Cancer prevention nutrition or diet tips and Cancer-Fighting Foods

Whether you have a history of cancer in your family, or are currently battling the disease, lifestyle factors, including your diet, can make a huge difference in helping you fight off cancer. Some foods actually increase your risk of cancer, while others support your body and strengthen your immune system. By making smart food choices, you can protect your health, feel better, and boost your ability fight off cancer and other disease

What you need to know about cancer and diet

Not all health problems are avoidable, but you have more control over your health than you may think. Research shows that a large percentage of cancer-related deaths—maybe even the majority—are directly linked to lifestyle choices such as smoking, drinking, a lack of exercise, and an unhealthy diet. Avoiding cigarettes, limiting alcohol, and getting regular exercise are a great start to an anti-cancer lifestyle. But to best support your health, you also need to look at your eating habits.
What you eat—and don’t eat—has a powerful effect on your health, including your risk of cancer. Without knowing it, you may be eating many foods that fuel cancer, while neglecting the powerful foods and nutrients that can protect you. If you change your diet and behaviors, you can minimize your risk of disease and possibly even stop cancer in its tracks.

Cancer prevention diet tip # 1: Focus on plant-based foods

The best diet for preventing or fighting cancer is a predominantly plant-based diet that includes a variety of vegetables, fruits, and whole grains. A plant-based diet means eating mostly foods that come from plants: vegetables, fruits, nuts, grains, and beans. 
The less processed these foods are—the less they’ve been cooked, peeled, mixed with other ingredients, stripped of their nutrients, or otherwise altered from the way they came out of the ground—the better.
There are many ways to add plant-based foods to your diet. A nice visual reminder is to aim for a plate of food that is filled at least two-thirds with whole grains, vegetables, beans, or fruit. Dairy products, fish, and meat should take up no more than a third of the plate. Keep in mind that you don’t need to go completely vegetarian. Instead, focus on adding “whole” foods, which are foods close to their original form. Just as important, try to minimize or reduce the amount of processed foods you eat. Eat an apple instead of drinking a glass of apple juice, for example. Or enjoy a bowl of oatmeal with raisins instead of an oatmeal raisin cookie.

Simple tips for getting more plant-based foods in your diet

• Breakfast: Add fruit and a few seeds or nuts to your whole grain breakfast cereal (such as oatmeal).
• Lunch: Eat a big salad filled with your favorite beans and peas or other combo of veggies. Always order lettuce and tomato (plus any other veggies you can) on your sandwiches. Order whole grain bread for your sandwiches. Have a side of veggies like cut up carrots, sauerkraut, or a piece of fruit.
• Snacks: Fresh fruit and vegetables. Grab an apple or banana on your way out the door. Raw veggies such as carrots, celery, cucumbers, jicama, peppers, etc. are great with a low-fat dip such as hummus. Keep trail mix made with nuts, seeds, and a little dried fruit on hand.
• Dinner: Add fresh or frozen veggies to your favorite pasta sauce or rice dish. Top a baked potato with broccoli and yogurt, sauteed veggies, or with salsa. Replace creamy pasta sauces, with sauteed vegetables or tomato sauce made with healthy olive oil.
• Dessert: Choose fruit instead of a richer dessert. Or a single square of dark chocolate.

Cancer prevention diet tip # 2: Bulk up on fiber

Another benefit of eating plant-based foods is that it will also increase your fiber intake. Fiber, also called roughage or bulk, is the part of plants (grains, fruits, and vegetables) that your body can’t digest. Fiber plays a key role in keeping your digestive system clean and healthy. It helps keep food moving through your digestive tract, and it also moves cancer-causing compounds out before they can create harm.
Fiber is found in fruits, vegetables, and whole grains. In general, the more natural and unprocessed the food, the higher it is in fiber. There is no fiber in meat, dairy, sugar, or “white” foods like white bread, white rice, and pastries.

Simple ways to add more fiber to your diet:

• Use brown rice instead of white rice
• Substitute whole-grain bread for white bread
• Choose a bran muffin over a croissant or pastry
• Snack on popcorn instead of potato chips
• Eat fresh fruit such as a pear, a banana, or an apple (with the skin)
• Have a baked potato, including the skin, instead of mashed potatoes
• Enjoy fresh carrots, celery, or bell peppers with a hummus or salsa, instead of chips and a sour cream dip
• Use beans instead of ground meat in chili, casseroles, tacos, and even burgers (bean burgers can taste great)

  

High-fiber, cancer-fighting foods
Whole grains--	whole-wheat pasta, raisin bran, barley, oatmeal, oat bran muffins, popcorn, brown rice, whole-grain or whole-wheat bread
Fruit-------------	raspberries, apples, pears, strawberries, bananas, blackberries, blueberries, mango, apricots, citrus fruits, dried fruit, prunes, raisins
Legumes--------	lentils, black beans, split peas, lima beans, baked beans, kidney beans, pinto, chick peas, navy beans, black-eyed peas
Vegetables-----	broccoli, spinach, dark green leafy vegetables, peas, artichokes, corn, carrots, tomatoes, Brussels sprouts, potatoes

Cancer prevention diet tip # 3: Cut down on meat

Research shows that vegetarians are about fifty percent less likely to develop cancer than those who eat meat. So what’s the link between meat and cancer risk? First, meat lacks fiber and other nutrients that have been shown to have cancer-protective properties. What it does have in abundance, however, is fat—often very high levels of saturated fat. High-fat diets have been linked to higher rates of cancer. And saturated fat is particularly dangerous. Finally, depending on how it is prepared, meat can develop carcinogenic compounds.

Making better meat and protein choices

You don’t need to cut out meat completely and become a vegetarian. But most people consume far more meat than is healthy. You can cut down your cancer risk substantially by reducing the amount of animal-based products you eat and by choosing healthier meats.

• Keep meat to a minimum. Try to keep the total amount of meat in your diet to no more than fifteen percent of your total calories. Ten percent is even better.
• Eat red meat only occasionally. Red meat is high in saturated fat, so eat it sparingly.
• Reduce the portion size of meat in each meal. The portion should be able to fit in the palm of your hand.
• Use meat as a flavoring or a side, not the entree. You can use a little bit of meat to add flavor or texture to your food, rather than using it as the main element.
• Add beans and other plant-based protein sources to your meals.
• Choose leaner meats, such as fish, chicken, or turkey. If possible, buy organic.
• Avoid processed meats such as hot dogs, sausage, deli meats, and salami.

Cancer prevention diet tip #4: Choose your fats wisely

A major benefit of cutting down on the amount of meat you eat is that you will automatically cut out a lot of unhealthy fat. Eating a diet high in fat increases your risk for many types of cancer. But cutting out fat entirely isn’t the answer, either. In fact, some types of fat may actually protect against cancer. The trick is to choose your fats wisely and eat them in moderation.

• Fats that increase cancer risk – The two most damaging fats are saturated fats and Trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoil—which is very good for food manufacturers, and very bad for you.
• Fats that decrease cancer risk – The best fats are unsaturated fats, which come from plant sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flax seeds.

Tips for choosing cancer-fighting fats and avoiding the bad

• Reduce your consumption of red meat, whole milk, butter, and eggs, as these are the primary source of saturated fats.
• Cook with olive oil instead of regular vegetable oil. Canola oil is another good choice, especially for baking.
• Check the ingredient list on food labels and avoid anything with hydrogenated or partially hydrogenated oils, which are usually found in stick margarines, shortenings, salad dressings, and other packaged foods.
• Trim the fat off of meat when you do eat it, and avoid eating the skin of the chicken.
• Choose nonfat dairy products and eggs that have been fortified with omega-3 fatty acids.
• Add nuts and seeds to cereal, salads, soups, or other dishes. Good choices include walnuts, almonds, pumpkin seeds, hazelnuts, pecans, and sesame seeds.
• Use flax seed oil in smoothies, salad dressings, or mixed in snacks such as applesauce. But do not cook with flax seed oil, as it loses its protective properties when heated.
• Limit fast food, fried foods, and packaged foods, which tend to be high in trans fats. This includes foods like potato chips, cookies, crackers, French fries, and doughnuts.
• Eat fish once or twice a week. Good choices include wild salmon, sardines, herring, and black cod. But be conscious of mercury, a contaminant found in many types of fish. 

Cancer prevention diet tip #5: Choose cancer-fighting foods

Your immune system keeps you healthy by fighting off unwanted invaders in your system, including cancer cells. There are many things you can eat to maximize the strength of your immune system, as well as many cancer-fighting foods. But keep in mind that there is no single miracle food or ingredient that will protect you against cancer. Eating a colorful variety gives you the best protection.

• Boost your antioxidants. Antioxidants are powerful vitamins that protect against cancer and help the cells in your body function optimally. Fruits and vegetables are the best sources of antioxidants such as beta-carotene, vitamin C, vitamin E, and selenium.
• Eat a wide range of brightly colored fruits and vegetables. Colorful fruits and vegetables are rich in phytochemicals, a potent disease–fighting and immune–boosting nutrient. The greater the variety of colors that you include, the more you will benefit, since different colors are rich in different phytochemicals.
• Flavor with immune-boosting spices and foods. Garlic, ginger, and curry powder not only add flavor, but they add a cancer-fighting punch of valuable nutrients. Other good choices include turmeric, basil, rosemary, and coriander. Use them in soups, salads, casseroles, or any other dish.
• Drink plenty of water. Water is essentially to all bodily processes. It stimulates the immune system, removes waste and toxins, and transports nutrients to all of your organs. 

Cancer prevention diet tip #6: Prepare your food in healthy ways

Choosing healthy food is not the only important factor. It also matters how you prepare and store your food. The way you cook your food can either help or hurt your anti-cancer efforts.

Preserving the cancer-fighting benefits of vegetables

Here are a few tips that will help you get the most benefits from eating all those great cancer-fighting vegetables:

• Eat at least some raw fruits and vegetables. These have the highest amounts of vitamins and minerals, although cooking some vegetables can make the vitamins more available for our body to use.
• When cooking vegetables, steam until just tender using a small amount of water. This preserves more of the vitamins. Overcooking vegetables removes many of the vitamins and minerals. If you do boil vegetables, use the cooking water in a soup or another dish to ensure you’re getting all the vitamins.
• Wash all fruits and vegetables. Use a vegetable brush for washing. Washing does not eliminate all pesticide residue, but will reduce it. Choose organic produce if possible, grown without the use of pesticides.

Cooking and carcinogens

Carcinogens are cancer-causing substances found in food. Carcinogens can form during the cooking or preserving process—mostly in relation to meat—and as foods start to spoil. Examples of foods that have carcinogens are cured, dried, and preserved meats (e.g. bacon, sausage, beef jerky); burned or charred meats; smoked foods; and foods that have become moldy. Here are some ways reduce your exposure to carcinogens:

• Do not cook oils on high heat. Low-heat cooking or baking (less than 240 degrees) prevents oils or fats from turning carcinogenic. Instead of deep-frying, pan-frying, and sauteing, opt for healthier methods such as baking, boiling, steaming, or broiling.
• Go easy on the barbecue. Burning or charring meats creates carcinogenic substances. If you do choose to barbecue, don’t overcook the meat and be sure to cook at the proper temperature (not too hot).
• Store oils in a cool dark place in airtight containers, as they quickly become rancid when exposed to heat, light, and air.
• Choose fresh meats instead of cured, dried, preserved, or smoked meats.
• Avoid foods that look or smell moldy, as they likely contain aflatoxin, a strong carcinogen. Aflatoxin is most commonly found on moldy peanuts. Nuts will stay fresh longer if kept in the refrigerator or freezer.
• Be careful what you put in the microwave. Use waxed paper rather than plastic wrap to cover your food in the microwave. And always use microwave-safe containers. 

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Take cancer prevention into your own hands

Take cancer prevention into your own hands
You've probably heard conflicting reports about cancer prevention. Sometimes the specific cancer-prevention tip recommended in one study or news report is advised against in another.
In many cases, what is known about cancer prevention is still evolving. However, it's well accepted that your chances of developing cancer are affected by the lifestyle choices you make.
So if you're concerned about cancer prevention, take comfort in the fact that some simple lifestyle changes can make a big difference. Consider these seven cancer prevention tips.

1. Don't use tobacco

Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, bladder, cervix and kidney. And chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don't use tobacco, exposure to secondhand smoke might increase your risk of lung cancer.
Avoiding tobacco — or deciding to stop using it — is one of the most important health decisions you can make. It's also an important part of cancer prevention. If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.

2. Eat a healthy diet

Although making healthy selections at the grocery store and at mealtime can't guarantee cancer prevention, it might help reduce your risk. Consider these guidelines:

• Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
• Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources. High-fat diets tend to be higher in calories and might increase the risk of overweight or obesity — which can, in turn, increase cancer risk.
• If you choose to drink alcohol, do so only in moderation. The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you've been drinking regularly.

3. Maintain a healthy weight and be physically active

Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney.
Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer.
Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic physical activity. You can also do a combination of moderate and vigorous activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.

4. Protect yourself from the sun

Skin cancer is one of the most common kinds of cancer — and one of the most preventable. Try these tips:

• Avoid midday sun. Stay out of the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
• Stay in the shade. When you're outdoors, stay in the shade as much as possible. Sunglasses and a broad-brimmed hat help, too.
• Cover exposed areas. Wear tightly woven, loose fitting clothing that covers as much of your skin as possible. Opt for bright or dark colors, which reflect more ultraviolet radiation than pastels or bleached cotton.
• Don't skimp on sunscreen. Use generous amounts of sunscreen when you're outdoors, and reapply often.
• Avoid tanning beds and sunlamps. These are just as damaging as natural sunlight.

5. Get immunized

Cancer prevention includes protection from certain viral infections. Talk to your doctor about immunization against:

• Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. The hepatitis B vaccine is recommended for certain high-risk adults — such as adults who are sexually active but not in a mutually monogamous relationship, people with sexually transmitted infections, intravenous drug users, men who have sex with men, and health care or public safety workers who might be exposed to infected blood or body fluids.
• Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical and other genital cancers as well as squamous cell cancers of the head and neck. The HPV vaccine is available to both men and women age 26 or younger who didn't have the vaccine as adolescents.

6. Avoid risky behaviors

Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:

• Practice safe sex. Limit your number of sexual partners, and use a condom when you have sex. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection — such as HIV or HPV. People who have HIV or AIDS have a higher risk of cancer of the anus, liver and lung. HPV is most often associated with cervical cancer, but it might also increase the risk of cancer of the anus, penis, throat, vulva and vagina.
• Don't share needles. Sharing needles with an infected drug user can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug abuse or addiction, seek professional help.

7. Get regular medical care

Regular self-exams and screenings for various types of cancers — such as cancer of the skin, colon, prostate, cervix and breast — can increase your chances of discovering cancer early, when treatment is most likely to be successful. Ask your doctor about the best cancer screening schedule for you.

Take cancer prevention into your own hands, starting today. The rewards will last a lifetime. 

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Know about cancer diseases details

What Is Cancer?

Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death.

Normal cells in the body

The body is made up of trillions of living cells. Normal body cells grow, divide to make new cells, and die in an orderly way. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries.

How cancer starts

Cancer starts when cells in a part of the body start to grow out of control. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells can’t do. Growing out of control and invading other tissues are what makes a cell a cancer cell.

Cells become cancer cells because of DNA (deoxyribonucleic acid) damage. DNA is in every cell and it directs all its actions. In a normal cell, when DNA is damaged the cell either repairs the damage or dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn’t die like it should. Instead, the cell goes on making new cells that the body doesn’t need. These new cells all have the same damaged DNA as the first abnormal cell does.

People can inherit abnormal DNA (it’s passed on from their parents), but most often DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in the environment. Sometimes the cause of the DNA damage may be something obvious like cigarette smoking or sun exposure. But it’s rare to know exactly what caused any one person’s cancer.

In most cases, the cancer cells form a tumor. Over time, the tumors can replace normal tissue, crowd it, or push it aside. Some cancers, like leukemia, rarely form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow.

Origins of Cancer

All cancers begin in cells, the body's basic unit of life. To understand cancer, it's helpful to know what happens when normal cells become cancer cells.
The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.
However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

Not all tumors are cancerous; tumors can be benign or malignant.

• Benign tumors aren't cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.
• Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.

Some cancers do not form tumors. For example, leukemia is a cancer of the bone marrow and blood.

How cancer spreads

Cancer cells often travel to other parts of the body where they can grow and form new tumors. This happens when the cancer cells get into the body’s bloodstream or lymph vessels. The process of cancer spreading is called metastasis.

No matter where a cancer may spread, it’s always named based on the place where it started. For example, colon cancer that has spread to the liver is called metastatic colon cancer, not liver cancer. In this case, cancer cells taken from the liver would be the same as those in the colon. They would be treated in the same ways too.

How cancers differ

Different types of cancer can behave very differently. For instance, lung cancer and skin cancer are very different diseases. They grow at different rates and respond to different treatments. This is why people with cancer need treatment that’s aimed at their kind of cancer.

Tumors that are not cancer

A tumor is an abnormal lump or collection of cells, but not all tumors are cancer. Tumors that are n’t cancer are called benign. Benign tumors can cause problems – they can grow very large and press on healthy organs and tissues. But they can’t grow into (invade) other tissues. Because they can’t invade, they also can’t spread to other parts of the body (metastasize). These tumors are seldom life threatening. 

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Side effects of asthma treatments

Side effects of relievers and presenters

Relievers are a safe and effective medicine and have few side effects, as long as they are not used too much. The main side effects include a mild shaking of the hands, headache and muscle cramps. These usually only happen with high doses of reliever inhaler and usually only last for a few minutes.

Presenters are very safe at usual doses, although they can cause a range of side effects at high doses, especially over long-term use. The main side effect of presenter inhalers is a fungal infection (oral candidacies) of the mouth or throat. You may also develop a hoarse voice. Using a spacer can help prevent these side effects. Also, rinse your mouth or clean your teeth after taking your presenter inhaler.

Your doctor or nurse will discuss with you the need to balance control of your asthma with the risk of side effects, and how to keep side effects to a minimum.

Side effects of add on therapy

Long-acting relievers may cause similar side effects to short-acting relievers, including a mild shaking of the hands, headache and muscle cramps. Your GP can discuss the risks and benefits of this drug with you. You should be monitored at the beginning of your treatment and reviewed regularly. If you find there is no benefit to using the long-acting reliever, it should be stopped.

Theophylline tablets have been known to cause side effects in some people, including headaches, nausea, insomnia, vomiting, irritability and stomach upsets. These can usually be avoided by adjusting the dose.

Leukotriene receptor agonists do not generally cause side effects, although there have been reports of stomach upsets, feeling thirsty and headache.

Side effects of steroid tablets

Oral steroids carry a risk if they are taken for more than three months or if they are taken frequently (three or four courses of steroids a year). Side effects can include:

• osteoporosis (fragile bones)  
• high blood pressure (hypertension)  
• diabetes 
• weight gain  
• cataracts and glaucoma (eye disorders)  
• thinning of the skin  
• easy bruising  
• muscle weakness

To minimize the risk of taking oral steroids:

• Eat a healthy, balanced diet with plenty of calcium. 
• Maintain a healthy body weight. 
• Stop smoking (if you smoke). 
• Do regular exercise.

You will also need regular appointments to check for high blood pressure, diabetes and osteoporosis.

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Do you know asthma treatment? All treatment of asthma patients

Personal asthma action plan

As part of your initial assessment, you should be encouraged to draw up a personal asthma action plan with your GP or asthma nurse. If you have been admitted to hospital because of an asthma attack, you should be offered an action plan (or the opportunity to review an existing action plan) before you go home.

The action plan should include information about your asthma medicines and will help you recognize when your symptoms are getting worse and what steps to take. You should also be given information about what to do if you have an asthma attack.

Your personal asthma action plan should be reviewed with your GP or asthma nurse at least once a year, or more frequently if your symptoms are severe.

As part of your asthma plan, you may be given a peak flow meter. This will give you another way of monitoring your asthma, rather than relying only on symptoms.

Taking asthma medicines

Inhalers

Asthma medicines are usually given by inhalers, which are devices that deliver the drug directly into the airways through your mouth when you breathe in. Inhaling a drug is an effective way of taking an asthma medicine as it goes straight to the lungs, with very little ending up elsewhere in the body. However, each inhaler works in a slightly different way. You should have training from your GP or nurse in how to use your device. This should be checked at least once a year.

Spacers

Some inhalers emit an aerosol jet when pressed. These work better if given through a spacer, which can increase the amount of medication that reaches the lungs and reduces the side effects. Some people find using inhalers difficult, and spacers can help them. However, spacers are often advised even for people who use inhalers well as they improve the distribution of medication in the lungs. Spacers are plastic or metal containers with a mouthpiece at one end and a hole for the inhaler at the other. The medicine is 'puffed' into the spacer by the inhaler and then breathed in through the spacer mouthpiece. Spacers are also good for reducing the risk of thrush in the mouth or throat, which can be a side effect of inhaled asthma medicines.

Reliever inhalers

Reliever inhalers are taken to relieve asthma symptoms quickly. The inhaler usually contains a medicine called a short-acting beta2-agonist. It works by relaxing the muscles surrounding the narrowed airways. This allows the airways to open wider, making it easier to breathe again. Examples of reliever medicines include salbutamol and terbutaline. They are generally safe medicines with few side effects, unless over used. However, they should rarely be necessary if asthma is well controlled, and anyone needing to use them three or more times a week should have their treatment reviewed.

Everyone with asthma should be given a reliever inhaler, also known simply as a reliever. It is often blue.

Preventer inhalers

Preventer inhalers work over time to reduce the amount of inflammation and 'twitchiness' in the airways and prevent asthma attacks occurring. You will need to use the preventer inhaler daily for some time before you gain the full benefit. You may still occasionally need the reliever inhaler (usually blue) to relieve symptoms, but if you continue to need them often, your treatment should be reviewed.

The preventer inhaler usually contains a medicine called an inhaled corticosteroid. Examples of preventer medicines include beclometasone, budesonide, fluticasone and mometasone. Preventer inhalers are often brown, red or orange.

Preventer treatment is normally recommended if you:

• have asthma symptoms more than twice a week
• wake up once a week due to asthma symptoms
• have to use a reliever inhaler more than twice a week

Smoking can reduce the effects of preventer inhalers.

Inhaled corticosteroids can occasionally cause a mild fungal infection (oral thrush) in the mouth and throat, so rinse your mouth thoroughly after inhaling a dose. For more information on side effects, see below.

Other treatments and 'add on' therapy

Long-acting reliever inhaler

If your asthma does not respond to treatment, the dose of preventer inhaler can be increased in discussion with your healthcare team. If this does not control your asthma symptoms, you may be given an inhaler containing a medicine called a long-acting reliever (long-acting bronchodilator/long acting beta2-agonist or LABA) to take as well. Or you may be given an inhaler combining an inhaled steroid and a long-acting bronchodilator in the one device, called a 'combination' inhaler. These work in the same way as short-acting relievers, but they take longer to work and can last up to 12 hours. Examples of long-acting reliever inhalers include formoterol and salmeterol

Only use your long-acting reliever inhaler in combination with the preventer inhaler and never by itself. Studies have shown that using only a long-acting reliever can increase the chance of an asthma attack and can even increase the risk of death. Examples of combination inhalers include Seretide, Symbicort and Fostair. These are usually purple, red and white, or maroon.

Preventer medicines

If treatment of your asthma is still not successful, additional preventer medicines will be tried. Two possible alternatives include:

• leukotriene receptor antagonists (montelukast): tablets that block part of the chemical reaction involved in inflammation of the airways
• theophyllines: tablets that help widen the airways by relaxing the muscles around them

If your asthma is still not under control, you may be prescribed regular oral steroids (steroid tablets). This treatment is usually monitored by a respiratory specialist (a specialist in asthma). Long-term use of oral steroids has possible serious side effects, so they are only used once other treatment options have been tried. See below for more information on the side effects of steroid tablets.

Occasional use of oral steroids

Most people only need to take a course of oral steroids for one or two weeks. Once your asthma is under control, you can be 'stepped-down' to your previous treatment.

Omalizumab (Xolair)

Omalizumab, also known as Xolair, is the first of a new category of drugs. It binds to one of the proteins involved in the immune response and reduces its level in the blood. This reduces the chance of an immune reaction happening. The National Institute for Heath and Clinical Excellence (NICE) recommends that omalizumab can be used in people with frequent severe asthma attacks which require visits to A&E or hospital admission.

Omalizumab is given as an injection every two to four weeks. It should only be prescribed in a specialist centre. If omalizumab does not control asthma symptoms within 16 weeks, the treatment should be stopped.

Bronchial thermoplasty

Bronchial thermoplasty is a relatively new procedure not yet widely available. In some cases it may be used to treat severe asthma by reducing airway narrowing.

The procedure is carried out either with sedation or under general anesthetic. A bronchoscope (a type of hollow tube) containing a probe is inserted through the mouth or nose into the airway and expanded so it touches the airway wall and heated. Three treatment sessions are usually needed with at least three weeks between each session.

There is some evidence to show this procedure may reduce asthma attacks and improve the quality of life of someone with severe asthma. However, the long-term risks and benefits are not yet fully known.

You should discuss this procedure fully with your clinician if the treatment is offered.

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What causes asthma, common triggers, treating asthma, diagnosing asthma

What causes asthma?

The cause of asthma is not fully understood, although it is known to run in families. You are more likely to have asthma if one or both of your parents has the condition.

Common triggers

A trigger is anything that irritates the airways and brings on the symptoms of asthma. These differ from person to person and people with asthma may have several triggers.

Common triggers include house dust mites, animal fur, pollen, tobacco smoke, exercise, cold air and chest infections.

Read more about the causes of asthma.

Asthma can also be made worse by certain activities, such as work. For example, some nurses develop asthma symptoms after exposure to latex. This is often referred to as work-related asthma or occupational asthma.  

Treating asthma

While there is no cure for asthma, there are a number of treatments that can help effectively control the condition. Treatment is based on two important goals:

• relieving symptoms 
• preventing future symptoms and attacks from developing

Treatment and prevention involves a combination of medicines, lifestyle advice and identifying and then avoiding potential asthma triggers.

Read more about living with asthma.

Who is affected?

In the UK, 5.4 million people are currently receiving treatment for asthma. That is 1 in every 12 adults and 1 in every 11 children. Asthma in adults is more common in women than men.

Symptoms of asthma

The symptoms of asthma can range from mild to severe. When asthma symptoms get significantly worse, it is known as an asthma attack.

The symptoms of asthma include:

• feeling breathless (you may gasp for breath)
• a tight chest, like a band tightening around it 
• wheezing, which makes a whistling sound when you breathe
• coughing, particularly at night and early morning
• attacks triggered by exercise, exposure to allergens and other triggers

You may experience one or more of these symptoms. Symptoms that are worse during the night or with exercise can mean your asthma is getting worse. Talk to your doctor or asthma nurse about this.

Asthma attack

A severe asthma attack usually develops slowly, taking 6 to 48 hours to become serious. However, for some people, asthma symptoms can get worse quickly.

As well as symptoms getting worse, signs of an asthma attack include:

• you get more wheezy, tight-cheated or breathless
• the reliever inhaler is not helping as much as usual
• there is a drop in your peak expiratory flow (see diagnosing asthma for more information)

If you notice these signs, do not ignore them. Contact your GP or asthma clinic or consult your asthma action plan, if you have one.

Signs of a severe asthma attack include:

• the reliever inhaler, which is usually blue, does not help symptoms at all
• the symptoms of wheezing, coughing, tight chest are severe and constant
• you are too breathless to speak
• your pulse is racing
• you feel agitated or restless
• your lips or fingernails look blue

Causes of asthma

There is no single cause of asthma, but certain things may increase the likelihood of developing it. These include genetics and the environment.

Who is at risk of developing asthma?

Things known to increase the likelihood of developing asthma include:

• a family history of asthma or other related allergic conditions (known as atopic conditions), such as eczema, food allergy or hay fever 
• developing another atopic condition such as a food allergy
• having bronchiolitis as a child (a common lung infection among children) 
• being exposed to tobacco smoke as a child, particularly if your mother smoked during pregnancy 
• being born prematurely (especially if you needed a ventilator) 
• being born with a low birth weight (less than 2kg or 4.5 pounds)

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Asthma triggers

The symptoms of asthma can have a range of triggers, but they do not affect everyone in the same way. Once you know your asthma triggers, you can try to avoid them.

Triggers include:

• Airway and chest infections. Upper respiratory infections, which affect the upper airways, are often caused by cold and flu viruses and are a common trigger of asthma. 
• Allergens. Pollen, dust mites, animal fur or feathers, for example, can trigger asthma.
• Airborne irritants. Cigarette smoke, chemical fumes and atmospheric pollution may trigger asthma.
• Medicines. The class of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, can trigger asthma for some people, although are fine for most. Children under 16 years of age should not be given aspirin. 
• Emotional factors. Asthma can be triggered by emotional factors, such as stress or laughing.
• Foods containing sulphites. Sulphites are naturally occurring substances found in some food and drink. They are also sometimes used as a food preservative. Food and drinks high in sulphites include concentrated fruit juice, jam, prawns and many processed or pre-cooked meals. Most people with asthma do not have this trigger, but some may. Certain wines can also trigger asthma in susceptible people.
• Weather conditions. A sudden change in temperature, cold air, windy days, poor air quality and hot, humid days are all known triggers for asthma.
• Indoor conditions. Mould or damp, house dust mites and chemicals in carpets and flooring materials may trigger asthma.
• Exercise. Sometimes, people with asthma find their symptoms are worse when they exercise.
• Food allergies. Although uncommon, some people may have allergies to nuts or other food items, known as an anaphylactic reaction. If so, these can trigger severe asthma attacks.

What happens during an asthma attack?

During an asthma attack:

• the bands of muscles around the airways tighten
• there is increased inflammation in the linings of the airways, which swell
• the airways produce sticky mucus or phlegm, which can further narrow the airways

The passages of the airways narrow, making it more difficult for the air to pass through and, therefore, more difficult to breathe. This can cause the characteristic wheezy noise, although not everyone with asthma will wheeze. In a life-threatening attack, there may not be a wheezy sound.

An asthma attack can happen at any time. However there are usually warning signs for a couple of days before. These include symptoms getting worse, especially during the night, and needing to use the reliever inhaler more and more.

If you or someone else is having a severe asthma attack and cannot breathe, dial 999 immediately for emergency medical treatment.

Diagnosing asthma

If you have typical asthma symptoms, your GP is likely to be able to make a diagnosis. Your GP will want to know when your symptoms happen and how often, and if you have noticed anything that might trigger them.

A number of tests can be carried out to confirm the diagnosis.

Spirometry

A breathing test called spirometry is carried out to assess how well your lungs work. You will be asked to breathe into a machine called a spirometer.

The spirometer takes two measurements: the volume of air you can breathe out in one second (called the forced expiratory volume in one second or FEV1) and the total amount of air you breathe out (called the forced vital capacity or FVC).

You may be asked to breathe out a few times to get a consistent reading.

The readings are compared with normal measurements for your age, which can show if your airways are obstructed.

Sometimes an initial set of measurements is taken, then you are given a medicine to open up your airways (a reliever inhaler) to see if this improves your breathing. Another reading is taken and, if it is much higher after taking the medicine, this can support the diagnosis.

Peak expiratory flow rate test

A small hand-held device known as a peak flow meter can be used to measure how fast you can blow air out of your lungs in one breath. This is your peak expiratory flow rate (PEFR), and the test is usually called a peak flow test.

You may be given a peak flow meter to take home and a diary to record measurements of your peak flow. Your diary may also have a space to record your symptoms. This will help you recognize when your asthma is getting worse.

Other tests

Some people, but not all, may need more tests. The tests may confirm the diagnosis of asthma or help diagnose a different condition. This will help you and your doctor plan your treatment.

Airway responsiveness tests

This test is used to see how your airways react when they come into contact with a trigger. You will be asked to take a mannitol challenge test which involves breathing in increasing amounts of a dry powder. This deliberately triggers asthma symptoms and cause the airways to narrow. In children, exercise is sometimes used as a trigger.

You then blow into the spriometer to measure how much your FEV1 and FVC have changed in response to breathing in the trigger. If there is a significant decrease in these measurements, you may have asthma.

Testing airway inflammation

• Phlegm sample. The doctor may take a sample of phlegm to check whether you have inflammation in the lungs.
• Nitric oxide concentration. As you breathe out, the level of nitric oxide in your breath is measured. A high level of nitric oxide can be a sign of airway      inflammation.

Allergy tests

Skin testing or a blood test can be helpful to confirm whether your asthma is associated with specific allergies, for example to dust mites, pollen or foods.

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