Health
Skin cancer: symptoms, prevention and treatment
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4 months agoon
Skin cancer: symptoms, prevention and treatment
Skin cancer is the abnormal growth of skin cells. This problem generally occurs in areas of the skin that are exposed to sunlight, but sometimes it occurs in areas of the skin that are not normally exposed to light.
Brief anatomy of the skin
The skin is the largest organ of the body and consists of three main layers:
- Epidermis: It is a very thin outer layer of the skin that acts as a barrier to environmental infections and controls the amount of water that evaporates from the body.
- Dermis: The middle and thicker layer of the skin that contains hair follicles as well as nerves and a large number of blood and lymph vessels embedded in a framework of collagen.
- Hypodermis: the deepest layer of the skin, which is rich in fat and collagen and has many blood and lymphatic vessels.
Most skin cancers appear from the cells in the epidermis layer. Keratinocytes are the main cells in this layer of the skin. Deep in the epidermis and near the dermis layer, these cells grow and actively produce new skin cells. This layer is the basal cell layer. Over time, these cells migrate to the surface of the skin and become squamous cells. Among the basal cells, there are brown pigments called melanin that make up the melanocyte cells. These are located close to other cells that remove foreign substances such as bacteria or cancer cells from the skin and deliver them to the lymph nodes through the lymphatic vessels (ie Langerhans cells of the skin).
The lymphatic vessels of the skin reach the lymph nodes of the groin, armpit, and neck. These vessels carry lymph fluid and are one of the fluid circulation systems in the body. This system is considered part of the body’s immune system, but at the same time, it is a pathway that skin cancer cells can use to spread throughout the body. Lymph nodes act as a filter and trap these cells. The proliferation of these cells in the lymph nodes causes the lymph nodes to enlarge.
Types of skin cancer
There are two types of skin cancer based on the type of cells involved:
Keratinocyte cancer
This type of skin cancer includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These are the most common forms of skin cancer. These are more likely to develop in areas of the body that are exposed to sunlight more, i.e. the head and neck. In this form of skin cancer, the probability of the spread of cancer cells and the death of the patient is less than in other types, but if it is not treated, it may grow and spread to other parts of the body.
Squamous cell cancer: This type of cancer occurs in the outer layer of the skin and is usually more aggressive than basal cell cancer. This disease may appear as red and scaly lesions on the skin.
Squamous cell skin cancer
Basal cell cancer: The most common form of skin cancer is basal cell cancer, which accounts for 90% of all skin cancer cases. These are slow-growing lumps that often appear in the head and neck area.
Basal cell skin cancer
Melanoma cancer
The second type of skin cancer is melanoma. This type of cancer is related to melanocytes. Benign moles created by melanocytes can become cancerous. These moles can form anywhere on the body, but they are more likely to develop on the chest and back. In women, the possibility of forming these moles on the legs is more. Most melanomas are curable if diagnosed and treated promptly. If left untreated, they can spread to other areas of the body and become more difficult to treat. This type of skin cancer is more likely to spread than basal cell cancer and squamous cell cancer. This type of skin cancer is less common, but it is considered the most dangerous type of skin cancer. In fact, melanoma only accounts for one percent of skin cancers, but the majority of skin cancer-related deaths each year are related to this disease.
Melanoma cancer
There are types of skin lesions that are a subset of skin cancer. All of these are not skin cancers, but they can become cancerous. One of these cases is actinic keratosis: these red or pink lesions on the skin are not cancerous but are considered a precancerous condition. If left untreated, it can turn into squamous cell carcinoma.
Actinic keratosis is a precancerous condition that can develop into squamous cell carcinoma if left untreated.
Symptoms of skin cancer
All skin cancers are not the same and may cause different symptoms. However, abnormal changes in the skin can be a warning sign for different types of skin cancer. Awareness of the condition of the skin can help diagnose the disease faster.
- Skin lesions: A new mole, abnormal growth, bump, sore, skin patch, or dark spot that appears and does not go away.
- Asymmetry: both sides of skin lesions or moles are not the same.
- Edges: The edges of the skin lesions are jagged and the edges are not equal.
- Color: The stain has an unusual color such as white, black, blue or red.
- Diameter: The thickness of the stain is more than half a centimeter.
- Change: A visible change in the size, color, or shape of a mole.
Moles and skin lesions that can be related to skin cancer often look like moles and skin spots that are not cancerous at all, so you must see a doctor for diagnosis.
Causes of skin cancer
Both types of skin cancer occur when mutations occur in the DNA of skin cells. These mutations cause the skin cells to grow out of control and create a mass of cancer cells in the skin. Basal cell skin cancer is caused by ultraviolet (UV) rays from the sun or tanning devices. UV rays can damage the DNA in skin cells, which will result in abnormal cell growth. Squamous cell cancer is also caused by ultraviolet radiation. In addition, squamous cell cancer may also occur as a result of long-term exposure to cancer-causing chemical agents. This condition can manifest itself in wounds from burns or other injuries, and viruses such as the human papillomavirus (HPV) may cause it.
The cause of melanoma is not clear. Most moles don’t turn into melanoma, and researchers aren’t sure why in some cases they do become cancerous. Like basal cell cancer and squamous cell cancer, melanoma may be caused by UV radiation. However, melanoma can also develop in parts of the body that are not normally exposed to sunlight.
When is a mole dangerous or at high risk of becoming skin cancer?
Moles are usually harmless and rarely turn into skin cancer. If a mole becomes cancerous, it becomes melanoma. There is a precancerous stage called a dysplastic mole where the mole is no longer normal. An early sign of melanoma is a change in a mole: asymmetry, abnormal edges, changes in color, increased diameter, or other changes in condition can indicate that the mole has turned into melanoma. Moles never develop into basal cell carcinoma or squamous cell carcinoma. In the figure below, a normal mole (top row) is compared to a cancerous mole (bottom row).
Skin cancer diagnosis
If a person notices suspicious spots and lumps on their skin or if they notice a change in spots that were already there, they should see a doctor. The specialist doctor examines the shape, size, color, and texture of the suspicious area on the skin, and if he suspects that the area is cancerous, he may perform a biopsy (tissue sampling). During this simple and safe procedure, a sample of suspicious tissue is isolated and examined. With this examination, it is determined whether a person has skin cancer or not. If a person is diagnosed with skin cancer, other tests may be needed to determine how far the disease has progressed. The patient’s treatment plan depends on the type, stage of the disease, and other factors.
Skin cancer screening
Screening for skin cancer by a dermatologist is quick and easy. The patient is asked to remove his clothes and the doctor looks all over his skin for unusual spots and moles. Early detection is the best way to ensure successful skin cancer treatment. Unlike other organs, the skin is always visible so that anyone can notice unusual changes or changes in the condition of their skin.
Stages of skin cancer
To determine the stage or severity of skin cancer, the doctor pays attention to the size of the tumor, and its status in terms of spreading to the lymph nodes and other parts of the body. Skin cancers are divided into two main groups in terms of stage of development: non-melanoma skin cancer and melanoma skin cancer.
Non-melanoma skin cancers include basal and squamous cell cancers, which have the following stages:
- Stage zero: Abnormal cells have not spread beyond the outer layer of the skin, the epidermis.
- Stage one: The cancer may have reached the next layer of the skin, the dermis, but its thickness is not more than two centimeters.
- Stage two: In this stage, the tumor has a size of more than two centimeters, but it has not yet reached the surrounding areas or lymph nodes.
- Stage three: The cancer has spread from the primary site to the adjacent tissue or bone and its size is more than three centimeters.
- Stage four: The cancer has spread to more distant areas than the primary tumor and has entered the lymph nodes, bone, and tissue. The size of the tumor is more than three centimeters.
Melanoma includes the following stages:
- Stage zero: This non-invasive type of skin cancer has not yet penetrated the lower part of the epidermis.
- Stage one: The cancer may have penetrated the second layer of the skin, the dermis, but its size is small.
- Stage two: The cancer has not spread beyond the primary tumor, but it is larger and thicker, and other signs and symptoms such as bleeding or scaling may also be seen.
- Stage three: The cancer has spread and entered the lymph nodes or adjacent tissue and skin.
- Stage four: It is the most advanced form of melanoma. In stage four, the cancer has spread beyond the primary tumor and is seen in lymph nodes, organs, or tissues far from the original cancer site.
If the cancer comes back after treatment, it is called recurrent skin cancer. There is a possibility of cancer returning in any person whose skin cancer has been diagnosed and treated, so it is necessary to conduct investigations in this field on these patients.
Skin cancer treatment methods
The treatment method for this disease depends on various factors such as the size, location, type, and stage of the disease. After considering these factors, the medical team may recommend one or more of the following treatments:
Micrographic Maze surgery: the desired area is locally numbed and the surgeon removes the tumor along with a small amount of surrounding healthy tissue. The tissue is quickly examined under a microscope and areas that still contain microscopic remnants of the tumor are removed and reexamined until no trace of tumor-related cells is seen (figure below). This complex and expensive treatment option is the treatment of choice in cases where it is critical to preserve the healthy tissues around the tumor, as well as in the cases where the borders of the tumor are not well defined, as well as in the cases of tumors that have been treated before but have recurred.
Tumor destruction by curettage and electrocautery (EDC): The tumor area is numbed using a local anesthetic and scraped repeatedly using a sharp blade, and then the edges of the wound are cauterized using an electric needle (electrode). The advantage of this method is that it is fast, easy, and relatively cheap. The problem with this method is that the scar is usually unpleasant and the probability of recurrence is 15%.
In the EDC method, first, the infected area is repeatedly scraped using a sharp blade to remove abnormal tissues.
The edges of the wound are cauterized with an electric needle to remove the remnants of cancer cells.
Surgical tumor removal: First, the tumor area is numbed using a local anesthetic. A ball-like section of skin, which includes the tumor, is removed from the skin, and then the edges of the wound are sutured. In the case of large tumors, a skin graft may be needed to close the wound. The advantage of this method of treatment is that its success rate is more than 90% and the surgeon can simultaneously check whether the entire tumor has been removed or not. The wound created in this way is better than the wound produced by the EDC method, but it has more complexity and cost.
Radiation therapy: In this method, during 10 to 15 sessions, the tumor and a small amount of the surrounding skin area are exposed to high radiation. This form of treatment is useful in cases where patients cannot undergo surgery. The advantage of this method is that no cutting is done. One of the disadvantages of this expensive method is that the treated area cannot be examined at the same time to determine whether the entire tumor is gone or not, and the wounds caused by this method may worsen over time. This method is usually used for elderly people.
Drug therapy: In the case of superficial basal cell cancer, some creams, gels, and solutions such as Imiquimod (Aldara) can be used. The way these drugs work is to stimulate the patient’s immune system to produce interferon. Interferons are proteins that attack cancer cells. Another effective drug in this field is fluorouracil (5-FU), which is a chemotherapy drug. Some patients do not experience any side effects from these topical treatments, but some may experience redness, inflammation, and skin irritation. One of the disadvantages of topical drugs is that because no tissue is available for examination, it is not possible to determine whether the tumor has been completely removed or not.
Cryotherapy: In this method, the tissue is frozen and destroyed using liquid nitrogen. The doctor sprays liquid nitrogen on the infected area and some of the surrounding areas. This causes a burning or stinging sensation in the person, which disappears within a few minutes. Liquid nitrogen freezes and kills the abnormal cells, creating a sore that will be red for several days and may blister and ooze. The area may be swollen for a few days, and in some cases this may need to be repeated. A crust will form over the wound and the dead tissue will fall off within one to four weeks, depending on the size of the treated area. After that, healthy skin cells grow and a scar may remain. Healing may take several weeks, and the healed skin will likely be paler than the surrounding area.
In the cryotherapy method, liquid nitrogen is used to freeze and destroy tissue
Photodynamic therapy (PDT): In this method of treatment, a drug and a special type of light are used. The drug is a chemical that sensitizes the skin to light. This drug is called a photosensitizing agent. The light can be a laser or another type of light. The drug can be used as a cream on the skin or injected into the bloodstream. By absorbing the drug, the cells become sensitive to light. Then the doctor shines light on the desired area and destroys the cancer cells.
Prevention of skin cancer
To reduce the risk of skin cancer, long-term exposure to sunlight and other sources of ultraviolet radiation should be avoided. for example:
- Avoiding tanning devices and solar lamps
- Avoid exposure to sunlight when the intensity of the radiation is high, otherwise you should use an umbrella.
- Using face and lip sunscreens with SPF of 30 or more
- Using a brimmed hat and protective clothing in the sun
- Use sunglasses that have 100% protection against UVB and UVA.
It is also important to check your skin regularly to see if there are any lesions on the skin or if the previous spots and moles have changed.
Skin cancer risk factors
Certain factors increase the risk of skin cancer. For example, a person is more likely to develop skin cancer if:
- Have a family history of skin cancer.
- exposed to certain substances such as arsenic compounds, radium, bitumen, and creosote.
- exposed to radiation, for example, during special treatments for acne and eczema.
- exposed to excessive sunlight, tanning lamps, and other similar factors.
- Live in sunny, hot climates or high altitudes.
- Be constantly engaged in outdoor work.
- Have a history of severe burns.
- They have many large and abnormal moles.
- The skin is pale and has freckles.
- Have skin that gets sunburned easily.
- Have natural blonde or red hair.
- Have blue or green eyes.
- Have precancerous skin lesions.
- Have a weak immune system, for example, have HIV infection.
- Have a history of organ transplantation and taking immunosuppressive drugs.
The use of sunglasses with 100% UVB and UVA protection is recommended to prevent skin cancer.
Doctors who treat skin cancer
If a person is diagnosed with skin cancer, a group of doctors may help the patient with different aspects of the condition. for example:
- A dermatologist who treats skin diseases.
- A cancer surgeon who treats cancer through surgery.
- A radiation therapy specialist who treats cancer using radiation therapy.
- A cancer drug treatment specialist who treats cancer using targeted drug therapies, immunotherapy, chemotherapy, or other drugs.
Complications and complications related to skin cancer
Side effects of skin cancer include the following:
- Disease recurrence means the return of cancer after treatment
- Local recurrence means the spread of cancer to nearby tissues
- Cancer progression in which cancer cells spread to the muscles, nerves, or other organs of the body.
If a person has skin cancer, there is a high risk that the disease will reappear in another part of his body.
Is skin cancer hereditary?
Since most types of skin cancer are caused by exposure to ultraviolet light, they are generally not considered hereditary skin cancers. But the fact that skin cancer is more common among people with less skin pigmentation, and skin color trait is an inherited trait, so it can be said that the role of genetics is important. There are several rare genetic syndromes that lead to an increased frequency of skin cancer cases among those with these syndromes. There is a type of hereditary melanoma called FAM-M syndrome, which is caused by a mutation in the CDKN2A gene located on chromosome 9. This mutation is also called the p16 mutation.
What is the prognosis and longevity of skin cancer?
In general, the prognosis for non-melanoma skin cancer is excellent. Both basal cell carcinoma and squamous cell carcinoma are highly treatable. Almost no death occurs from basal cell cancer, and rarely, death can occur from squamous cell cancer, which is mainly in people who are immunosuppressed. Depending on the treatment method and the location and type of skin cancer, the probability of recurrence of a skin cancer treated in the maze surgery method is 1-2% and in the electric burning and curettage method it is about 10-15%. Early detection of skin cancers can lead to better treatment outcomes.
The results of new research related to effective factors on skin cancer
Statistics show strong evidence that drinking water contaminated with arsenic compounds increases the risk of skin cancer. Arsenic contamination is common in underground water and arsenic contamination of drinking water is significant in some areas. At least 140 million people in 50 countries of the world are consuming drinking water whose concentration of arsenic compounds exceeds the set limit (10 micrograms per liter). Arsenic is one of the natural compounds of the earth’s crust and is widely present in the air, water, and soil. This substance is very toxic in its inorganic form. People are exposed to high levels of inorganic arsenic through drinking contaminated water, using contaminated water to prepare food and irrigate agricultural crops, industrial activities, eating contaminated food, and using tobacco. Long-term exposure to inorganic arsenic, mainly through consumption of contaminated food and water, can lead to chronic arsenic poisoning. Skin lesions and skin cancer are some of the undesirable effects of this substance. In Iran, few researches have been conducted in the field of arsenic contamination of drinking water in different regions. In a study conducted in Ardabil City in 2017, it was found that the concentration of arsenic in the drinking water of this region is higher than the standard (with an average of 15 micrograms per liter). In a similar study in Kashmir city, the presence of high concentrations of arsenic compounds in drinking water was confirmed.
Skin lesions and skin cancer are the main characteristics of arsenic pollution
Being taller at puberty also increases the risk of developing malignant melanoma. Beta-carotene supplementation has no significant effect on increasing the risk of non-melanoma skin cancer. Drinking coffee may reduce the risk of malignant melanoma in women and may reduce the risk of basal cell carcinoma in men and women. There is also evidence that drinking alcoholic beverages may increase the risk of malignant melanoma and basal cell carcinoma.
How common is skin cancer?
In general, melanoma skin cancer is the 15th most common cancer among men and women. The prevalence of both melanoma and non-melanoma skin cancer has increased in recent decades. Currently, about 2 to 3 million cases of non-melanoma skin cancer and 132,000 cases of melanoma skin cancer occur worldwide every year. One out of every three cancers diagnosed is skin cancer, and one in five Americans will develop skin cancer in their lifetime. In 2018, 300,000 new cases of this cancer have been diagnosed. Australia, New Zealand, Norway, Denmark, and the Netherlands are among the countries in the world with the highest prevalence of this disease.
With the process of destroying the ozone layer, the atmosphere loses its protective layer and more ultraviolet rays reach the earth’s surface. It is estimated that a ten percent decrease in the ozone layer will lead to the occurrence of 300,000 cases of non-melanoma skin cancer and 4,500 cases of melanoma skin cancer. The global prevalence of melanoma is increasing, although the main predisposing factors for the development of melanoma appear to be related to recreational exposure to sunlight and having a history of sunburn. The responsibility for these factors lies with the people themselves.
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Pronoun: An indefinite large number of people or things.
Noun: A multitude; a great aggregate; a mass of people; the generality; the common herd.
Noun: A considerable number.
Adjective: Existing in large number; numerous.
How does loneliness affect the brain and body?
People were alone even before Corona. Before the spread of Corona, people approached each other without anxiety; But now researchers have found that Americans are lonelier than ever. According to Cigna Health Center research in 2018, almost 54% of the 20,000 Americans who participated in this research felt lonely. In a period of more than a year, this figure reached 61%. Generation Z adults between the ages of 18 and 22 can be considered the only generation to surpass Boomers, Generation X, and Millennials. (Generation Z refers to those born from the mid-90s to the 2010s. The boomer generation or the boom generation refers to those born between 1946 and 1964, Generation X refers to those born in the early 1960s to 1980s, and the millennial generation refers to those born in the 1980s to the early 2000s. will be).
According to Doug Namek, Cigna’s chief medical officer, loneliness can throw off the worldly equation. According to many researchers, staying alone for a certain period of time is harmful to people’s mental and physical health. Signal research has also placed the health risks of loneliness alongside smoking and obesity. A Lancet research in 2018 describes loneliness as follows:
Conditions that cause irritability, depression and self-centeredness have a direct relationship with a 26% increase in the risk of premature death.
On the other hand, due to the spread of Covid-19, maintaining distance is the safest way to stay healthy. Although social distancing can increase feelings of isolation. As a result, COVID-19 can be seen as a new reason for the effect of loneliness on the brain, heart, and immune system.
Why are we lonely?
Loneliness can mean separation from friends and family, but the feeling of loneliness is much deeper than not having a companion on holidays or not going to various celebrations and ceremonies. From an evolutionary point of view, membership in groups and communities has always meant self-protection, division of labor, and increased chances of survival. On the other hand, humans have evolved over a long period of time and need their tribes. According to Julian Hutt Lundstad, professor of psychology and neuroscience at the University of Birmingham:
Loneliness and lack of membership in groups leads to anxiety. In this situation, we have to deal with the environment alone without the help of others, that’s why our brain is on alert and also sends a warning signal to other parts of the body.
Alertness leads to increased stress. Stress hormones, including cortisol and norepinephrine, can affect sleepiness, weight gain, and anxiety over long periods of time. According to Halt Lundstedt, the coronavirus is one of the most stressful situations that many people have experienced in their lifetime. Daily life has been disrupted, unemployment has risen dramatically, and more than 6 million people worldwide have been infected with the virus. Usually, people in difficult situations need the support of family and friends. Due to the nature of the coronavirus, people are now more alone than before and can hardly communicate with each other.
The genetic structure of lonely people is more prone to disease
Study alone
Almost everyone can cope with loneliness, but scientists are still looking to investigate its effects on health. On the other hand, loneliness is a subjective feeling that cannot be measured. Even the social circle of people is not a guarantee that they are not alone.
According to Holt Lundstedt, surveys usually ask people about loneliness either directly (how lonely do you usually feel?) or indirectly (do you feel friendless?).
NASA has been investigating the effects of isolation and the enclosed environment on astronauts for years and has reached similar results to other studies: isolation conditions can lead to behavioral and cognitive problems. Researchers are also looking to investigate the biological dimensions of loneliness as well as its physical effects on the body in other places.
Perhaps, to understand the feeling of loneliness, it is necessary to examine people’s brains. Researchers at the Rush Alzheimer’s Disease Center in Chicago studied 823 adults over a four-year period. They used questionnaires to assess loneliness, categorize Alzheimer’s disease and dementia, as well as test participants’ thinking, learning, and memory, and set loneliness scores between 1 and 5. According to the results, the risk measure of Alzheimer’s disease increases by 51% for each point of the scale.
Loneliness puts the body in a state of alert and leads to an increase in anxiety
Also, the dead people were autopsied during the investigation period. According to the results, loneliness is the cause of brain changes associated with Alzheimer’s disease, including plaques and neural tangles or tissue damage due to lack of blood flow. However, Robert S. Wilson, one of the researchers of this study, believes that loneliness can make people vulnerable to the neurodegenerative effects associated with aging. According to Turhan Connelly, professor of neuroscience at Stony Brook University: “Loneliness can be a predictor of cognitive decline.”
The exact relationship between loneliness and health problems is still unclear. According to Connelly, if a person is lonely and feels bad about themselves, they will take less care of themselves. For example, these people don’t eat well usually drink a lot, have a lot of worries, or lack sleep. Such habits will have long-term consequences. Connelly also discussed a collaboration with David Bennett, another researcher at the Rush Alzheimer’s Center who has studied the genes of people who are not alone.
Bennett began a long research almost thirty years ago. In this research, the participants agreed to give their brains to researchers after death in exchange for an annual physical and mental check-up. The researchers investigated two points of the brain related to cognition and emotion. According to the results, genes related to cancer, cardiovascular, and inflammatory diseases appeared more in single people. According to Connelly:
There is usually a network of relationships between different genes that can influence each other. For this reason, the effect of loneliness on the occurrence of diseases can have a genetic reason.
Of course, the above findings do not mean that loneliness leads to heart disease. Rather, more research is necessary, such as the role of heredity in the occurrence of genes. Early research by UCLA researcher Steve Cole suggests one possibility: the release of certain hormones under conditions of stress and loneliness can activate specific genes that cause health problems. According to Connelly:
The mental experience of the brain can become a biological process, which is our goal to investigate this process.
A better understanding of the above relationships can affect the treatment methods of patients.
The future and loneliness
Despite the reduction in the intensity of quarantine and the gradual removal of restrictions on the activities of restaurants and public places, the impact of social distancing on society is still unclear. According to Harvard researchers in April, compliance with social distancing is necessary until 2022. NASA astronaut Scott Kelly spent 340 days alone in space, and in March published an op-ed based on his experiences in the New York Times Magazine. Kelly recommends reading magazines, keeping a schedule and discipline, as well as having fun in your alone time. Namek from the Cigna Institute also believes that it is necessary to examine loneliness in people and have an honest conversation about loneliness with people who struggle with this problem. According to him:
We need to contact our friends maintain our relationships and have meaningful conversations. It is necessary to always feel comfortable in asking the feelings of the other party.
Noun: The condition or state of being alone or having no companions.
Noun: The state of being unfrequented or devoid of human activity (of a place or time).
Noun: A desire to be alone; disposition to solitude.
Noun: A feeling of depression resulting from being alone or from having no companions.
Noun: The condition or state of being alone or having no companions.
Noun: The state of being unfrequented or devoid of human activity (of a place or time).
Noun: A desire to be alone; disposition to solitude.
Why is the loneliness epidemic so hard to cure?
Richard Weisbord, a psychologist and lecturer at Harvard University, started a new study in the early months of 2020 along with the worldwide quarantine of Covid-19. In his opinion, loneliness or its specter is everywhere. Two years ago, Weisbord read a study from insurance provider Cigna that found 46 percent of Americans sometimes or always feel lonely, a number that rose to 52 percent in 2019 when the study was repeated. Weisbord thought, in quarantine, this number has increased a lot.
Weisbord wanted to know how loneliness feels for lonely people. What are its possible consequences? And what causes it? It is difficult to answer these questions; Because loneliness is a complex or multidimensional emotion; That is, it includes the elements of sadness and anxiety, fear and heartbreak. The experience of loneliness is personal and highly subjective (internal) and depends on a person’s way of thinking. A clerk in a busy grocery store can be intensely lonely, just as a recluse living in a cave can endure solitude in complete happiness.
Loneliness should not be confused with isolation. For convenience, most researchers still use the definition coined by social psychologists almost three decades ago, in the early 1980s. Loneliness is described as “the difference between desired and achieved levels in one’s social relationships” which, unfortunately, is also very subjective.
To understand the current loneliness crisis, Weisbord, who leads a Harvard project on health and well-being, created a 66-question survey and sent it to about 950 people across the United States. With the exception of a few direct statements such as “In the past four weeks, how often have you felt lonely?”, most questions indirectly explore loneliness from different angles; For example, are there people in your life who ask for your opinion on things that are important to you?
Loneliness is an epidemic that is more felt in today’s society
Some of the other questions in the questionnaire included: “Do you feel that you connect with people more than they connect with you?” or “Has anyone ever taken more than a few minutes to ask you how you’re doing in a way that makes you feel like they really care?”
When the results came in, Weisbord was shocked by the extent of the loneliness problem; 36% of respondents experienced chronic loneliness, and 37% experienced occasional loneliness in the last month. Among those who felt lonely, 46 percent said they interacted with people more than people interacted with them, and 19 percent felt that no one outside of their family cared about them at all.
In February 2021, as Harvard planned to resume face-to-face classes, the Weissboard team released the results of the survey, highlighting deep social issues in America. These findings attracted a lot of attention and many saw themselves as partners.
A 2021 Gallup poll found that 25 percent of adults often feel lonely, and nearly 40 percent of young adults do so regularly. Although these numbers have improved slightly, 25 percent of Americans still feel more lonely than before they were born.
Last year, U.S. Surgeon General Vivek Murthy released a report calling loneliness an epidemic that affects Americans more than diabetes or obesity. The World Health Organization also classified loneliness as a global public health concern. Like depression and anxiety, loneliness has become a hot topic in culture and has spawned numerous articles, self-help books, podcasts, and even startups focused on loneliness.
Japan and Britain have even appointed single ministers tasked with monitoring and ameliorating the depth of the crisis, either through public awareness campaigns or initiatives such as a scheme in the UK where letter carriers were asked to meet elderly residents on routes. Call yourself.
Attempts to address loneliness often show that simple actions such as a phone call, email, or meeting can solve the problem by restoring lost social connections. However, this view misunderstands the complexities of modern life and may distract from deeper problems such as alienation, isolation, mistrust, and disconnection. These issues stem from the weakening of institutions and traditions that once bound people together, and addressing them requires more than a return to the past.
Unlike anxiety or depression, loneliness is a relatively modern concern. Historian Fei Bond Alberti notes in his book A Biography of Loneliness that loneliness, as we understand it today, did not become widespread in the world until after the 1800s. The West was not discussed.
Loneliness is a relatively modern concern
It is not correct to say that no one knew the word loneliness before the 1800s, But loneliness was not always associated with negative feelings. While the word appeared in Shakespeare and Robinson Crusoe, solitude was often seen as a positive experience, especially in the busy past.
Prior to the 19th century, loneliness did not carry the same emotional weight as it does today, Alberti notes. His research shows that there was no mention of “solitude” in English literature until about the 1820s when the term suddenly became very popular. This change coincided with rapid changes in society, such as war, industrialization, and urbanization, which tore apart traditional societies and led people to seek new ways to express the emotional effects of these changes.
In the 1950s, American scholars began to explore loneliness as a modern subject, paving the way for loneliness studies. Sociologist David Reisman linked loneliness to social changes in post-war America. In his book The Lonely Population, Reisman explained how prosperity leads Americans to focus on material possessions and social comparisons; A behavior that he called “other-oriented”. This phenomenon is similar to today’s term FOMO (fear of being left behind). When people can’t get what others enjoy, the feeling of loneliness starts.
Some experts consider loneliness a severe medical condition, similar to depression, with debilitating effects. American psychologists Louise Hawkley and John Cacioppo used hypnosis in an experiment to induce loneliness in participants. This led to an increase in people’s blood pressure and inflammation, showing that loneliness directly affects health. When the loneliness induction ended, their health indicators improved.
Loneliness is a biological signal designed to motivate us to seek social connection and support
In another study by Hawkley and Cacioppo, participants were removed from a social activity to show that loneliness, similar to physical pain, triggers a pain response in the brain. Like hunger, this response is a biological signal designed to motivate us to seek social connections and support.
Loneliness can become a self-reinforcing cycle, where fear and anxiety convince people that they are not worth connecting with, making them feel trapped and increasingly isolated. A 2021 study by psychologist Daniel Maitland found that when lonely people are asked to share personal details, they experience a lot of stress, suggesting that vulnerability is a big challenge for them. This makes the traditional advice to join social activities ineffective, as such gatherings are outdated and unattractive to many.
In his book “Bowling Alone”, Robert Putnam noted the decline of American participation in organizations and social groups. Almost 25 years later in 2024, fewer Americans are getting married than in the middle of the 20th century. The number of people living alone has more than tripled to 29%. But being married doesn’t necessarily prevent loneliness, because a bad marriage can be very isolating, and likewise, living alone doesn’t always mean being alone.
Less attendance at religious ceremonies is also an example of reducing the traditional activities of society. Weisbord believes religious communities are places where adults engage with children, defend moral values, and engage children with big moral questions. He says he does not suggest becoming more religious; But in those aspects of religion where you feel an obligation to your ancestors and children, there is a structure to deal with grief. We have to figure out how to reproduce those aspects of religion in secular life.
Weisbord and Milena Batanova, the project’s director of research and evaluation, found in a follow-up survey that many respondents attributed their loneliness to a lack of “meaningful connection”; Even when surrounded by others. Emotional closeness rather than physical presence was often the main issue, and some felt devalued or disconnected from those around them.
Working doesn’t bring much relief, as fewer Americans find meaning in their careers, especially as the rise of remote work complicates community building. Older people are more likely to have found meaningful relationships and close friends at work, while younger people struggle with dating due to the shift to telecommuting and virtual communication.
The epidemic of loneliness has left lasting effects on social interactions; So many people with poor social skills were released from quarantine. Simultaneously with the rise of frictionless forms of digital interaction such as automated payment systems and food delivery, a phenomenon has emerged that some experts call “cocooning”; It means retreating to the digital world that lacks meaningful communication with people.
Julian Holt Lanstad, professor of psychology and neuroscience at Brigham Young University, noted that from 2003 to 2020, Americans spent more time alone and less time with friends and family. The data backs this up, showing that many people struggle with relationship issues and feel like they don’t connect well with people. This suggests that many Americans are not getting the social support they need, either because of loneliness or actual isolation.
Historically, the peak of loneliness has coincided with major social changes. Sociologist Eric Kleinenberg notes that loneliness often became a major concern during times of cultural change, such as the advent of radio in the early 1900s, the rise of car culture, and the social upheavals of the 1960s and 1970s. According to Kleinenberg, loneliness is often used to explain the discomfort that people feel when cultural change happens too quickly and people cannot adapt.
The epidemic of loneliness today is very deep; Because it is happening on an unprecedented scale, driven by drastic changes in social life, including political dysfunction, mental health crises, and the transformation of communication through the Internet. Many people express longing for the past when social connections seem stronger, but this nostalgia may not provide a realistic solution to the current crisis. Instead, efforts such as encouraging face-to-face activities and fostering traditional forms of community may help, but perhaps not completely solve the problem.
Perhaps the solution to loneliness is new ways of interacting
History shows that social change often leads to new forms of society rather than a return to old forms. For example, during the Industrial Revolution, people adapted to building new urban societies instead of retreating to rural life. Similarly, the way out of today’s loneliness may involve embracing new forms of communication, such as those enabled by smartphones and the Internet, that can create meaningful relationships despite physical distance.
The evolution of social interactions today, with online platforms allowing people to communicate in ways that were previously impossible. Such an opportunity may be part of a broader adaptation process. In other words, the current period of loneliness can be a transitional phase in which society adapts to new realities and finds new ways to connect and support each other.
Finally, the crisis of loneliness may represent an evolutionary step toward new forms of togetherness; Where, despite physical separation, people find ways to reconnect and create meaningful relationships in the modern world.
Health
The secret of the human heart; How did evolution make the vital organ of our body unique?
Published
3 weeks agoon
31/08/2024The secret of the human heart; How did evolution make the vital organ of our body unique?
From the giant blue whale to the tiny insectivore, mammals inhabit almost every corner of our planet. Their amazing adaptability to different environments has long fascinated scientists, as each species has developed its own characteristics to survive and thrive in different environments.
Despite the wide biodiversity of mammals, until recently it was thought that the structure and function of the heart is similar in all species. But a new study by a team of researchers from Swansea University’s School of Medicine, Health and Life Sciences in Wales shows that the human heart is an exception, and is strikingly similar to the hearts of our closest relatives, the great apes, including chimpanzees, bonobos, Orangutans, and gorillas are different. But what is the reason for the difference in human hearts?
Humans diverged from chimpanzees ( Pan troglodytes ), our last common ancestor with the great apes, about five to six million years ago. In contrast, humans evolved to stand and perform more physical activities, such as continuous hunting and developed much larger brains.
The changes in the human body were associated with a very high increase in the need for metabolism; The body needed more blood to pump blood from the heart to the muscles and brain. A new study shows that the human heart has adapted to support standing on two legs, moving around, and growing a bigger brain.
Humans evolved to stand and perform continuous physical activity
Over the past 10 years, researchers have conducted numerous assessments of the cardiovascular system of great apes around the world. The study’s research team managed to collaborate on this project with veterinarians and care workers in the UK, Europe, Africa and Asia. One of the important aspects of this collaboration and evaluations was the use of cardiac ultrasound, which can be used to examine the structure and function of the heart, the size and manner of contraction, twisting and rotation of the heart muscle.
Researchers have concluded in previous studies that the structure of the human heart may be different from the heart of a chimpanzee. Using ultrasound of the heart, they found that the left ventricle of the heart, which is where the heart pumps the heart, in chimpanzees has bundles of muscle embedded in “turgidized” tissue.
Trabeculation or trabeculation refers to the formation of small and network-like muscle bundles inside the ventricles of the heart. Tortigated tissues are like little blades that help the heart muscle to work better when pumping blood.
Comparison of left ventricular tortification in great apes.
The aim of the researchers in the new study was to investigate the structure of tortiginated tissue in other great apes. They found that other great apes have the same heart structure as chimpanzees. In contrast, humans have a smooth wall in their left ventricle. This difference is especially obvious at the bottom of the left ventricle. In the lower part of the left ventricle, the smoothness of the human heart is approximately four times greater than that of the great apes.
A single heart meets our need for more physical activity and a bigger brain
The study not only showed structural differences in the left ventricle of humans compared to great apes but also found a major difference in how the hearts function. Using a specialized technique called speckle tracking echocardiography, which follows the movement of the heart muscle during contraction and expansion, the researchers investigated how this muscle thickens, twists, rotates, and stretches.
The results of the examination of the hearts were surprising. The lowest rate of tortuosity is seen in the human heart, but it was much higher during contraction, twisting, and turning in the lower part of the human heart. In contrast, great apes, with heavily tortiginated hearts, exhibited less motion.
Researchers believe that the human heart evolved from the tortiginated structure seen in other great apes to increase its ability to twist and contract more efficiently. This increased torsion, along with the smooth walls of the ventricles, probably allows the human heart to pump more blood with each beat. This satisfies our need for more physical activity and a bigger brain.
The findings of the study challenge the hypothesis of the sameness and similarity of the structure of the heart in all mammals. Instead, subtle but critical differences in cardiac anatomy and function have emerged in response to unique environmental challenges.
Cardiovascular diseases
A new study by researchers reveals the secret of the evolution of the human heart. However, the research in the field of analyzing the heart of endangered great apes is still going on. Unfortunately, the leading cause of death in captive great apes is cardiovascular disease.
Unlike humans, great apes do not appear to develop coronary artery disease. But their heart muscle undergoes a fibrotic process (thickening or degeneration of the fibers) that leads to weak contraction and susceptibility to arrhythmia, a critical problem in heart rhythm regulation. The cause of this disease remains unknown, therefore, a group of researchers in the International Primate Heart Project evaluated the cardiovascular physiology of great apes around the world to gain a better understanding of this disease.
Prior to the current project, little was known about the normal cardiovascular physiology of great apes. Through a collaboration with veterinarians, the new study has yielded critical data and critically improved our understanding of the evolution of the human heart, as well as the understanding, diagnosis, and management of cardiovascular disease in great apes.
The findings of the study have been published in the journal Nature.
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