The Docs: How to talk to children about cancer

— BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.

Q: My sister was diagnosed with breast cancer (they caught it early), and she’s going to have to go through a lumpectomy and chemotherapy.

The part she’s really agonizing over is how and what to tell her 10-year-old daughter. Any advice? -- Sharon B., Lincoln, Nebraska

A: At age 10, kids understand a lot, so your sister doesn’t have to worry too much about her daughter grasping the basic medical facts -- and she should share them. They’re much more reassuring than any fantasy or worries her daughter might cook up in her own mind or hear from friends. But emotional reactions need careful management, too. That’s why it’s important for your sister to tell her daughter about her diagnosis when everyone is well-rested and comfortable, and there’s plenty of time on the schedule.

First, she needs to explain the basics, such as what cancer is (bad cells that need to be stopped), that it isn’t contagious and that her specific cancer is effectively treated these days.

Then, she should explain why she’s decided on her course of treatment and mention that she may feel pretty rotten from the treatment sometimes, but when that happens she’s not getting worse, she’s getting better.

Your sister should ask her daughter what questions she has or if she’d like to think about them and talk again later. Then she should keep an eye out for any change in behavior or mood swings. And make yourself available to your niece. She might open up to you about concerns that she’s reluctant to discuss with her mom. One more thing -- your sis should ask her doc about genetic testing; if she was diagnosed before age 40, she may carry an identifiable mutation.

Just so YOU know, according to the American Cancer Society, if the cancer hasn’t spread beyond the breast or in the lymph nodes (stage one), the five-year relative survival rate is 99 percent!

Q: My husband, 62, has high blood pressure and heart disease, and as if that weren’t enough to worry about, now I hear it can affect his brain, too.

How does that work, and what can he do to protect himself? -- Kay D., Iowa City, Iowa

A: You’re right: High blood pressure is a threat to more than heart health. It endangers blood vessels everywhere, including in the brain. Fortunately, we have powerful lifestyle and medical remedies available.

A study recently published in Neurology found that high blood pressure late in life (65-plus) boosted the risk for constriction/blockage in the brain’s blood vessels that are associated with vascular dementia by 46 percent when participants’ top/systolic blood pressure number was 147, compared with participants with a mean level of 134.

The researchers also found that elevated systolic blood pressure increased Alzheimer’s disease-associated tangles in the brain.

Unfortunately, 50 percent of older folks with high blood pressure aren’t receiving beneficial treatment. In a 2013 study, researchers found that taking potassium-sparing diuretics reduced the risk of Alzheimer’s nearly 75 percent, and taking any type of antihypertensive medication lowered the risk by about a third. Some of the meds also made Alzheimer’s, once diagnosed, less likely to progress.

But folks in their 40s and 50s don’t get off any easier. Elevated blood pressure in middle age increases their risk of vascular dementia and Alzheimer’s disease -- especially when accompanied by elevated lousy LDL cholesterol.

A study presented at the Alzheimer’s Association meeting recently found that when systolic blood pressure was lowered to 120, folks were 19 percent less likely to develop mild cognitive and info-processing problems, and 15 percent less likely to eventually develop cognitive decline and dementia.

For prevention:

  1. Eat unprocessed foods, whole grains and lean proteins.

  2. Lose weight if you need to; weight gain increases blood pressure.

  3. Get in 10,000 steps or the equivalent daily.

  4. Get your blood pressure checked regularly.

To treat high blood pressure add:

  1. Work with your doctor to find the right antihypertensive med or meds for you.

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(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)

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