By Michael Roizen, M.D., And Mehmet Oz, M.D.


Workouts for a busy schedule; brachytherapy versus external beam

Q: I'm a video editor and I'm chained to my desk for hours at a time. I get an occasional bike ride with the kids on the weekends, but what can I do at my workstation to keep my muscles toned? - Gus Y., Brooklyn, New York

A: When you have a busy schedule, it's hard to find time during the week to stay active. So we have a couple of tips for you to keep toned during your desk-bound workweek.

First, there's the "build abs while you wait" routine:

-While you're standing in line at the coffee shop before work or waiting for your computer(s) to load or boot up, stand tall, breathe in slowly as you move your shoulders back, clench your butt muscles, suck in your belly and tighten your abs. Exhale slowly while you hold it for 10 seconds; repeat as many times as you can.

Then, there are desk moves:

-Sit 'n' Tone works if you take time once an hour to "walk" 100-200 steps by lifting your heels up and down off the floor. Then extend your arms out straight from your shoulders, palms up; rotate your straightened arms 25 times backward and 25 times forward. Then pinch shoulder blades together and release 25 times. Whew!

-Consider a pedaling device or an actual pedal desk, or like Dr. Mike, get a treadmill desk. For video editing, you probably could use it only while waiting for downloads, compressions and transfers. But you could engineer a setup that works with a stand-up/sit-down desk.

There are "Take a Break" toners:

-Set a timer to go off every 30-60 minutes. When it goes off, walk around the office or up and down the stairs.

-Need a coach? Check out Mel Miller's 10-Minute Workout Tips at Sharecare.com.

If that all seems like a lot of time while you're working, you'll be surprised at how much more work you get done when you stimulate your blood and brain with simple movements.

Q: My sister has cervical cancer and was told by her insurance company that they would pay for an external radiation beam treatment, but not internal brachytherapy. They claim that external beam is just as effective, but that's not true, is it? - Coleen B., Omaha, Nebraska

A: You are right. Research shows that brachytherapy is the gold standard for treatment and has a higher success rate and fewer side effects than external beam.

According to the American Cancer Society, there are two kinds of brachytherapy for cervical cancer; low-dose rate (LDR) brachytherapy, in which the patient stays in the hospital for a few days for treatment, and high-dose rate (HDR) brachytherapy, which is done on an outpatient basis, usually once a week. The two treatments are very different; one may be used for first-time treatment, and the other for a cancer that's returned.

Recently, researchers at the University of Virginia School of Medicine pointed out that brachytherapy runs at more than two and a half times the cost of external beam therapy and said that the higher cost "may be a potential driver of reported national trends toward poor compliance with brachytherapy."

Regardless, whatever treatment her doctor/oncologist decides is right for her - and sometimes it's a combination of external beam and brachytherapy - that is what she should get. And even though brachytherapy is the gold standard for treating cervical, prostate, some breast and skin cancers, she should get a second opinion too.

If she gets a second opinion and the doctor agrees that brachytherapy is the way to go, that's a lot of fuel for her argument with the insurance company. The primary oncologist and or oncological surgeon and your sister should re-petition the insurance company (maybe more than twice) for preapproval and/or prior authorization for the brachytherapy. Hang in there. There are a lot of success stories out there about people resubmitting and getting what they want and need. Good luck.

© 2018 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.

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