As we move through life, the spectre of chronic disease grows bigger and bigger on the horizon. There are certain factors that put some of us at risk of contracting chronic disease as we age; but there are also ways to prevent the onset of chronic disease. I did what we should all do when we have concerns about medical matters – I talked to my doctor.
Adil Ladak is the newest general practitioner at Island Health Services. He has taken over Andrew West’s St George’s office, as the doctor has retired after more than half a century of service to the people of the Olde Towne.
Dr Ladak comes to Bermuda after spending several years providing medical care to world class athletes as a member of the Chelsea Football Club medical team. I, for one, am very happy to have him as my GP – if only for the chance to talk football with him when I visit. Today’s conversation, however, is about the importance of early detection in the management of chronic disease.
“Early detection is the single most important intervention in the management of chronic diseases and can vastly reduce their progression, a patient’s suffering and reduce the financial burden of chronic illness on our healthcare system,” Dr Ladak said.
“Chronic disease causes silent damage over many years. Patients with conditions like high blood pressure and high cholesterol often have no symptoms, and may not be aware of their health issues. Educating patients is crucial to help them understand the importance of early diagnostic testing and screening.”
It is especially important for folks reaching those middle-aged years to start thinking about getting screened for cancer, diabetes, heart disease and other serious conditions, he added.
“The annual physical exam is crucial, and recognised by health insurance providers as a way to reduce the incidence, progression and long-term impacts of these conditions. It’s beneficial for individuals, even in their twenties, to begin having annual physicals – it is always great to see young patients coming in.
“For heart disease and its underlying causes – high blood pressure, cholesterol and blood sugar levels – it’s advisable for everyone, regardless of gender, to undergo annual blood tests, an EKG, and physical examination especially after the age of 40. If any abnormalities are detected, patients have the opportunity to implement lifestyle changes, and repeat the tests after three months to monitor progress.”
Many important tests are gender specific as well.
“All women should participate in cervical and breast cancer screening annually. These cancers are prevalent, but highly treatable when detected early. Men should have their prostate-specific antigen levels measured annually, monitoring for any unexpected increases or new symptoms. Colonoscopy screenings are an increasingly useful tool due to rising global rates of bowel cancer. This straightforward and quick procedure should be considered by everyone over the age of 40, and then repeated according to individual advice from their doctor, and based on their risk profile. For those at low risk, this test may only be necessary every ten years.”
Once you’ve had all the recommended tests and screenings, what else can you do to lessen your risk of contracting chronic conditions?
Many people have underlying health concerns that may make them more susceptible to chronic diseases – those are the folks who need to pay the most attention to preventive lifestyle choices. Dr Ladak champions the power of physical activity in the battle to keep chronic diseases at bay.
“Physical activity is the single most important lifestyle change we can make to better our health and prevent chronic disease. This was a key message taught to me whilst studying public health as part of sports and exercise medicine,” he said.
“Physical activity is more powerful than any medication we have for the prevention and treatment of chronic disease. Physical activity reduces the burden of heart disease, strokes, osteoarthritis, dementia, mental health illnesses and cancer.”
Obesity has been identified as the cause of up to one-third of known cancers, Dr Ladak added.
“With people living longer, and an ageing population, education about the benefits of physical activity must be a priority and the time commitment is very manageable.
“The research suggests that most of this benefit can be achieved by completing 150 minutes per week of moderate physical activity – such as brisk walking or cycling – or 75 minutes per week of vigorous activity. Strength and flexibility training of the major muscle groups is recommended twice per week. For anyone contemplating a lifestyle change, I would recommend a very short video called 23 and ½ Hours on YouTube, which delivers this message powerfully.”
But how about vaccines? Are they a viable way to manage chronic disease?
“Vaccines have become very controversial, particularly in the wake of Covid, and any vaccine’s efficacy and safety must be established when used to treat chronic illnesses. The childhood vaccine programme has been very effective at greatly reducing – and, in some cases, eliminating – viruses such as Polio. Influenza and pneumococcal vaccines have been very useful in reducing illness in immunocompromised individuals; those living with cancer and lung diseases such as asthma and COPD [chronic obstructive pulmonary disease]. Travel vaccines have been very effective at reducing transmission of infectious disease, and the Hepatitis B vaccination schedule has greatly reduced risk in susceptible populations,” he said.
“The Human Papilloma Virus (HPV) vaccine is a very important scientific advancement and greatly reduces the potential for HPV-medicated cancers, cervical being the most important. Looking forward, I hope for the development of an HIV vaccine to help eradicate the virus in humans. Although, modern treatments now allow for a normal life expectancy and prevent the transmission of the virus to others.”
Education is the key to evading the approaching spectre of chronic disease. And while screening, medication, and physical activity are defining variables, ultimately it’s up to you to maintain your temple. It is a fact that Dr Ladak closes with: “Personal responsibility taken by the patient, regular, structured diagnostic testing and discussion with their physician will lead to good health outcomes.”
