Increasing Sun Exposure Is Not The Way To Decrease Breast Cancer Risk, Say Yale Experts

Cancer researchers and physicians have warned of link between unprotected sun exposure and the development of skin cancer for decades, but experts from Yale Cancer Center warn that recent publicity about a new study linking a decreased risk of breast cancer to increased levels of vitamin D may be confusing.

A recent study, published in Breast Journal, evaluated the incidence of breast cancer in 107 countries. The authors found that higher levels of serum Vitamin D and living closer to equator correlated with a lower incidence of breast cancer. " While ultraviolet B radiation from sun is primary source of vitamin D in our body, unprotected sun exposure isn't a recommended way to reduce a person's risk of developing breast cancer, " said David J. Leffell, M. D. , Yale Cancer Center member and Professor and Section Chief of Dermatologic Surgery at Yale School of Medicine.

UV radiation is an undisputed carcinogen responsible for most of estimated 1. 5 million skin cancers that occur annually in the United States, he notes. " We are alarmed by the potential consequences of this study and urge women to continue to follow a careful sun protection program including the use of UV-blocking sunscreens. Women should absolutely avoid tanning salons, " Leffell said.

While this particular study showed that countries closer to equator have lower incidence of breast cancer, many factors in addition to sunlight exposure vary across these countries, according to the Yale experts. " The link between vitamin D and breast cancer isn't clearly known at this time. One recent U. S. study actually measured blood vitamin D levels in individual women and found that women with higher blood vitamin D levels didn't have significantly lower risk of subsequent breast cancer, " explained Susan Mayne, Director of Population Sciences at Yale Cancer Center and Professor of Epidemiology at Yale Schools of Medicine and Public Health. " Because the data are not consistent at this time, women who wish to reduce their risk of breast cancer should focus on more established risk factors. "

Accepted ways to decrease a woman's risk of breast cancer include avoidance of weight gain, moderation in alcohol consumption if any, regular physical activity, and a healthy and balanced diet, say Yale experts.

Yale Cancer Center is one of a select network of comprehensive cancer centers in country designated by National Cancer Institute and only one in Southern New England. Bringing together the resources of Yale-New Haven Hospital and the Yale University School of Medicine, its mission encompasses patient care, research, cancer prevention and control, community outreach, and education. For more information visit http: //www. yalecancercenter. org

Citation: Breast Journal ( Mar 17, 2008 ) .

http: //www. yale. edu

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Understanding Enalapril.

Enalapril: uses Enalapril is used to treat high blood pressure ( hypertension ) . Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

Enalapril contains two medications, enalapril and hydrochlorothiazide. Enalapril is called an ACE inhibitor and works by relaxing blood vessels so blood can flow more easily. Hydrochlorothiazide is called a water pill ( diuretic ) and causes your body to get rid of extra salt and water. This increases amount of urine we make. Getting rid of extra water and salt probably also helps to relax blood vessels so that blood can flow more easily. These medications are used together when one drug is not controlling your blood pressure.

Enalapril: how to use Take Enalapril by mouth with or without food, usually once or twice daily or as directed by your doctor. If we take this drug too close to bedtime, you may need to wake up to urinate. Therefore, it's best to take Enalapril at least 4 hours before your bedtime. Consult your doctor or pharmacist if we have questions about your dosing schedule.

The dosage is based on your age, medical condition and response to therapy. If we have severe liver or kidney problems, your dosage may need to be adjusted.

Use Enalapril regularly in order to get the most benefit from it. To help we remember, take it at same time each day. It's important to continue taking Enalapril even if you feel well. Most people with high blood pressure don't feel sick. It may take up to several weeks before full benefit of Enalapril takes effect.

Don't stop taking Enalapril without first consulting your doctor. Some conditions may become worse when drug is abruptly stopped. Your dose may need to be gradually decreased.

Inform your doctor if your condition worsens ( e. g. , your routine blood pressure readings increase ) .

Enalapril: other used This section contains uses of Enalapril that are not listed in approved professional labeling for drug but that may be prescribed by your health care professional. Use Enalapril for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Enalapril may also be used to treat certain heart conditions ( e. g. , congestive heart failure ) .

Enalapril: side effects Dizziness or lightheadedness may occur while use Enalapril as your body adjusts to medication. Nausea, tiredness, headache or dry cough may also occur. You may also experience decreased sexual ability or increased sensitivity to sun. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed Enalapril because he or she has judged that benefit to we is greater than risk of side effects. Many people using Enalapril don't have serious side effects.

The hydrochlorothiazide in Enalapril may cause too much body water and salts to be lost ( dehydration ) . Tell your doctor immediately if we have any of these unlikely but serious symptoms of dehydration:

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Enalapril may rarely cause serious ( possibly fatal ) liver problems. Tell your doctor immediately if we notice any of following rare but very serious side effects:

Tell your doctor immediately if any of these rare but very serious side effects occur:

A very serious allergic reaction to Enalapril is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Enalapril: precautions Before taking Enalapril, tell your doctor or pharmacist if we are allergic to either enalapril or hydrochlorothiazide; or to other ACE inhibitors ( e. g. , captopril, lisinopril ) ; or to other thiazides ( e. g. , polythiazide ) ; or to sulfa medications; or if you have any other allergies.

Enalapril should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if we have:

Before using Enalapril, tell your doctor or pharmacist your medical history, especially of:

Enalapril may make you dizzy; use caution while engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages.

To reduce risk of dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

Drink plenty of fluids while taking Enalapril to help prevent dizziness. Too much sweating, diarrhea or vomiting may cause we to feel lightheaded. Avoid heavy exercise. Report prolonged diarrhea or vomiting to your doctor.

Before having surgery, tell your doctor or dentist that we are taking Enalapril.

Enalapril may make we more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.

Enalapril may increase or decrease your potassium levels. Before using potassium supplements or salt substitutes containing potassium, consult your doctor or pharmacist. If you have diabetes, this product may increase your blood sugar levels. Check your blood glucose levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar, such as increased thirst and urination. Your anti-diabetic medication or diet may need to be adjusted.

Caution is advised when using Enalapril in elderly because they may be more sensitive to its effects, especially dizziness.

Enalapril is not recommended for use during pregnancy due to the risk for harm to an unborn baby. Consult your doctor for more details. ( See also Warning section. )

The enalapril and hydrochlorothiazide in Enalapril pass into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using Enalapril is not recommended. Consult your doctor before breast-feeding.

Enalapril: interactions Also see Precautions. Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring you for it. Don't start, stop or change dosage of any medicine before checking with them first.

Enalapril should not be used with following medication because very serious interactions may occur while use Enalapril:

Before using Enalapril, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:

A very serious reaction may occur while use Enalapril if you're getting injections for bee/wasp sting allergy ( desensitization ) and are also taking enalapril with hydrochlorothiazide. Make sure all your doctors know which medicines you're using.

If taken together with Enalapril, cholestyramine and colestipol can decrease amount of Enalapril that's absorbed by your body. If you are taking either of these drugs, separate them from this medication by at least 4 hours.

Check labels on all your medicines ( e. g. , cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction ) because they may contain ingredients that could increase your blood pressure or cause a fast heartbeat ( e. g. , pseudoephedrine, phenylephrine, chlorpheniramine, diphenhydramine, clemastine, ibuprofen, naproxen ) . Ask your pharmacist about safe use of those products.

Some nonprescription medicines may also contain aspirin, which may decrease effect of enalapril in Enalapril. Low-dose aspirin, as prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention ( usually at dosages of 81-325 milligrams per day ) should be continued. Consult your doctor or pharmacist for more details.

Enalapril can affect results of certain lab tests ( e. g. , parathyroid, certain tests that measure digoxin drug levels ) . Make sure laboratory personnel and your doctors know you use Enalapril.

This document does not contain all possible interactions. Therefore, before using Enalapril, tell your doctor or pharmacist of all products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

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