Prostate cancer and statins – a complex relationship

25th December 2021, Dr Chee L Khoo

PSA screening

There is increasing evidence that supports an inverse association between statin use and cancer risk. The findings for prostate cancer, particularly advanced disease, are the most promising of all cancers studied. There are studies suggesting the usefulness of statins in secondary and tertiary prevention. For example, patients undergoing radiotherapy for prostate cancer improved their prostate specific survival if they are on statins.…

Cataract surgery delay – does it contribute to dementia risk?

11th December 2021, Dr Chee L Khoo

Cataracts

Cataract is a leading cause of blindness worldwide, affecting more than 35 million people globally and causing blindness in approximately 20 million. Visual impairment is an important dementia risk. Addressing sensory loss from visual impairment that affects older adults may be a potentially modifiable risk factor for dementia in late life (1,2) Because sensory impairments and dementia are both strongly associated with aging the link between sensory impairment and dementia may have important implications for individual and global public health, particularly if interventions to improve sensory function reduce dementia risk (3).…

Breast cancer surgery – is more necessarily better?

13th May 2021, Dr Chee L Khoo

The radical mastectomy introduced by Halsted was the treatment of choice for breast cancer of any size or type, regardless of the patient’s age, for 80 years. Any attempt in surgery less than a radical mastectomy was not widely considered during those years. Subsequent randomised controlled trials designed in 1969 and published in 1973 (1) and 1981 (2) showed that survival rates were equal after radical or breast-conserving surgery (BCS).…

Knee MRI – how reliable is it?

27th April, Spectrum Medical Imaging

Acute knee pain is a pretty common presentation in general practice. In experienced hands, a thorough physical examination can narrow the differential diagnosis to a few common injuries. Often we have to resort to an MRI to confirm our suspicion. How reliable is the MRI diagnosis?

In a novel study to evaluate the reproducibility, repeatability, and agreement of MRI evaluation with the gross pathology examination at operation, in 23 patients undergoing total knee arthroplasty, MRIs were performed just before the surgery (1).…

Monoclonal Ab for rhinosinusitis? – what will they think of next

25th April 2021, Dr Chee L Khoo

chronic rhinosinusitis

Chronic rhinosinusitis is a very common problem in general practice. Despite the “-itis”, infection is not actually the core problem. That is why antibiotic scripts after antibiotics script isn’t always the solution. There is often a significant inflammatory/allergic component in the pathogenesis. Current standard of care consists of intranasal steroids, nasal saline irrigation and short courses of systemic corticosteroids.…

Aspirin for colorectal cancer prevention – who will benefit?

13th February 2021, Dr Chee L Khoo

colorectal cancer

Aspirin as a chemoprotective agent against colorectal cancer (CRC) has gone through quite exhaustive reviews over the last 20 years. After initially recommended against using aspirin for CRC prevention in 2007, the US Preventative Services Task Force (USPSTF) in 2015 recommended initiating low-dose aspirin use for the primary prevention of CVD and CRC in “adults aged 50 to 59 years who have a >10% 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years and are willing to take low-dose aspirin daily for at least 10 years” (1).…

Sex hormones and eye abnormalities – how are they related?

11th January 2021, Dr Chee L Khoo

Sex hormones are not just responsible for the function of the reproductive system. They are also responsible for bone and cardiovascular health. Interestingly, they are produced, not only by the gonads, but also by other organs (1,2) including the central nervous system (CNS). Well, the eye is a neural structure and there is increasing evidence that oestrogens exert a neuro-protective role (3,4).…

Does wearing a facemask cause hypoxia?

14th November 2020, Dr Chee L Khoo

facemasks

It’s been at least 12 weeks since we started to wear facemasks at the practice full time with all face to face consultations. I must admit that during the first week, I did feel a bit suffocating with the mask on. I remember having to stop mid-sentence to catch my breath. I could sympathise with many patients, particularly patients who has COPD, asthma or heart failure.…

Aortic aneurysm and fluoroquinolones don’t mix well – do they?

13th October 2020, Dr Chee L Khoo

Aortic aneurysm (AA) and aortic dissection (AD) are potentially fatal conditions. Without treatment, ruptured AA/AD carries a mortality rate of up to 90%. Population-based studies estimated the annual incidence to be 2.4 to 14.8 per 100 000 persons for AA (1-4) and 3.8 to 8.8 per 100 000 persons for AD (3,5-7). Although the incidence varied across countries, the number has universally increased over time (1-5,7).…

Knee Osteoarthritis – is jogging good or bad?

24th May 2020, Dr Chee L Khoo

In primary care, we are frequently preventing disease or at least we try to. Apart from lifestyle measures, we prescribe statins, anti-hypertensive, aspirin and beta-blockers to reduce cardiovascular events. What about arthritis? In patients who do not have arthritis (yet) but are at high risk of degenerative osteoarthritis, is there something we can do to reduce the patients’ risk of progressing to full blown arthritis?…

Aspirin – which cancers will it benefit?

The US Preventive Services Task Force (USPSTF) recommends low-dose aspirin use for the prevention of cardiovascular disease among average-risk individuals aged 50 to 59 years with a 10% or greater 10-year risk of cardiovascular disease (1). Long-term regular aspirin use is also associated with reduced risk of obesity- and inflammation-associated cancers, particularly colorectal cancer (CRC) (2,3). Numerous follow up trials have consistently demonstrated significant reductions in risk in GI cancers – the NIH-AARP (4), the Nurses Health Study (5) and the Health Professionals Follow-up study (6,7).…