV are known to be behind 70 per cent of cervical cancers in women. HPV is also a factor in some anal cancers, some other genital cancers and some head-and-neck cancers, but the percentage is much smaller.
The Alberta government initiated an immunization program in 2008, with all girls entering Grade 5 eligible to receive the Gardasil vaccine to protect them against HPV and, later in life, to avoid those cervical cancer cases that are related to the two types of virus. The current program vaccinates only girls and young women, but this could change. In February 2011, Health Canada approved Gardasil for use in boys and men age nine to 26 and, at the end of May, indicated of Gardasil for the prevention of anal cancer in both men and women.
That’s good news according to Dr. Martin Lavoie, Alberta’s deputy chief medical officer. “Females and males do transmit the disease, so by immunizing males we would see a reduction in the spread of the disease,” says Lavoie. “Also, it will protect males directly because they’re also at risk, in particular of anal cancer.”
The approval of the vaccine for boys and men is recent, so you should stay tuned for more information about who should be getting the vaccine and how they can get it. “It’s a step in the right direction in terms of having one more tool to reduce the spread of these infections and their complications and the burdens associated to that,” says Lavoie of the recent approval.
The National Advisory Committee on Immunization, the body that informs Canadians and regional health agencies how to use a vaccine, has not yet issued a statement advising boys and young men to get the vaccine. Based on the committee’s recommendation, which was still pending as of August, individual provinces and territories will determine their own vaccination programs, including the possible expansion of the program in Alberta to boys and young men. “It’s not going to take forever, but it is a process we’re going through and it is going to take a little while to get there,” says Lavoie.
In the meantime, young men who want to get the vaccine can contact their physician to discuss it, though Lavoie notes there may be some lag time between approval and accessibility of the vaccine.
Q: I am supposed to avoid cruciferous veggies because they mess with my blood thinner. How? What can I eat instead?
Cruciferous vegetables contain high amounts of vitamin K, which can counteract the effects of your blood thinner medication, explains Dr. Raylene Reimer, a professor at the University of Calgary in the faculty of kinesiology and the faculty of medicine, department of biochemistry and molecular biology.
“Vitamin K is involved in our body’s ability for the blood to clot,” says Reimer. “Blood thinner medication, under names like Coumadin and Warfarin, works by blocking the action of vitamin K. That is how the medication prevents blood clots from forming in the body.”
Vegetables that are high in vitamin K are cruciferous vegetables (including broccoli, brussels sprouts and cabbage) and leafy green vegetables (spinach, lettuce and other greens). Doctors will advise people taking blood thinners to be very aware of their vitamin K intake. This can include recommendations to try to eat the same amount of vitamin K every week, in order for your doctor to correctly adjust your dose of medication. Or, you may be instructed to limit your intake of food rich in vitamin K.
“It’s very important that you get the right levels of vitamin K in the body [when on blood thinner medication], because that determines how quickly your blood will clot,” says Reimer. “You want a good balance so that you don’t bleed too easily, but on the other hand that you’re not forming blood clots too easily.”
That doesn’t mean cutting out vegetables altogether, though, as there are many vegetables that contain lower levels of vitamin K – like red, orange and yellow peppers, cucumbers, peas, tomatoes, carrots, squash and potatoes. Fruit, dairy and most protein choices are also naturally very low in vitamin K.
Q: I’ve heard that large waist measurements are a better indicator of poor health than the numbers on the scale. What is the best way to tell if I’m at a healthy weight?
While stepping on the scale, wrapping a measuring tape around your waist or calculating numbers to find your body mass index (BMI) are common at-home tools to determine if you’re a healthy weight, an obesity expert says such measures are just screening tools.
“Only a doctor can tell if you’re at a healthy weight,” says Dr. Arya Sharma, a professor of medicine and chair in obesity research and management at the University of Alberta. Health problems related to excess weight are subtle and people may not realize they have them, says Sharma, so a visit to your doctor is the best way to determine if you are at a healthy weight, instead of tools like BMI, measuring waist circumference or stepping onto a scale. “Because many of the problems related to excess weight can sneak up on you, it’s going to be a visit to your doctor that will actually tell you whether or not you have any obesity-related or excess weight-related problems,” says Sharma.
Those health problems include elevated blood pressure, high cholesterol levels and high glucose levels. “The risk of health problems is higher when someone is putting on weight or carries a few extra pounds,” says Dr. Sharma, “It doesn’t mean that they have those problems, but it certainly means that they’re at risk for those problems. A checkup would be something that they might want to do.”
Dr. Sharma says during such a checkup, patients can expect their doctor to check blood pressure, order lab work, complete a physical exam and ask questions to help determine if there are any current or potential weight-related health issues.
Ask our experts questions regarding cancer prevention and treatment. Please submit them via email to Ask the Experts. Remember, the advice below is never a substitute for talking directly to your family doctor.
