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#having to make the decision whether to stabilize folks against the 5% chance of a nat 1 or hoping they hit the 5% chance of popping back up
swarmkeepers · 1 year
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AAAAAAAA WE LIVED BITCH
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Are You Headed Toward Bankruptcy? Don’t Touch Your Retirement Savings & Other Considerations!
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If you, like so many Americans right now, are struggling with job loss or other financial stressors, you may be considering the prospect of bankruptcy. While bankruptcy may be an option of last resort, many Americans think that they can avoid bankruptcy by cannibalizing their retirement accounts or making other moves that simply forestall the inevitable.
In the current economic climate, bankruptcies are to be expected. Congress is attempting to stem the tsunami of bankruptcies that will clog up the American courts, but no one knows whether the funds extending unemployment and stimulus checks will be there a few months down the road. This has many Americans worriedly looking over their finances and planning financial moves for their future.
While planning for the future is generally a good thing, you don’t have to rob the future to pay the present. In this article, we’ll discuss what you should and should not do if you are one of the nearly 40 million Americans who are unemployed right now.
Talk to a Bankruptcy Lawyer Now
Even if there’s a chance that you aren’t heading toward bankruptcy, the financial advice that bankruptcy lawyers provide is much different than the type of advice credit counselors or financial planners provide. We can tell you how to divest your liabilities while hanging onto your assets. In other words, we can help leave you in a better financial position than you were before you entered bankruptcy.
Of course, there’s a caveat to that. Your credit could take a hit. This is one of the several factors that bankruptcy attorneys will discuss with you when you meet with them. The best thing about many bankruptcy attorneys (and in particular Butcher Law Office, LLC) is that they provide you with a free hour-long consultation. There is no need to file for bankruptcy or commit to settling your debts in that manner. So getting a free consultation and listening to what we have to say may provide you with a firmer foundation to make your next move. That doesn’t mean that you should rush to file for bankruptcy. But knowing all of your options helps you make a more informed decision.
Do Not Touch Your Retirement Savings!
Your retirement savings are protected under bankruptcy law. In other words, creditors cannot usually use that money to recover some of the debts you owe.
Unfortunately, many Americans are raiding their retirement savings right now. Why? Because the federal government is allowing Americans to borrow from their retirement accounts while minimizing certain penalties. The money withdrawn is taxable, and can be repaid within a three-year period without incurring a tax liability. But most prognostications find that Americans who borrow from their retirement savings now will not be able to pay them back in the future. That money will just be gone.
A Chapter 7 bankruptcy filer can protect IRAs and 401(k)s using Chapter 7 exemptions. The amount of money you can protect in the account may be capped in certain cases, but chances are good that you will be able to protect all the money in the account. So if you use that money to pay debts you can discharge in Chapter 7, you are taking a double loss.
Don’t mortgage your future by using your retirement funds to pay off debts that can be erased in bankruptcy!
Roth IRAs and Bankruptcy
Because retirement accounts offer broad-scale protection from bankruptcy, they can be useful for protecting assets. Yet many frugal-minded Americans will simply let cash pile up in their bank accounts as a buffer for bills and other debts that are piling up.
You shouldn’t do that. Firstly, you can only protect so much money in Chapter 7 and that includes savings and checking accounts. The more money that you protect in your bank accounts, the less money you have to protect other assets.
Similarly, if a creditor files a lawsuit against you to recover a debt and wins the judgment, the creditors can levy these bank accounts to recover the debt. They cannot, however, levy a Roth IRA.
There are certain precautions to be taken in using a Roth IRA to help protect assets, however. An experienced bankruptcy lawyer can discuss using a Roth IRA to help protect a set amount of money in the context of bankruptcy.
Don’t Liquidate Your Assets (Yet)
Most folks, when they meet financial turmoil, will find assets they can sell off to stabilize their situation. This may work in the short term, but if the situation doesn’t change, you can find yourself without any assets, still making payments on those same debts.
If you’re considering bankruptcy, then the bankruptcy trustee through the court could void asset transfers that occurred recently for which you did not receive equal or fair market value as exchange. This is especially true if the court thinks you’re moving these assets simply for the purpose of protecting them. That would be considered fraud.
So before you start divesting yourself of valuable assets, discuss the matter with a bankruptcy attorney.
Forbearance Options Can Help
Federally-backed mortgages now qualify for forbearance. This means that you won’t incur a penalty for not paying on your mortgage, at least for now. What it really means is that lenders can’t foreclose on your home during this time. That could change in several months when the legislation protecting borrowers expires and they find themselves in a position of owing several months’ worth of mortgage payments. Lenders may likely offer options to roll arrearages into a current monthly payment ideally.
If lenders will not work with you after the forbearance, there is always the possibility of filing a Chapter 13 bankruptcy — to catch up on the missed mortgage payments over a 5 year period.
Schedule a Free Consultation with a Eugene, OR Bankruptcy Lawyer Today
Talking to a bankruptcy attorney about your options heading into the coming months is a wise idea if for no other reason than we can help you make a smarter and better informed decision. Call Butcher Law Office, LLC today to schedule your free consultation with Tom.
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Are You Headed Toward Bankruptcy? Don’t Touch Your Retirement Savings & Other Considerations!
Tumblr media
If you, like so many Americans right now, are struggling with job loss or other financial stressors, you may be considering the prospect of bankruptcy. While bankruptcy may be an option of last resort, many Americans think that they can avoid bankruptcy by cannibalizing their retirement accounts or making other moves that simply forestall the inevitable.
In the current economic climate, bankruptcies are to be expected. Congress is attempting to stem the tsunami of bankruptcies that will clog up the American courts, but no one knows whether the funds extending unemployment and stimulus checks will be there a few months down the road. This has many Americans worriedly looking over their finances and planning financial moves for their future.
While planning for the future is generally a good thing, you don’t have to rob the future to pay the present. In this article, we’ll discuss what you should and should not do if you are one of the nearly 40 million Americans who are unemployed right now.
Talk to a Bankruptcy Lawyer Now
Even if there’s a chance that you aren’t heading toward bankruptcy, the financial advice that bankruptcy lawyers provide is much different than the type of advice credit counselors or financial planners provide. We can tell you how to divest your liabilities while hanging onto your assets. In other words, we can help leave you in a better financial position than you were before you entered bankruptcy.
Of course, there’s a caveat to that. Your credit could take a hit. This is one of the several factors that bankruptcy attorneys will discuss with you when you meet with them. The best thing about many bankruptcy attorneys (and in particular Butcher Law Office, LLC) is that they provide you with a free hour-long consultation. There is no need to file for bankruptcy or commit to settling your debts in that manner. So getting a free consultation and listening to what we have to say may provide you with a firmer foundation to make your next move. That doesn’t mean that you should rush to file for bankruptcy. But knowing all of your options helps you make a more informed decision.
Do Not Touch Your Retirement Savings!
Your retirement savings are protected under bankruptcy law. In other words, creditors cannot usually use that money to recover some of the debts you owe.
Unfortunately, many Americans are raiding their retirement savings right now. Why? Because the federal government is allowing Americans to borrow from their retirement accounts while minimizing certain penalties. The money withdrawn is taxable, and can be repaid within a three-year period without incurring a tax liability. But most prognostications find that Americans who borrow from their retirement savings now will not be able to pay them back in the future. That money will just be gone.
A Chapter 7 bankruptcy filer can protect IRAs and 401(k)s using Chapter 7 exemptions. The amount of money you can protect in the account may be capped in certain cases, but chances are good that you will be able to protect all the money in the account. So if you use that money to pay debts you can discharge in Chapter 7, you are taking a double loss.
Don’t mortgage your future by using your retirement funds to pay off debts that can be erased in bankruptcy!
Roth IRAs and Bankruptcy
Because retirement accounts offer broad-scale protection from bankruptcy, they can be useful for protecting assets. Yet many frugal-minded Americans will simply let cash pile up in their bank accounts as a buffer for bills and other debts that are piling up.
You shouldn’t do that. Firstly, you can only protect so much money in Chapter 7 and that includes savings and checking accounts. The more money that you protect in your bank accounts, the less money you have to protect other assets.
Similarly, if a creditor files a lawsuit against you to recover a debt and wins the judgment, the creditors can levy these bank accounts to recover the debt. They cannot, however, levy a Roth IRA.
There are certain precautions to be taken in using a Roth IRA to help protect assets, however. An experienced bankruptcy lawyer can discuss using a Roth IRA to help protect a set amount of money in the context of bankruptcy.
Don’t Liquidate Your Assets (Yet)
Most folks, when they meet financial turmoil, will find assets they can sell off to stabilize their situation. This may work in the short term, but if the situation doesn’t change, you can find yourself without any assets, still making payments on those same debts.
If you’re considering bankruptcy, then the bankruptcy trustee through the court could void asset transfers that occurred recently for which you did not receive equal or fair market value as exchange. This is especially true if the court thinks you’re moving these assets simply for the purpose of protecting them. That would be considered fraud.
So before you start divesting yourself of valuable assets, discuss the matter with a bankruptcy attorney.
Forbearance Options Can Help
Federally-backed mortgages now qualify for forbearance. This means that you won’t incur a penalty for not paying on your mortgage, at least for now. What it really means is that lenders can’t foreclose on your home during this time. That could change in several months when the legislation protecting borrowers expires and they find themselves in a position of owing several months’ worth of mortgage payments. Lenders may likely offer options to roll arrearages into a current monthly payment ideally.
If lenders will not work with you after the forbearance, there is always the possibility of filing a Chapter 13 bankruptcy — to catch up on the missed mortgage payments over a 5 year period.
Schedule a Free Consultation with a Eugene, OR
Bankruptcy Lawyer Today
Talking to a bankruptcy attorney about your options heading into the coming months is a wise idea if for no other reason than we can help you make a smarter and better informed decision. Call Butcher Law Office, LLC today to schedule your free consultation with Tom.
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unixcommerce · 5 years
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Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips
When businesses become overleveraged, bad things happen. When businesses are able to maintain financial flexibility, they’re far more likely to enjoy long-term success. Where does your business land on this spectrum? And what does it look like to move from overleveraged to flexible?
What Does it Mean to be Financially Flexible?
Every CFO and finance guru will have his or her own opinion on what it means to be financially flexible, but it’s ultimately a company’s ability to quickly access new funds to satisfy major business needs that arise suddenly as the result of an opportunity or crisis.
According to an academic study on the effect of financial flexibility on financial behavior of publicly traded companies, firms with financial flexibility are able to stand against financial pressures in an unexpected situation and seize a profitable opportunity. This means they’re able to come up with the cash needed without incurring negative financial circumstances in the present or the future.
In other words, financial flexibility is the measure of an organization’s ability to do what it wants when it wants without compromising the larger financial picture. The benefits of which include:
Quick response. When a business is financially flexible, the company is able to make quick decisions on how to react to situations that demand a rapid response. In certain industries, this can mean the difference between seizing market share and becoming obsolete.
Future stability. Companies that lack financial flexibility often pursue present opportunities at the expense of future growth and sustainability. When you have flexibility, you don’t have to mortgage the future away.
Better focus. Think about how much time and energy goes toward figuring out the best way to finance a major business decision. For firms with a high degree of financial flexibility, less energy has to be given to this part of the decision. Instead, focus can be directed toward creativity and execution. Money is still an important issue, but it isn’t the primary
Greater adaptability. Financial flexibility gives a business the ability to adapt, pivot, and evolve with relative ease. There’s far less friction involved in the process, and you’re able to do more with less.
Less volatility. When money is tight and there are questions about how certain expenses and projects will be financed, business leaders often feel like they’re being tossed around in a pinball machine. But when a firm is financially flexible, there’s far less volatility. A sense of calmness leaches into the company culture and everyone feels at ease.
Financial flexibility means different things to different business leaders, but it’s something every company should strive for. With it, there’s far more potential and peace of mind.
5 Tips to Achieve Optimal Financial Flexibility
Financial flexibility sounds great, but how do companies achieve it? That’s a question that business leaders and corporate executives have asked for decades – and one that doesn’t have a perfect response. But if you want to increase your organization’s chances of enjoying greater financial flexibility, here are some practical steps you can take in a positive direction:
1. Use Profits Wisely
Let’s start by talking about profitability. For businesses with healthy bottom line profit margins, there’s ample opportunity for financial flexibility. Unfortunately, many of these organizations squander the profits in a selfish and/or unsustainable fashion. Don’t let your company experience a similar demise.
For young companies, in particular, there’s a temptation for business owners and executives to quickly turn profits into cash bonuses and salary increases. (Naturally, the folks making the money want to pocket some of the harvest.) But consider whether or not this is the best approach.
When profits are immediately turned into year-end bonuses, the business remains stagnant. While the company has grown, cash reserves haven’t. Eventually, too much growth without healthy increases in cash will create an imbalance and profits will fall – at which point (ironically) there won’t be any way practical way to build up those cash reserves.
It’s okay for business owners and executives to take some small bonuses when profits exceed expectations, but do so sparingly. The majority of profits should be reinvested into the business by bolstering a cash emergency fund or paying down debt (which ultimately improves future cash flow). In doing so, you’ll ensure that the business model is sustainable for years to come (yielding greater personal financial benefit down the road).
2. Develop Better Budgets
Now that we’ve discussed profits and how they should be handled, let’s dig into the topic that nobody likes to discuss: budgeting.
If you’re serious about achieving financial flexibility, you need a budget — a detailed budget that tells your money where to go. Only then can you maximize your revenue, reduce expenses, and put your business in a position to afford the investments that are needed to flourish.
The key with a budget is to avoid expense creep. If you aren’t careful, expenses will slowly get tacked on to your budget month after month. It’ll look like $25 here, $300 there, and $100 over there. In the grand scheme of things, this might not seem problematic. But suddenly you look up and two years from now your expenses are $2,000 higher per month than they were when you drafted your initial budget.
Budgets fluctuate, but expenses shouldn’t creep up on you. Plan ahead and take charge. This will leave you with a healthier profit margin, which will yield greater flexibility. 
3. Use Strategic Financing
Financial flexibility isn’t about having cash to pay for everything. Very few large organizations are totally debt-free (nor should they be). Debt is a powerful instrument that serves a distinct purpose. The key is to use financing strategically.
Instead of taking on a bunch of debt just for the sake of having debt, be purposeful about which types of financing you use and what purpose they serve. The key is to have access to funds without paying interest on funds you don’t need. This is why many organizations turn to a business line of credit — and perhaps you should too. It improves cash flow on an as-needed basis and basically serves as an insurance policy that can be tapped in times of opportunity or need.
“The amount of funding accessible to your business, along with the repayment terms, depends on a variety of factors including your credit rating, revenue stream, longevity, and other financial variables,” Business Line of Credit Hub explains.
Be careful not to overestimate your need for credit. Run some estimations and calculations to determine the type of scenarios that would require you to tap into this line and how much you’d need in a worst-case scenario. This will help you zero in on a figure that’s adequate for your needs.
4. Diversify Your Revenue Streams
We’ve spent the bulk of this article discussing ways to manage money with intelligence so that your organization can enjoy a greater degree of flexibility. However, it’s also smart to think about how you’re producing revenue.
For optimal flexibility, look for ways to diversify your revenue streams. This will ensure you’re able to weather storms, crises, recessions, and other painful circumstances.
“What separates brands who survived the financial crisis from those that were swallowed whole by it, is the flexibility in their business models to offer value to multiple demographics and customer segments,” entrepreneur Tahnee Elliot explains.
When you have a wide customer demographic, a single negative economic condition isn’t going to run your business into the ground. You’re poised to weather turbulent conditions and can let other revenue streams prop up the areas of your business that are struggling. 
5. Avoid Crippling Mistakes
Maintaining financial flexibility isn’t just about doing the right things — it’s also about avoiding mistakes that can otherwise cripple your business and handcuff your finances.
Excessive debt on depreciating assets is one surefire way to kill your cash flow and limit your ability to pivot in situations that call for action. You should also avoid hiring people who go against your financial ideology. Too much friction among financial decision makers will lead to sloppy mistakes that are hard to recover come. 
Give Your Business a Strong Foundation
One of the first things an entrepreneur learns in business school is the importance of staying focused on the present. If you get too caught up in the past, you’ll miss out on what’s happening in the moment. And if you daydream about the future, you’ll fail to seize opportunities as they emerge. But having said all of this, you can’t ignore where your business is going. Your organization needs a strong foundation upon which you can facilitate future growth.
Financial flexibility allows you to accomplish both at once. You can make intelligent decisions in the present and simultaneously set your business up for future success through smart financial choices and sustainable strategies that maximize profitability at every step along the way.
Heed the advice outlined in this article and figure out how it aligns with your current business strategy. Start with the low-hanging fruit and focus on making incremental progress. Your momentum will eventually carry you into bigger and more transformational undertakings.
Republished by permission. Original here
Image: Due.com
This article, “Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips” was first published on Small Business Trends
https://smallbiztrends.com/
The post Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips appeared first on Unix Commerce.
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cristinajourdanqp · 6 years
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A Primal Guide to Prostate Health
Many of you have asked about prostate health in a Primal context. Men are interested because they know men have a decent chance of getting prostate cancer. Women are interested because they’re worried about the men in their lives getting prostate cancer. Today, I’m going to delve deep into the topic, exploring the utility (or lack thereof) of standard testing, the common types of treatment and their potential efficacy, as well as preventive and unconventional ways of reducing your risk and mitigating the danger of prostate cancer.
Let’s go.
First, what does the prostate do, anyway? Most people only think about it in terms of prostate cancer.
It’s a gland about the size of a small apricot that manufactures a fluid called prostatic fluid that combines with sperm cells and other compounds to form semen. Prostatic fluid protects sperm against degradation, improves sperm motility, and preserves sperm genetic stability.
What Goes Wrong With the Prostate?
There are a few things that can happen.
Prostatitis
Inflammation of the prostate, usually chronic and non-bacterial. A history of prostatitis is a risk factor for prostate cancer.
Benign Prostatic Hyperplasia
Non-cancerous enlargement of the prostate. As men age, the prostate usually grows in size. This isn’t always cancer but can cause similar symptoms.
Prostate Cancer
What most of us are interested in when we talk about prostate health… After skin cancer, prostate cancer is the most common cancer among men and the sixth most common cause of cancer death among men worldwide. Yet, most men diagnosed with prostate cancer do not die from it; they die with it. The 5-year survival rate in the US is 98%.
That said, there is no monolithic “prostate cancer.” Like all other cancers, there are different grades and stages of prostate cancer. Each grade and stage has a different mortality risk:
Low-grade prostate cancer grows more slowly and is less likely to spread to other tissues.
High-grade prostate cancer grows more quickly and is more likely to spread to other tissues.
Local prostate cancer is confined to the prostate. The 5-year relative survival rate (survival compared to men without prostate cancer) for local prostate cancer is almost 100%.
Regional prostate cancer has spread to nearby tissues. The 5-year relative survival rate for regional prostate cancer is almost 100%.
Distant prostate cancer has spread to tissues throughout the body. The 5-year relative survival rate for distant prostate is 29%. Distant prostate cancer explains most of the prostate-related mortality.
What Are Symptoms of Prostate Cancer?
The primary symptom is problems with urination. When the prostate gland grows, it has the potential to obstruct the flow of urine out of the bladder, causing difficulty urinating, weak urine flow, painful urination, or frequent urination. This can also be caused by benign prostatic hyperplasia, a non-cancerous enlargement of the prostate.
What Causes Prostate Cancer?
A big chunk is genetic. People with “knockout” alleles for BRCA, which codes for tumor suppression, have an elevated risk of some forms of prostate cancer. That’s the same one that confers added risks for breast cancer.
Ethnicity matters, too. Men of Sub-Saharan African descent, whether African-Americans in the U.S. or Caribbean men in the U.K., have the highest risk in the world for prostate cancer—about 60% greater than other ethnic groups. White men have moderate risks; South Asian, East Asian, and Pacific Islander men have lower risks.
Testosterone has a confusing relationship with prostate cancer. Conventional wisdom tends to hold that testosterone stimulates prostate cancer growth, and there’s certainly some evidence of a relationship, but it’s not that simple.
In one study, men with low free testosterone levels were less likely to have low-grade (less risk of spreading) prostate cancer but more likely to have high-grade (higher risk of spreading) prostate cancer.
In another, testosterone deficiency predicted higher aggressiveness in localized prostate cancers.
In Chinese men, those who went into treatment with low testosterone were more likely to present with higher-grade localized prostate cancers.
Other studies have arrived at similar results, finding that “hypogonadism represents bad prognosis in prostate cancer.”
Many prostate cancer treatments involve testosterone deprivation, a hormonal reduction of testosterone synthesis. This can reduce symptoms and slow growth of prostate tumors during the metastatic phase, but prostate cancer tends to be highly plastic, with the ability to adapt to changing hormonal environments. These patients often see the cancer return in a form that doesn’t require testosterone to progress.
What About Testing?
If you have a prostate, should you get tested starting at age 40?
Not necessarily. The value of early testing hasn’t been established. Some researchers even question whether early testing is more harmful than ignoring it, and most of the research finds middling to nonexistent evidence in favor of broad testing for everyone. Early testing has a small effect on mortality from prostate cancer, but no effect on all-cause mortality.
PSA testing can also be inaccurate. PSA is prostate specific antigen, a protein produced by the prostate. It’s normal to have low levels of PSA present in the body, and while high levels of PSA are a good sign of prostate cancer—even years before it shows up in imaging or digital probes—they can also represent a false positive. Those two other common yet relatively benign prostate issues—benign hyperplasia and prostatitis—can also raise PSA levels well past the “cancer threshold.”
Other causes of high levels of PSA include:
Urinary tract infections
Recent sex or ejaculation
Recent, vigorous exercise
Certain medications.
In fact, if you have a PSA reading of 4 (the usual threshold), there’s still just a 30% chance it actually indicates cancer.
What About Treatment?
Let’s say you do have prostate cancer, confirmed by PSA and a biopsy (or two, or three, as needle biopsies often miss cancers). What next? Should you definitely treat it?
It’s unclear whether treatment improves survival outcomes. One study took men aged 50-69 with prostate cancer diagnosed via PSA testing, divided them among three treatment groups, and followed them for ten years. One group got active monitoring—they continued to test and monitor the status of the cancer. One group received radiotherapy—radiation therapy to destroy the tumor. And the last group had the cancer surgically removed.  After ten years, there was no difference among the groups for all-cause mortality, even though the active-monitoring group saw higher rates of prostate cancer-specific deaths (8 deaths—in a group of 535 men— vs 5 in the surgery group and 4 in the radiotherapy group), cancer progression, and metastasis.
In another study of men with localized prostate cancer, removing the prostate only improved all-cause mortality rates among men with very high PSAs (more than 10). In men with lower PSAs, “waiting and seeing” produced similar outcomes as surgery.
Prostate removal also carries many unwanted side effects, like incontinence and sexual dysfunction. No one wants prostate cancer, but it’s no small thing to have problems with urination and sex for the rest of your life. Those are major aspects of anyone’s quality of life.
Before you make any decisions, talk to your doctor about your options, the relative mortality risk of your particular cancer’s stage and grade, and how the treatments might affect your quality of life.
How Can You Reduce the Risk of Prostate Cancer? 1. Inflammation is definitely an issue.
For one, there’s the relationship between prostatitis, or inflammation of the prostate, and prostate cancer that I already mentioned above.
Two, there’s the string of evidence linking anti-inflammatory compounds to reductions in prostate cancer incidence. For example, aspirin cuts prostate cancer risk. Low-dose aspirin (under 100 mg) reduces both the incidence of regular old prostate cancer and the risk of metastatic prostate cancer. It’s also associated with longer survival in patients with prostate cancer; other non-steroidal anti-inflammatories are not.
Third, anti-inflammatory omega-3 fatty acids (found in seafood and fish oil) are generally linked to lower rates of prostatic inflammation and a less carcinogenic environment; omega-6 fatty acids can trigger disease progression. A 2001 study of over 6,000 Swedish men found that the folks eating the most fish had drastically lower rates of prostate cancer than those eating the least. Another study from New Zealand found that men with the highest DHA (an omega-3 found in fish) markers slashed their prostate cancer risk by 38% compared to the men with the lowest DHA levels.
2. The phytonutrients you consume make a difference.
A series of studies on phytonutrient intake and prostate cancer incidence in Sicilian men gives a nice glimpse into the potential relationships:
The more polyphenols they ate, the less prostate cancer they got.
The more phytoestrogens they ate, the more prostate cancer they got. Except for genistein, an isoflavone found in soy and fava beans, which was linked to lower rates of prostate cancer. The Sicilians are eating more fava than soy, I’d imagine.
How about coffee, the richest source of polyphenols in many people’s daily diets? It doesn’t appear to reduce the incidence of prostate cancer, but it does predict a lower rate of fatal prostate cancer.
3. Your circadian rhythm and your sleep are important.
Like everything else in life, tumor suppression follows a circadian pattern. Nighttime melatonin—which is suppressed if your sleep hygiene is bad and optimal if your sleep hygiene is great—inhibits the growth of prostate cancer cells and reduces their ability to utilize glucose. One way to enhance nighttime melatonin is by getting plenty of natural, blue light during the day; this actually makes nighttime melatonin more effective at prostate cancer inhibition. On the other hand, getting that blue light at night is a major risk factor for prostate cancer.
4. Get a handle on your fasting blood sugar and insulin.
In one study, having untreated diabetic-level fasting blood sugar was a strong risk factor for prostate cancer. Another study found that insulin-lowering metformin reduced the risk, while an anti-diabetic drug that raised insulin increased the risk of prostate cancer. Metformin actually lowers PSA levels, which, taken together with the previous study, indicates a causal effect.
5. Keep moving, keep playing, keep lifting.
This has a number of pro-prostate effects:
It keeps you insulin sensitive, so neither fasting insulin, nor fasting glucose get into the danger zone.
If you’re doing testosterone suppression treatment, exercise can maintain (and even increase) your muscle mass, improve your quality of life, and increase your bone mineral density.
Oh, and do some deadlifts. Men with prostate cancer who trained post-surgery had better control over their bodily functions, as long as they improved their hip extensor strength. If you don’t know, hip extension is the act of standing up straight, of moving from hip flexion (hip hinging, bending over) to standing tall. It involves hamstrings, glutes, and the entire posterior chain. Deadlifts are the best way to train that movement pattern.
The prostate cancer issue is frightening because it’s so common. Almost all of us probably know someone who has or had it, even unknowingly. But the good news is that most prostate cancers aren’t rapidly lethal. Many aren’t lethal at all. So whatever you do, don’t rush into serious treatments or procedures without discussing the full range of options in a frank, honest discussion with your doctor.
That’s it for today, folks. Thanks for reading. If you have any questions, comments, or concerns about prostate cancer, feel free to chime in down below. I’d love to hear from you.
References:
Perletti G, Monti E, Magri V, et al. The association between prostatitis and prostate cancer. Systematic review and meta-analysis. Arch Ital Urol Androl. 2017;89(4):259-265.
Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519.
Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostatic carcinoma with prostate specific antigen. J Urol. 1992;147(3 Pt 2):841-5.
Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl. 2012;14(3):409-14.
Watts EL, Appleby PN, Perez-cornago A, et al. Low Free Testosterone and Prostate Cancer Risk: A Collaborative Analysis of 20 Prospective Studies. Eur Urol. 2018;
Neuzillet Y, Raynaud JP, Dreyfus JF, et al. Aggressiveness of Localized Prostate Cancer: the Key Value of Testosterone Deficiency Evaluated by Both Total and Bioavailable Testosterone: AndroCan Study Results. Horm Cancer. 2018;
Dai B, Qu Y, Kong Y, et al. Low pretreatment serum total testosterone is associated with a high incidence of Gleason score 8-10 disease in prostatectomy specimens: data from ethnic Chinese patients with localized prostate cancer. BJU Int. 2012;110(11 Pt B):E667-72.
Teloken C, Da ros CT, Caraver F, Weber FA, Cavalheiro AP, Graziottin TM. Low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy: hypogonadism represents bad prognosis in prostate cancer. J Urol. 2005;174(6):2178-80.
Banerjee PP, Banerjee S, Brown TR, Zirkin BR. Androgen action in prostate function and disease. Am J Clin Exp Urol. 2018;6(2):62-77.
Zhou CK, Daugherty SE, Liao LM, et al. Do Aspirin and Other NSAIDs Confer a Survival Benefit in Men Diagnosed with Prostate Cancer? A Pooled Analysis of NIH-AARP and PLCO Cohorts. Cancer Prev Res (Phila). 2017;10(7):410-420.
Russo GI, Campisi D, Di mauro M, et al. Dietary Consumption of Phenolic Acids and Prostate Cancer: A Case-Control Study in Sicily, Southern Italy. Molecules. 2017;22(12)
Russo GI, Di mauro M, Regis F, et al. Association between dietary phytoestrogens intakes and prostate cancer risk in Sicily. Aging Male. 2018;21(1):48-54.
Discacciati A, Orsini N, Wolk A. Coffee consumption and risk of nonaggressive, aggressive and fatal prostate cancer–a dose-response meta-analysis. Ann Oncol. 2014;25(3):584-91.
Dauchy RT, Hoffman AE, Wren-dail MA, et al. Daytime Blue Light Enhances the Nighttime Circadian Melatonin Inhibition of Human Prostate Cancer Growth. Comp Med. 2015;65(6):473-85.
Kim KY, Lee E, Kim YJ, Kim J. The association between artificial light at night and prostate cancer in Gwangju City and South Jeolla Province of South Korea. Chronobiol Int. 2017;34(2):203-211.
Murtola TJ, Vihervuori VJ, Lahtela J, et al. Fasting blood glucose, glycaemic control and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Br J Cancer. 2018;118(9):1248-1254.
Haring A, Murtola TJ, Talala K, Taari K, Tammela TL, Auvinen A. Antidiabetic drug use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Scand J Urol. 2017;51(1):5-12.
Park JS, Lee KS, Ham WS, Chung BH, Koo KC. Impact of metformin on serum prostate-specific antigen levels: Data from the national health and nutrition examination survey 2007 to 2008. Medicine (Baltimore). 2017;96(51):e9427.
Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010;28(2):340-7.
Ying M, Zhao R, Jiang D, Gu S, Li M. Lifestyle interventions to alleviate side effects on prostate cancer patients receiving androgen deprivation therapy: a meta-analysis. Jpn J Clin Oncol. 2018;48(9):827-834.
Uth J, Fristrup B, Haahr RD, et al. Football training over 5 years is associated with preserved femoral bone mineral density in men with prostate cancer. Scand J Med Sci Sports. 2018;28 Suppl 1:61-73.
Park J, Yoon DH, Yoo S, et al. Effects of Progressive Resistance Training on Post-Surgery Incontinence in Men with Prostate Cancer. J Clin Med. 2018;7(9)
0 notes
watsonrodriquezie · 6 years
Text
A Primal Guide to Prostate Health
Many of you have asked about prostate health in a Primal context. Men are interested because they know men have a decent chance of getting prostate cancer. Women are interested because they’re worried about the men in their lives getting prostate cancer. Today, I’m going to delve deep into the topic, exploring the utility (or lack thereof) of standard testing, the common types of treatment and their potential efficacy, as well as preventive and unconventional ways of reducing your risk and mitigating the danger of prostate cancer.
Let’s go.
First, what does the prostate do, anyway? Most people only think about it in terms of prostate cancer.
It’s a gland about the size of a small apricot that manufactures a fluid called prostatic fluid that combines with sperm cells and other compounds to form semen. Prostatic fluid protects sperm against degradation, improves sperm motility, and preserves sperm genetic stability.
What Goes Wrong With the Prostate?
There are a few things that can happen.
Prostatitis
Inflammation of the prostate, usually chronic and non-bacterial. A history of prostatitis is a risk factor for prostate cancer.
Benign Prostatic Hyperplasia
Non-cancerous enlargement of the prostate. As men age, the prostate usually grows in size. This isn’t always cancer but can cause similar symptoms.
Prostate Cancer
What most of us are interested in when we talk about prostate health… After skin cancer, prostate cancer is the most common cancer among men and the sixth most common cause of cancer death among men worldwide. Yet, most men diagnosed with prostate cancer do not die from it; they die with it. The 5-year survival rate in the US is 98%.
That said, there is no monolithic “prostate cancer.” Like all other cancers, there are different grades and stages of prostate cancer. Each grade and stage has a different mortality risk:
Low-grade prostate cancer grows more slowly and is less likely to spread to other tissues.
High-grade prostate cancer grows more quickly and is more likely to spread to other tissues.
Local prostate cancer is confined to the prostate. The 5-year relative survival rate (survival compared to men without prostate cancer) for local prostate cancer is almost 100%.
Regional prostate cancer has spread to nearby tissues. The 5-year relative survival rate for regional prostate cancer is almost 100%.
Distant prostate cancer has spread to tissues throughout the body. The 5-year relative survival rate for distant prostate is 29%. Distant prostate cancer explains most of the prostate-related mortality.
What Are Symptoms of Prostate Cancer?
The primary symptom is problems with urination. When the prostate gland grows, it has the potential to obstruct the flow of urine out of the bladder, causing difficulty urinating, weak urine flow, painful urination, or frequent urination. This can also be caused by benign prostatic hyperplasia, a non-cancerous enlargement of the prostate.
What Causes Prostate Cancer?
A big chunk is genetic. People with “knockout” alleles for BRCA, which codes for tumor suppression, have an elevated risk of some forms of prostate cancer. That’s the same one that confers added risks for breast cancer.
Ethnicity matters, too. Men of Sub-Saharan African descent, whether African-Americans in the U.S. or Caribbean men in the U.K., have the highest risk in the world for prostate cancer—about 60% greater than other ethnic groups. White men have moderate risks; South Asian, East Asian, and Pacific Islander men have lower risks.
Testosterone has a confusing relationship with prostate cancer. Conventional wisdom tends to hold that testosterone stimulates prostate cancer growth, and there’s certainly some evidence of a relationship, but it’s not that simple.
In one study, men with low free testosterone levels were less likely to have low-grade (less risk of spreading) prostate cancer but more likely to have high-grade (higher risk of spreading) prostate cancer.
In another, testosterone deficiency predicted higher aggressiveness in localized prostate cancers.
In Chinese men, those who went into treatment with low testosterone were more likely to present with higher-grade localized prostate cancers.
Other studies have arrived at similar results, finding that “hypogonadism represents bad prognosis in prostate cancer.”
Many prostate cancer treatments involve testosterone deprivation, a hormonal reduction of testosterone synthesis. This can reduce symptoms and slow growth of prostate tumors during the metastatic phase, but prostate cancer tends to be highly plastic, with the ability to adapt to changing hormonal environments. These patients often see the cancer return in a form that doesn’t require testosterone to progress.
What About Testing?
If you have a prostate, should you get tested starting at age 40?
Not necessarily. The value of early testing hasn’t been established. Some researchers even question whether early testing is more harmful than ignoring it, and most of the research finds middling to nonexistent evidence in favor of broad testing for everyone. Early testing has a small effect on mortality from prostate cancer, but no effect on all-cause mortality.
PSA testing can also be inaccurate. PSA is prostate specific antigen, a protein produced by the prostate. It’s normal to have low levels of PSA present in the body, and while high levels of PSA are a good sign of prostate cancer—even years before it shows up in imaging or digital probes—they can also represent a false positive. Those two other common yet relatively benign prostate issues—benign hyperplasia and prostatitis—can also raise PSA levels well past the “cancer threshold.”
Other causes of high levels of PSA include:
Urinary tract infections
Recent sex or ejaculation
Recent, vigorous exercise
Certain medications.
In fact, if you have a PSA reading of 4 (the usual threshold), there’s still just a 30% chance it actually indicates cancer.
What About Treatment?
Let’s say you do have prostate cancer, confirmed by PSA and a biopsy (or two, or three, as needle biopsies often miss cancers). What next? Should you definitely treat it?
It’s unclear whether treatment improves survival outcomes. One study took men aged 50-69 with prostate cancer diagnosed via PSA testing, divided them among three treatment groups, and followed them for ten years. One group got active monitoring—they continued to test and monitor the status of the cancer. One group received radiotherapy—radiation therapy to destroy the tumor. And the last group had the cancer surgically removed.  After ten years, there was no difference among the groups for all-cause mortality, even though the active-monitoring group saw higher rates of prostate cancer-specific deaths (8 deaths—in a group of 535 men— vs 5 in the surgery group and 4 in the radiotherapy group), cancer progression, and metastasis.
In another study of men with localized prostate cancer, removing the prostate only improved all-cause mortality rates among men with very high PSAs (more than 10). In men with lower PSAs, “waiting and seeing” produced similar outcomes as surgery.
Prostate removal also carries many unwanted side effects, like incontinence and sexual dysfunction. No one wants prostate cancer, but it’s no small thing to have problems with urination and sex for the rest of your life. Those are major aspects of anyone’s quality of life.
Before you make any decisions, talk to your doctor about your options, the relative mortality risk of your particular cancer’s stage and grade, and how the treatments might affect your quality of life.
How Can You Reduce the Risk of Prostate Cancer? 1. Inflammation is definitely an issue.
For one, there’s the relationship between prostatitis, or inflammation of the prostate, and prostate cancer that I already mentioned above.
Two, there’s the string of evidence linking anti-inflammatory compounds to reductions in prostate cancer incidence. For example, aspirin cuts prostate cancer risk. Low-dose aspirin (under 100 mg) reduces both the incidence of regular old prostate cancer and the risk of metastatic prostate cancer. It’s also associated with longer survival in patients with prostate cancer; other non-steroidal anti-inflammatories are not.
Third, anti-inflammatory omega-3 fatty acids (found in seafood and fish oil) are generally linked to lower rates of prostatic inflammation and a less carcinogenic environment; omega-6 fatty acids can trigger disease progression. A 2001 study of over 6,000 Swedish men found that the folks eating the most fish had drastically lower rates of prostate cancer than those eating the least. Another study from New Zealand found that men with the highest DHA (an omega-3 found in fish) markers slashed their prostate cancer risk by 38% compared to the men with the lowest DHA levels.
2. The phytonutrients you consume make a difference.
A series of studies on phytonutrient intake and prostate cancer incidence in Sicilian men gives a nice glimpse into the potential relationships:
The more polyphenols they ate, the less prostate cancer they got.
The more phytoestrogens they ate, the more prostate cancer they got. Except for genistein, an isoflavone found in soy and fava beans, which was linked to lower rates of prostate cancer. The Sicilians are eating more fava than soy, I’d imagine.
How about coffee, the richest source of polyphenols in many people’s daily diets? It doesn’t appear to reduce the incidence of prostate cancer, but it does predict a lower rate of fatal prostate cancer.
3. Your circadian rhythm and your sleep are important.
Like everything else in life, tumor suppression follows a circadian pattern. Nighttime melatonin—which is suppressed if your sleep hygiene is bad and optimal if your sleep hygiene is great—inhibits the growth of prostate cancer cells and reduces their ability to utilize glucose. One way to enhance nighttime melatonin is by getting plenty of natural, blue light during the day; this actually makes nighttime melatonin more effective at prostate cancer inhibition. On the other hand, getting that blue light at night is a major risk factor for prostate cancer.
4. Get a handle on your fasting blood sugar and insulin.
In one study, having untreated diabetic-level fasting blood sugar was a strong risk factor for prostate cancer. Another study found that insulin-lowering metformin reduced the risk, while an anti-diabetic drug that raised insulin increased the risk of prostate cancer. Metformin actually lowers PSA levels, which, taken together with the previous study, indicates a causal effect.
5. Keep moving, keep playing, keep lifting.
This has a number of pro-prostate effects:
It keeps you insulin sensitive, so neither fasting insulin, nor fasting glucose get into the danger zone.
If you’re doing testosterone suppression treatment, exercise can maintain (and even increase) your muscle mass, improve your quality of life, and increase your bone mineral density.
Oh, and do some deadlifts. Men with prostate cancer who trained post-surgery had better control over their bodily functions, as long as they improved their hip extensor strength. If you don’t know, hip extension is the act of standing up straight, of moving from hip flexion (hip hinging, bending over) to standing tall. It involves hamstrings, glutes, and the entire posterior chain. Deadlifts are the best way to train that movement pattern.
The prostate cancer issue is frightening because it’s so common. Almost all of us probably know someone who has or had it, even unknowingly. But the good news is that most prostate cancers aren’t rapidly lethal. Many aren’t lethal at all. So whatever you do, don’t rush into serious treatments or procedures without discussing the full range of options in a frank, honest discussion with your doctor.
That’s it for today, folks. Thanks for reading. If you have any questions, comments, or concerns about prostate cancer, feel free to chime in down below. I’d love to hear from you.
References:
Perletti G, Monti E, Magri V, et al. The association between prostatitis and prostate cancer. Systematic review and meta-analysis. Arch Ital Urol Androl. 2017;89(4):259-265.
Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519.
Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostatic carcinoma with prostate specific antigen. J Urol. 1992;147(3 Pt 2):841-5.
Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl. 2012;14(3):409-14.
Watts EL, Appleby PN, Perez-cornago A, et al. Low Free Testosterone and Prostate Cancer Risk: A Collaborative Analysis of 20 Prospective Studies. Eur Urol. 2018;
Neuzillet Y, Raynaud JP, Dreyfus JF, et al. Aggressiveness of Localized Prostate Cancer: the Key Value of Testosterone Deficiency Evaluated by Both Total and Bioavailable Testosterone: AndroCan Study Results. Horm Cancer. 2018;
Dai B, Qu Y, Kong Y, et al. Low pretreatment serum total testosterone is associated with a high incidence of Gleason score 8-10 disease in prostatectomy specimens: data from ethnic Chinese patients with localized prostate cancer. BJU Int. 2012;110(11 Pt B):E667-72.
Teloken C, Da ros CT, Caraver F, Weber FA, Cavalheiro AP, Graziottin TM. Low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy: hypogonadism represents bad prognosis in prostate cancer. J Urol. 2005;174(6):2178-80.
Banerjee PP, Banerjee S, Brown TR, Zirkin BR. Androgen action in prostate function and disease. Am J Clin Exp Urol. 2018;6(2):62-77.
Zhou CK, Daugherty SE, Liao LM, et al. Do Aspirin and Other NSAIDs Confer a Survival Benefit in Men Diagnosed with Prostate Cancer? A Pooled Analysis of NIH-AARP and PLCO Cohorts. Cancer Prev Res (Phila). 2017;10(7):410-420.
Russo GI, Campisi D, Di mauro M, et al. Dietary Consumption of Phenolic Acids and Prostate Cancer: A Case-Control Study in Sicily, Southern Italy. Molecules. 2017;22(12)
Russo GI, Di mauro M, Regis F, et al. Association between dietary phytoestrogens intakes and prostate cancer risk in Sicily. Aging Male. 2018;21(1):48-54.
Discacciati A, Orsini N, Wolk A. Coffee consumption and risk of nonaggressive, aggressive and fatal prostate cancer–a dose-response meta-analysis. Ann Oncol. 2014;25(3):584-91.
Dauchy RT, Hoffman AE, Wren-dail MA, et al. Daytime Blue Light Enhances the Nighttime Circadian Melatonin Inhibition of Human Prostate Cancer Growth. Comp Med. 2015;65(6):473-85.
Kim KY, Lee E, Kim YJ, Kim J. The association between artificial light at night and prostate cancer in Gwangju City and South Jeolla Province of South Korea. Chronobiol Int. 2017;34(2):203-211.
Murtola TJ, Vihervuori VJ, Lahtela J, et al. Fasting blood glucose, glycaemic control and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Br J Cancer. 2018;118(9):1248-1254.
Haring A, Murtola TJ, Talala K, Taari K, Tammela TL, Auvinen A. Antidiabetic drug use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Scand J Urol. 2017;51(1):5-12.
Park JS, Lee KS, Ham WS, Chung BH, Koo KC. Impact of metformin on serum prostate-specific antigen levels: Data from the national health and nutrition examination survey 2007 to 2008. Medicine (Baltimore). 2017;96(51):e9427.
Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010;28(2):340-7.
Ying M, Zhao R, Jiang D, Gu S, Li M. Lifestyle interventions to alleviate side effects on prostate cancer patients receiving androgen deprivation therapy: a meta-analysis. Jpn J Clin Oncol. 2018;48(9):827-834.
Uth J, Fristrup B, Haahr RD, et al. Football training over 5 years is associated with preserved femoral bone mineral density in men with prostate cancer. Scand J Med Sci Sports. 2018;28 Suppl 1:61-73.
Park J, Yoon DH, Yoo S, et al. Effects of Progressive Resistance Training on Post-Surgery Incontinence in Men with Prostate Cancer. J Clin Med. 2018;7(9)
0 notes
milenasanchezmk · 6 years
Text
A Primal Guide to Prostate Health
Many of you have asked about prostate health in a Primal context. Men are interested because they know men have a decent chance of getting prostate cancer. Women are interested because they’re worried about the men in their lives getting prostate cancer. Today, I’m going to delve deep into the topic, exploring the utility (or lack thereof) of standard testing, the common types of treatment and their potential efficacy, as well as preventive and unconventional ways of reducing your risk and mitigating the danger of prostate cancer.
Let’s go.
First, what does the prostate do, anyway? Most people only think about it in terms of prostate cancer.
It’s a gland about the size of a small apricot that manufactures a fluid called prostatic fluid that combines with sperm cells and other compounds to form semen. Prostatic fluid protects sperm against degradation, improves sperm motility, and preserves sperm genetic stability.
What Goes Wrong With the Prostate?
There are a few things that can happen.
Prostatitis
Inflammation of the prostate, usually chronic and non-bacterial. A history of prostatitis is a risk factor for prostate cancer.
Benign Prostatic Hyperplasia
Non-cancerous enlargement of the prostate. As men age, the prostate usually grows in size. This isn’t always cancer but can cause similar symptoms.
Prostate Cancer
What most of us are interested in when we talk about prostate health… After skin cancer, prostate cancer is the most common cancer among men and the sixth most common cause of cancer death among men worldwide. Yet, most men diagnosed with prostate cancer do not die from it; they die with it. The 5-year survival rate in the US is 98%.
That said, there is no monolithic “prostate cancer.” Like all other cancers, there are different grades and stages of prostate cancer. Each grade and stage has a different mortality risk:
Low-grade prostate cancer grows more slowly and is less likely to spread to other tissues.
High-grade prostate cancer grows more quickly and is more likely to spread to other tissues.
Local prostate cancer is confined to the prostate. The 5-year relative survival rate (survival compared to men without prostate cancer) for local prostate cancer is almost 100%.
Regional prostate cancer has spread to nearby tissues. The 5-year relative survival rate for regional prostate cancer is almost 100%.
Distant prostate cancer has spread to tissues throughout the body. The 5-year relative survival rate for distant prostate is 29%. Distant prostate cancer explains most of the prostate-related mortality.
What Are Symptoms of Prostate Cancer?
The primary symptom is problems with urination. When the prostate gland grows, it has the potential to obstruct the flow of urine out of the bladder, causing difficulty urinating, weak urine flow, painful urination, or frequent urination. This can also be caused by benign prostatic hyperplasia, a non-cancerous enlargement of the prostate.
What Causes Prostate Cancer?
A big chunk is genetic. People with “knockout” alleles for BRCA, which codes for tumor suppression, have an elevated risk of some forms of prostate cancer. That’s the same one that confers added risks for breast cancer.
Ethnicity matters, too. Men of Sub-Saharan African descent, whether African-Americans in the U.S. or Caribbean men in the U.K., have the highest risk in the world for prostate cancer—about 60% greater than other ethnic groups. White men have moderate risks; South Asian, East Asian, and Pacific Islander men have lower risks.
Testosterone has a confusing relationship with prostate cancer. Conventional wisdom tends to hold that testosterone stimulates prostate cancer growth, and there’s certainly some evidence of a relationship, but it’s not that simple.
In one study, men with low free testosterone levels were less likely to have low-grade (less risk of spreading) prostate cancer but more likely to have high-grade (higher risk of spreading) prostate cancer.
In another, testosterone deficiency predicted higher aggressiveness in localized prostate cancers.
In Chinese men, those who went into treatment with low testosterone were more likely to present with higher-grade localized prostate cancers.
Other studies have arrived at similar results, finding that “hypogonadism represents bad prognosis in prostate cancer.”
Many prostate cancer treatments involve testosterone deprivation, a hormonal reduction of testosterone synthesis. This can reduce symptoms and slow growth of prostate tumors during the metastatic phase, but prostate cancer tends to be highly plastic, with the ability to adapt to changing hormonal environments. These patients often see the cancer return in a form that doesn’t require testosterone to progress.
What About Testing?
If you have a prostate, should you get tested starting at age 40?
Not necessarily. The value of early testing hasn’t been established. Some researchers even question whether early testing is more harmful than ignoring it, and most of the research finds middling to nonexistent evidence in favor of broad testing for everyone. Early testing has a small effect on mortality from prostate cancer, but no effect on all-cause mortality.
PSA testing can also be inaccurate. PSA is prostate specific antigen, a protein produced by the prostate. It’s normal to have low levels of PSA present in the body, and while high levels of PSA are a good sign of prostate cancer—even years before it shows up in imaging or digital probes—they can also represent a false positive. Those two other common yet relatively benign prostate issues—benign hyperplasia and prostatitis—can also raise PSA levels well past the “cancer threshold.”
Other causes of high levels of PSA include:
Urinary tract infections
Recent sex or ejaculation
Recent, vigorous exercise
Certain medications.
In fact, if you have a PSA reading of 4 (the usual threshold), there’s still just a 30% chance it actually indicates cancer.
What About Treatment?
Let’s say you do have prostate cancer, confirmed by PSA and a biopsy (or two, or three, as needle biopsies often miss cancers). What next? Should you definitely treat it?
It’s unclear whether treatment improves survival outcomes. One study took men aged 50-69 with prostate cancer diagnosed via PSA testing, divided them among three treatment groups, and followed them for ten years. One group got active monitoring—they continued to test and monitor the status of the cancer. One group received radiotherapy—radiation therapy to destroy the tumor. And the last group had the cancer surgically removed.  After ten years, there was no difference among the groups for all-cause mortality, even though the active-monitoring group saw higher rates of prostate cancer-specific deaths (8 deaths—in a group of 535 men— vs 5 in the surgery group and 4 in the radiotherapy group), cancer progression, and metastasis.
In another study of men with localized prostate cancer, removing the prostate only improved all-cause mortality rates among men with very high PSAs (more than 10). In men with lower PSAs, “waiting and seeing” produced similar outcomes as surgery.
Prostate removal also carries many unwanted side effects, like incontinence and sexual dysfunction. No one wants prostate cancer, but it’s no small thing to have problems with urination and sex for the rest of your life. Those are major aspects of anyone’s quality of life.
Before you make any decisions, talk to your doctor about your options, the relative mortality risk of your particular cancer’s stage and grade, and how the treatments might affect your quality of life.
How Can You Reduce the Risk of Prostate Cancer? 1. Inflammation is definitely an issue.
For one, there’s the relationship between prostatitis, or inflammation of the prostate, and prostate cancer that I already mentioned above.
Two, there’s the string of evidence linking anti-inflammatory compounds to reductions in prostate cancer incidence. For example, aspirin cuts prostate cancer risk. Low-dose aspirin (under 100 mg) reduces both the incidence of regular old prostate cancer and the risk of metastatic prostate cancer. It’s also associated with longer survival in patients with prostate cancer; other non-steroidal anti-inflammatories are not.
Third, anti-inflammatory omega-3 fatty acids (found in seafood and fish oil) are generally linked to lower rates of prostatic inflammation and a less carcinogenic environment; omega-6 fatty acids can trigger disease progression. A 2001 study of over 6,000 Swedish men found that the folks eating the most fish had drastically lower rates of prostate cancer than those eating the least. Another study from New Zealand found that men with the highest DHA (an omega-3 found in fish) markers slashed their prostate cancer risk by 38% compared to the men with the lowest DHA levels.
2. The phytonutrients you consume make a difference.
A series of studies on phytonutrient intake and prostate cancer incidence in Sicilian men gives a nice glimpse into the potential relationships:
The more polyphenols they ate, the less prostate cancer they got.
The more phytoestrogens they ate, the more prostate cancer they got. Except for genistein, an isoflavone found in soy and fava beans, which was linked to lower rates of prostate cancer. The Sicilians are eating more fava than soy, I’d imagine.
How about coffee, the richest source of polyphenols in many people’s daily diets? It doesn’t appear to reduce the incidence of prostate cancer, but it does predict a lower rate of fatal prostate cancer.
3. Your circadian rhythm and your sleep are important.
Like everything else in life, tumor suppression follows a circadian pattern. Nighttime melatonin—which is suppressed if your sleep hygiene is bad and optimal if your sleep hygiene is great—inhibits the growth of prostate cancer cells and reduces their ability to utilize glucose. One way to enhance nighttime melatonin is by getting plenty of natural, blue light during the day; this actually makes nighttime melatonin more effective at prostate cancer inhibition. On the other hand, getting that blue light at night is a major risk factor for prostate cancer.
4. Get a handle on your fasting blood sugar and insulin.
In one study, having untreated diabetic-level fasting blood sugar was a strong risk factor for prostate cancer. Another study found that insulin-lowering metformin reduced the risk, while an anti-diabetic drug that raised insulin increased the risk of prostate cancer. Metformin actually lowers PSA levels, which, taken together with the previous study, indicates a causal effect.
5. Keep moving, keep playing, keep lifting.
This has a number of pro-prostate effects:
It keeps you insulin sensitive, so neither fasting insulin, nor fasting glucose get into the danger zone.
If you’re doing testosterone suppression treatment, exercise can maintain (and even increase) your muscle mass, improve your quality of life, and increase your bone mineral density.
Oh, and do some deadlifts. Men with prostate cancer who trained post-surgery had better control over their bodily functions, as long as they improved their hip extensor strength. If you don’t know, hip extension is the act of standing up straight, of moving from hip flexion (hip hinging, bending over) to standing tall. It involves hamstrings, glutes, and the entire posterior chain. Deadlifts are the best way to train that movement pattern.
The prostate cancer issue is frightening because it’s so common. Almost all of us probably know someone who has or had it, even unknowingly. But the good news is that most prostate cancers aren’t rapidly lethal. Many aren’t lethal at all. So whatever you do, don’t rush into serious treatments or procedures without discussing the full range of options in a frank, honest discussion with your doctor.
That’s it for today, folks. Thanks for reading. If you have any questions, comments, or concerns about prostate cancer, feel free to chime in down below. I’d love to hear from you.
References:
Perletti G, Monti E, Magri V, et al. The association between prostatitis and prostate cancer. Systematic review and meta-analysis. Arch Ital Urol Androl. 2017;89(4):259-265.
Ilic D, Djulbegovic M, Jung JH, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018;362:k3519.
Brawer MK, Chetner MP, Beatie J, Buchner DM, Vessella RL, Lange PH. Screening for prostatic carcinoma with prostate specific antigen. J Urol. 1992;147(3 Pt 2):841-5.
Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl. 2012;14(3):409-14.
Watts EL, Appleby PN, Perez-cornago A, et al. Low Free Testosterone and Prostate Cancer Risk: A Collaborative Analysis of 20 Prospective Studies. Eur Urol. 2018;
Neuzillet Y, Raynaud JP, Dreyfus JF, et al. Aggressiveness of Localized Prostate Cancer: the Key Value of Testosterone Deficiency Evaluated by Both Total and Bioavailable Testosterone: AndroCan Study Results. Horm Cancer. 2018;
Dai B, Qu Y, Kong Y, et al. Low pretreatment serum total testosterone is associated with a high incidence of Gleason score 8-10 disease in prostatectomy specimens: data from ethnic Chinese patients with localized prostate cancer. BJU Int. 2012;110(11 Pt B):E667-72.
Teloken C, Da ros CT, Caraver F, Weber FA, Cavalheiro AP, Graziottin TM. Low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy: hypogonadism represents bad prognosis in prostate cancer. J Urol. 2005;174(6):2178-80.
Banerjee PP, Banerjee S, Brown TR, Zirkin BR. Androgen action in prostate function and disease. Am J Clin Exp Urol. 2018;6(2):62-77.
Zhou CK, Daugherty SE, Liao LM, et al. Do Aspirin and Other NSAIDs Confer a Survival Benefit in Men Diagnosed with Prostate Cancer? A Pooled Analysis of NIH-AARP and PLCO Cohorts. Cancer Prev Res (Phila). 2017;10(7):410-420.
Russo GI, Campisi D, Di mauro M, et al. Dietary Consumption of Phenolic Acids and Prostate Cancer: A Case-Control Study in Sicily, Southern Italy. Molecules. 2017;22(12)
Russo GI, Di mauro M, Regis F, et al. Association between dietary phytoestrogens intakes and prostate cancer risk in Sicily. Aging Male. 2018;21(1):48-54.
Discacciati A, Orsini N, Wolk A. Coffee consumption and risk of nonaggressive, aggressive and fatal prostate cancer–a dose-response meta-analysis. Ann Oncol. 2014;25(3):584-91.
Dauchy RT, Hoffman AE, Wren-dail MA, et al. Daytime Blue Light Enhances the Nighttime Circadian Melatonin Inhibition of Human Prostate Cancer Growth. Comp Med. 2015;65(6):473-85.
Kim KY, Lee E, Kim YJ, Kim J. The association between artificial light at night and prostate cancer in Gwangju City and South Jeolla Province of South Korea. Chronobiol Int. 2017;34(2):203-211.
Murtola TJ, Vihervuori VJ, Lahtela J, et al. Fasting blood glucose, glycaemic control and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Br J Cancer. 2018;118(9):1248-1254.
Haring A, Murtola TJ, Talala K, Taari K, Tammela TL, Auvinen A. Antidiabetic drug use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Scand J Urol. 2017;51(1):5-12.
Park JS, Lee KS, Ham WS, Chung BH, Koo KC. Impact of metformin on serum prostate-specific antigen levels: Data from the national health and nutrition examination survey 2007 to 2008. Medicine (Baltimore). 2017;96(51):e9427.
Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol. 2010;28(2):340-7.
Ying M, Zhao R, Jiang D, Gu S, Li M. Lifestyle interventions to alleviate side effects on prostate cancer patients receiving androgen deprivation therapy: a meta-analysis. Jpn J Clin Oncol. 2018;48(9):827-834.
Uth J, Fristrup B, Haahr RD, et al. Football training over 5 years is associated with preserved femoral bone mineral density in men with prostate cancer. Scand J Med Sci Sports. 2018;28 Suppl 1:61-73.
Park J, Yoon DH, Yoo S, et al. Effects of Progressive Resistance Training on Post-Surgery Incontinence in Men with Prostate Cancer. J Clin Med. 2018;7(9)
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bitcoin24on · 6 years
Text
Former FDIC Chair Sheila Bair on Bitcoin: “Value — Like Beauty — Is in the Eye of Beholder”
Former Federal Deposit Insurance Corporation (FDIC) chair Sheila Bair was given a platform on Yahoo! Finance to share her thoughts on the world’s most popular cryptocurrency, bitcoin. While she trucks in regulatory speak, some of her ideas might surprise crypto enthusiasts.
Also read: Bundesbank Board Member: No Plans to Issue State-Backed Cryptocurrency
Bitcoin’s Value is Psychological
Agreeing the current price run-up is indeed a bubble, the former FDIC chair asks rhetorically what should be done. She alludes to Nobel Prize economist Joseph Stiglitz’ bromide at the digital asset for having no socially useful function, calling for an outright ban. But then she insists “Value — like beauty — is in the eye of beholder.”
Ms. Bair was appointed by President W. Bush to a five-year term fro summer 2006 through President Obama’s first term, ending summer of 2011. The FDIC is a Depression-era solution to pool private money into a fund in order to lessen bank runs.
Runs usually occur when confidence is lost in the deflationary aspect of a currency, and folks can see the value dropping; the quicker they get to it and spend it, trading it for something that holds better value, the less they’ll suffer. The FDIC since 2011 guarantees deposits up to 250,000 USD based on that private pool and 100 billion USD credit from the US Treasury. Currently close to 6,000 banks subscribe.
Unfortunately, Ms. Bair misses a chance to explain bitcoin and the Bitcoin network underlying it do possess inherent value, as they make it both a token and payment system. Instead, she equivocates, stating: “Since the beginning of commerce, humans have assigned value to things of no readily-apparent intrinsic worth. Particularly in the case of mediums of exchange, aka currency, we assign value simply because those with whom we transact do so as well. Whether it is the cowry shells of ancient India or the thin green pieces of paper many of us still carry in our wallets today, worth depends more on psychology than physical attributes,” she argues.
Loss is the Best Teacher
With the best of intentions, she rifles through use cases where faith in government fiat failed, such as in Germany and Southeast Asia. She does acknowledge the “strong allure” of peer-to-peer transacting and how “unlike fiat currency, its finite supply and purposeful constraints on the pace of ‘mining’ make it attractive to many as a store of value, similar to gold.” She attributes bitcoin prices to mania, but cautions government against feeding the frenzy. Banks participating in FDIC protection and services should not be allowed to participate, she warns. And while that would be an unpopular decision in the short run, it actually might win broad approval from bitcoiners who fear banks and their meddling.
Ms. Bair lauds the New York license, and believes Cboe and CME futures contracts will ultimately bring more regulation (to her mind, stability) to the digital asset by the very nature of sharing information with crypto exchanges. She is also appreciative of the SEC’s more aggressive moves against initial coin offerings. She too uses the blockchain buzzword (and she reveals she is part of a business dealing in the tech), and it’s ironic because of the usage of that word seems to be the real bubble. Businesses simply attaching blockchain to their names have seen crazy rises in valuations. Finally, she saves her soundest advice for last: “The best discipline for bitcoin speculation is the recent fall in price by one-third.”
What do you think about Ms. Bair’s appraisal? Let us know in the comments below.
Images: Pixabay, FDIC. 
Need to calculate your bitcoin holdings? Check our tools section.
The post Former FDIC Chair Sheila Bair on Bitcoin: “Value — Like Beauty — Is in the Eye of Beholder” appeared first on Bitcoin News.
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Why Trump's Korean war talk ought to be taken severely
Washington elites have lengthy regarded war with North Korea as all but unthinkable. However, obscured by the wild twists and every day cacophony of the Trump presidency, the typical wisdom is changing. Whilst President Donald Trump rattles sabers on Twitter and slams "Rocket Man" Kim Jong Un, there is also a perceptible hardening of tone amongst senior officers. Navy action to halt North Korea's march to a missile tipped with a nuclear warhead that could hit the US mainland seems to be a developing likelihood. Trump upped the rhetoric an additional notch in an job interview with Fox Organization Network broadcast Sunday, in which he explained Washington was "so ready, like you would not believe" for any contingency with Pyongyang. "You would be stunned to see how totally well prepared we are if we want to be," Trump mentioned. "Would it be good not to do that? The solution is yes. Will that take place? Who knows, who knows." Trump's electrical power to shock has been eroded by the amazing spectacle of his nine months as President. However it's still beautiful to hear an American President speaking so overtly about the chance of a war, that could, beneath some eventualities, trigger the most devastation of any US conflict, at the very least given that the Vietnam War. There are no quick indications that the administration is getting ready for military motion, for instance by way of evacuations of US navy family members in South Korea, or with a buildup of troops or materiel. But it is also achievable that the hardening of the administration's rhetoric and the narrowing window for diplomacy to operate represent a considerable minute in the evolution of a crisis that could ultimately determine the Trump presidency. The prospective humanitarian, navy and diplomatic price of a war with the reclusive dynastic point out has lengthy been cited as the purpose why it should and would never ever come about. Warnings about the North's countless numbers of rockets and artillery shells that could rain down on Seoul and threaten thousands and thousands of folks, replicate the fact that flourishing, democratic South Korea is a country hostage to its geography, unpredictable Northern brethren, and any decision by its ally the United States to start a preemptive strike. whysoviral , which includes the prospect of a collapse of the North Korean condition and a mass refugee crisis, not to point out a dangerous escalation of US-China tensions, have also intended that the prospect of a war with Pyongyang has remained largely a theoretical proposition for half a century. But Trump despatched regional nervousness soaring when he warned the US may rain "hearth and fury" on North Korea in August and later said America's military forces had been "locked and loaded." On one hand, Washington's toughened rhetoric can be place down to the elevating stakes of the showdown. North Korea's ballistic missile launches and nuclear test this year suggest that Trump will be the President who faces the dilemma that his predecessors have prolonged dreaded -- what to do about an unpredictable dictator, with the power to strike the US mainland with a nuclear-tipped, lengthy-selection ballistic missile. There is increasing worry, quietly expressed in non-public conversations in Washington amongst overseas coverage experts, customers of Congress, and former national stability officers, that war is becoming ever more achievable. A lot of properly-placed individuals are beginning to ponder whether or not there is a way out. Senior officials, talking above the last handful of months, have spoken much more forthrightly and publicly about the possibility of conflict in methods that are increasing questions about the administration's technique. Very last Sunday on CNN's "Condition of the Union," Secretary of Point out Rex Tillerson promised to hold up diplomacy till "the first bomb drops." His feedback could be interpreted as a willingness to by no means give up diplomacy, even however Trump instructed him in a latest tweet that he was "wasting his time." Or Tillerson could be searching for to widen his leverage with a credible threat of power: The perception that the US could never use power on the Korean Peninsula plainly erodes the toughness of its diplomatic position. But his responses could also carry a darker interpretation. Previous 7 days, CIA Director Mike Pompeo warned that the US must behave as although North Korea is shut to the "closing stage" of bringing 320 million Individuals inside of reach of a nuclear bomb. In a briefing in October, White Residence Chief of Staff John Kelly also spoke ominously. "Proper now, we consider the risk is workable, but in excess of time, if it grows outside of the place it is right now -- nicely, let us hope diplomacy works," he said. Relevant: US making ready for North Korea's 'final step' Previous CIA Director John Brennan very last week place the danger of US war with North Korea at minimum at a single-in-5. What about China? Regardless of the climbing risks, there are handful of symptoms of an intense administration diplomatic effort to reduce the disaster beyond new sanctions passed above the summer towards Pyongyang and backed by Russia and China. The pace will increase next month when Trump visits Asia on a trip that will spotlight the deepening North Korea disaster and could lead to more provocations by Pyongyang, including feasible new missile assessments. That journey might offer a clue about the administration's method, considering that conversing up the possibility of war would be a logical way to try out to hike stress on China to do more to influence its recalcitrant ally to adjust its actions. In line with the latest sanctions, China has tightened fiscal screws on North Korea, but it is unclear how considerably it is willing to go in isolating Pyongyang. Beijing has revealed no indicator that it has altered its long-held refusal to destabilize the Kim routine or eventually countenance a united Korea that it fears would be a US-allied condition on its borders. A lot of observers imagine Washington overestimates China's affect on Kim, who has no partnership with Chinese President Xi Jinping. If that check out is right, war speak could lock the United States into a cycle of escalation that requires on its possess momentum without having shifting China's calculation. Washington's placement — that Trump will never ever acknowledge North Korea getting a nuclear weapon that could achieve the United States -- is entrenched. Similarly, most experts imagine that Kim will never ever concur to give up a nuclear program that he sees as a guarantee of routine survival against a hostile United States that he has demonized to solidify his tyrannical rule. There looks little space for compromise, or diplomatic creativity, and the prospect that sanctions could topple Kim's regime before he can deploy a prolonged-range missile with a nuclear warhead appears dim. Neither Trump, nor Kim is leaving himself any confront-conserving off ramps from confrontation. That is why the war chat in Washington must be taken severely.
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omcik-blog · 7 years
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New Post has been published on OmCik
New Post has been published on http://omcik.com/doak-to-senate-panel-audit-the-aca-navigators/
Doak to Senate Panel: Audit the ACA Navigators
Oklahoma Insurance Commissioner John Doak (Photo: Senate HELP Committee)
John Doak, the Oklahoma insurance commissioner, today gave members of a Senate panel advice that would please many health insurance agents and brokers: He called for the Senate Committee on Health, Education, Labor and Pensions to investigate the Affordable Care Act Navigator program.
“I would ask for the full Senate committee to do an audit of the Navigator program,” Doak told Sen. Tammy Baldwin, R-Wis., a Senate HELP Committee member. “Are they doing the job they’re supposed to be doing? Where’s the checks and balance there?”
Doak was one of five state insurance commissioners who appeared as witnesses at a Senate HELP hearing on stabilizing the individual major medical insurance market. The hearing is one of four the committee has scheduled on the topic for this week and the next. The other witnesses at today’s hearing were Mike Kreidler of Washington state; Julie Mix McPeak of Tennessee; Teresa Miller of Pennsylvania; and Lori Wing-Heier of Alaska.
(Related: How to Watch the Senate Individual Health Rescue Hearings)
The ACA drafters hoped the Navigator program would create independent, nonprofit ombudsmen who would help consumers use the new ACA public health insurance exchange system. The idea was that the ombudsmen would show consumers the difference between a premium and a deductible, and how to use exchange websites, without trying to sell the consumers insurance.
Agents and brokers have complained for years that the Navigator ombudsmen have competed with them for business, and given consumers advice about complicated, sensitive matters without having the proper training or liability insurance.
As of Tuesday, none of the 20 witnesses scheduled to appear at the Senate HELP individual health hearings was appearing as an agent or broker.
Doak, however, has worked in the past as an insurance broker for Aon. One of the other commissioner witnesses, Wing-Heier, has worked as an independent broker and as a corporate risk manager.
Doak brought up the topic of agents and brokers at the hearing. Oklahoma has agents and brokers in each of its 77 counties, he said.
“They’re trained insurance professionals that should be the ones helping folk,” Doak said.
Here’s a look at seven other idea that came up at the hearing.
1. Make using an existing ACA rule waiver program earlier.
The ACA itself includes a provision, Section 1332, that lets states apply for waivers from some ACA rules in an effort to increase access to coverage, improve the quality or reduce the cost.
The Centers for Medicare and Medicaid Services, the U.S. Department of Health and Human Services arm in charge of the Section 1332 waiver program, has been helpful, Wing-Heier said.
But one problem is that, even though CMS is helpful, it has not created a form that a state can use to apply for a waiver and know whether its waiver proposal meets CMS guidelines, Wing-Heier said.
Officials at CMS then take six months to make a decision on the waiver program application, she said.
She said one thing officials could do to stabilize the individual major medical market is to create a clear process a state can use to apply for an individual market stabilization-related waiver.
2. Keep existing ACA subsidy programs in place until and unless new market rules replace the current ACA rules.
Doak, a Republican, is strongly opposed to the ACA, but he said the individual major medical market, as it is now structured, needs the ACA reinsurance program, which helps shield insurers against some of the cost of covering individual policyholders with catastrophic claims, and the ACA cost-sharing reduction subsidy program, which helps low-income exchange plan users pay their co-payments, coinsurance amounts and deductibles.
The other commissioners at the hearing, including both ACA opponents and ACA supporters, said they also agree on the need to keep the current stabilization programs in place at least until 2019.
3. Recognize that changing an insurance plan takes time.
The commissioners emphasized that insurers and regulators need a chance to comment on any proposed changes, and adequate time to implement any proposed changes.
“Insurers, right now, are already planning for 2019,” Kreidler said.
Any indication that policymakers will impose sudden changes or continue the current state of uncertainty about the market rules will chase more carriers out of the individual market, Kreidler said.
4. Consider letting individuals team up to buy health coverage.
Sen. Rand Paul, R-Ky., argued that the individual market works as poorly as it does partly because consumers have no ability to team up to buy coverage, and to enjoy the same kind of regulatory framework large, self-insured employers enjoy.
Another challenge is that health insurers have increased their overall profits to $15 billion per year, from $6 billion per year before the ACA started, largely because of strong profits in the group market, but then cherry pick and refuse to stay in the individual market, Paul said.
In the past, many insurance regulators and insurers have argued that various types of health plan purchasing coalition proposals would lead to antiselection programs, but Doak told Paul he thinks the purchasing coalition idea has some merit.
5. Remember that each state has its own problems.
Wing-Heier pointed out that Alaska has built-in cost problems because it has a small number of people in its individual market, many of those people have chronic conditions, and care is expensive.
Wing-Heier said Alaska has tried to find ways to merge its individual market with individual markets in other states, to benefit from putting its residents in a larger individual market risk pool.
“Our experience has been so bad that nobody’s wanted us,” she said. “We have not been an attractive risk.”
6. Invest in advertising for the individual major medical open enrollment period for 2018.
The Trump administration has proposed cutting overall advertising spending 90%, focusing on digital advertising, and cutting the Navigator organizations’ funding 40%.
Miller, Kreidler and Wing-Heier that stronger advertising and marketing support will help increase individual health enrollment, and that increasing enrollment will improve the stability of the individual market, by improving the average health level of the insured population.
7. Be open-minded about Navigators.
Oklahoma may have agents and brokers in every county, but Alaska has few agents and brokers outside the big cities, and it has few agents and brokers who can speak the many languages that the uninsured residents of Alaska speak, Wing-Heier said.
States like Alaska need Navigators to fill in outreach gaps, she said.
—Read 4 ACA Change Paths That Just Got More Popular on ThinkAdvisor.
We have a Facebook news feed. Visit https://www.facebook.com/ThinkAdvisorLifeHealth
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limgsblog · 7 years
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The 10 Most Common Mistakes Insurance Agents Make
[ad_1]
Problem # 1
Customers have more sales weight training than representatives often have in sales presentation skill.
Prospect response to insurance coverage representatives is designed to get just as much information as you are able to and become in charge of the situation. Customers usually mislead insurance coverage representatives about their particular intentions, exactly how much they'll spend, which tends to make decisions, etc.
The chance intention is designed to change representatives into unpaid experts, lead them on until they usually have the information they need, and often utilize their particular estimates to compare with regards to current agent or a competition.
Whenever leads have what they desire, they stop going back the agent's telephone calls.
Performs this make leads bad folks?
Of course perhaps not.
All of us make use of this system for coping with salespeople...it's very nearly 2nd nature.
Why do leads do that?
It really is simple.
It really works.
The stereotype of a representative is not an excellent picture for most of us, and leads that terrifies them on the market something they don't desire. Being protect by themselves, leads feel they need a method to deal with representatives. It really is an instinctive reaction to the negative stereotype of representatives that causes leads to put up a defensive wall.
Just how do most representatives deal with the leads system of defense? Most perform right into it. Many avoid using a systematic approach to selling. They let the possibility to take total control of the sales procedure. The agent eagerly:
o gives their particular understanding o tends to make commitments without getting any inturn o wastes sources on pursuing deals which will never ever close o gives estimates to non-prospects which never ever purchase o misinterpret the common "I'll think it over to get back" as the next sale
Just how can most sales organizations play a role in the difficulty? Regularly they target product understanding and ignore teaching exactly what circumstances or ideas services and products fit well with.
The solution: Train representatives on an organized approach to making presentations so they really have "a track to operate on." Working out should stabilize both the possibility and agent's most readily useful interest.
Problem number 2
Spending a lot of time with leads which will never ever get.
a manager recently evaluated two of their representatives similar to this: "Gary spends a lot of time with non-buyers, and gets too involved with non-productive tasks. One root cause with this behavior usually he does not ask the tough concerns. Amy is strong with leads, but both she and Gary have forfeit deals due to the fact competitors wants the company while they give estimates toward possibility." Why is this true?
Representatives never ask the difficult concerns up-front for concern about making their particular leads frustrated, they have been afraid they are going to drop something they don't have. Most representatives think their job is to shut everybody.
Over the years sales education has emphasized, "never take NO for a solution." Insurance representatives tend to be taught become persistent...handle stalls and objections...trial closes...always be shutting...and yes, even be manipulative. No wonder leads need sales weight to protect by themselves!
Customers recognize representatives do not want to know "NO" hence if they do, they'll "hang within" and try to change "NO" into "YES." When the bad possibility really suggests "NO," s/he has found the simplest way to eradicate a agent is to tell them, "I'll think it over, and I'll get back to you." What amount of "think it over's" really become business?
The solution: representatives need resources to separate tire-kickers from purchasers. They want a method that obtains support at the beginning of the sales period. They have to learn the artwork of tactfully qualifying leads in, perhaps not qualifying them out. The most notable representatives figure out how to ask the difficult concerns up-front, saving valuable sources for real opportunities. "NO" is a satisfactory reaction from a buyer. "Going for the NO" needs a tremendous paradigm shift for many representatives, nonetheless it usually takes all of the force from the agent and increase productivity. This method permits leads to feel in control, this then calms them, and lets them get instead of experiencing like they have been being "sold."
Problem # 3
Representatives talk too much.
a manager recently said, "My representatives' listening skills are not in which they should be; some one states something as well as never find out the real reason or intention behind issue, which will leave the prospect feeling like my representatives don't understand them or their particular problems.
Of course, whenever we sent them toward university of item Knowledge, completing these with technical understanding then sent them off to make their particular quotas, we should have anticipated this result."
So whatis the issue telling our story? Initially, folks purchase for reason, perhaps not the representatives factors, not their particular company's factors. 2nd, most companies' presentations sound the exact same toward possibility, so when they sound the exact same, the agent only becomes another agent toward possibility, then toward possibility, good deal becomes the identifying factor in obtaining the business.
The solution: wondering concerns may be the solution. Teach insurance coverage representatives to cease regurgitating toward possibility and commence asking concerns. Customers must do about 70% regarding the talking regarding sales call. The only way this may take place is for the merchant to inquire of countless concerns.
Questions gather information. Make inquiries to find out exactly what the prospect's "pain" is. Here is the ditto family physician does during an office go to. They ask - they don't inform you such a thing until they usually have made the appropriate analysis.
Problem number 4
Weak Agents target cost.
Pricing is never ever the real concern! Representatives target cost given that it's the first thing the prospect requires about. However study after study verifies that high quality and solutions have been more crucial than cost. Pricing is never ever the main reason to get and keeping business. Men and women purchase our services and products to either resolve an issue they usually have, or enhance something about their particular current situation or protect against future events.
The solution: Teach representatives become more effective in asking concerns and getting to genuine problems. When they figure out how to do that, cost won't be the identifying factor in generating sales.
Problem # 5
Product understanding is over-emphasized and misused. Thus, offering usually becomes nothing more than "pitching and presenting."
Most sales education centers around product understanding. studies also show that 80% of education dollars invested annually tend to be used on product understanding education. Representatives, when filled up with this system understanding, tend to be eager to share this information and become an expert, Unpaid Educator. The main focus then becomes totally on product, rather than regarding leads issue, which can be in which it belongs.
The solution: offer learning the strategy and strategies our representatives have to assist leads clearly define their particular dilemmas and co-build solutions that fit their demands. Product understanding is important, but just how it's used at each and every period regarding the buying procedure is the key.
Problem number 6
Representatives neglect to get leads to reveal budgets up-front. Many insurance coverage representatives tend to be uncomfortable referring to cash. Talking about money is regarded as invasive, and unpleasant. Many representatives avoid referring to cash, before possibility makes the matter. This is the five typical weaknesses that representatives have.
The solution: once you understand whether there's cash upfront may help the insurance coverage agent distinguish between a leads who is ready to resolve an issue in one who is perhaps not dedicated. Easily referring to money is a key to management, in which sources tend to be examined predicated on important thing effect. Teach your representatives to find out a few things about cash:
o simply how much the problem is costing the prospect; put another way the quantity in danger. o simply how much they would be ready to invest to solve the difficulty.
Without a candid discussion about cash, the agent is remaining to be sure assumptions. And we also all know what takes place when we make assumptions!
Problem #7
Representatives neglect to get fast commitments from leads.
Insurance representatives in many cases are very ready to leap in the possibility to do a quote, presentation, etc. This method is extremely time intensive and resource intensive.
What amount of estimates has your team/distribution distributed over the last twelve months that resulted in absolutely nothing? Exactly how much does it cost your team/distribution on a yearly foundation to complete estimates which go no place?
The solution: representatives must learn exactly what motivates visitors to get. They have to master the abilities required to assist leads come to be comfortable sharing dilemmas, as well as must figure out how to determine the leads' standard of commitment to resolve these problems before linked with emotions . offer their particular solutions.
Problem #8
Not enough sufficient prospecting.
a quote from a manager: "They don't do adequate prospecting, also 'when I use a lengthy stick.'" All professional representatives at some point be faced with a bout of call reluctance. You know the story - they usually have much documents on their work desk they can't possibly find the time to prospect for brand new business OR they may be so hectic calling on current consumers (which incidentally are not buying such a thing) there isn't any way they are able to include any brand new appointments. Getting ready to prepare yourself. The BT club (bout to) problem?
o Over 40% of all veteran sales professionals have experienced bouts of call reluctance extreme adequate to threaten their particular career in sales o And 80% of all brand new representatives which fail in their first year do this due to inadequate prospecting task.
The answer: Insurance representatives have to develop a realistic task plan. Track the program weekly and implement effective accountability.
Problem # 9
The insurance coverage agent has a powerful dependence on approval.
It really is a simple and typical mistake. "I love folks, so I'll be an insurance agent." You wind up with an insurance agent that could instead make "friends" with regards to leads than conduct business. While building interactions tend to be a significant part regarding the selling procedure, offering is not a spot for folks to get their particular emotional needs met. In reality, it is the opposite: a hardcore and demanding occupation, filled with getting rejected. People who internalize the getting rejected end up getting out from the occupation. Truth is, they need to not have gotten available. Sales interactions tend to be fundamentally different than personal interactions. Successful professionals comprehend and accept the important thing of skillfully offering is: EARNING MONEY.
The answer: Evaluate you to ultimately see whether you've got this dependence on approval. Managers have to ask pre-hire assessment concerns that can help to employ more powerful folks and help them learn something that can help hit the correct balance between building interactions and getting commitments.
Problem #10
Insurance representatives never treat sales as a profession.
Experts like doctors, solicitors, engineers, educators, and CPAs' all have one part of typical - they attend continuing education to steadfastly keep up and increase their particular proficiency. However what number of insurance coverage representatives tend to be continually searching for brand new ways to boost their particular skills? Many possess attitude, "i am offering for a long time, exactly what more can I learn?"
The solution: Top performers atlanta divorce attorneys occupation are always searching for ways to hone their particular skills and get the fine edge leading to constant success. Managers have to purchase top performers and help them grow their particular skills. Ego stunts your growth so managers need to be ready to set their particular ego apart and become ready to grow, modeling behavior that demonstrates its more important to the manager to work rather than be right. We could all learn from one another.
In Summary:
Contracting: Distributions, supervisors and managers must complete, step by step, an official procedure for profiling, attracting, recruiting, interviewing and employing top performers. Aim to employ goal achievers perhaps not goal setters. Most managers employ goal setters consequently they are surprised whenever representatives never ever achieve their particular goals. The stark reality is the agent only had a wish record. Ask the agent whenever interviewing or mentoring to spell it out goals they set and "how" they accomplished objective. If they didn't achieve it ended up being it a goal or only a wish record?
Effective recruiting and hiring is the most important job of any manager. No amount of education, mentoring or mentoring is likely to make up for a poor hiring decision. Do it right the first time.
Managing: Implement a sales management procedure that emphasizes more effective recruiting, employing, mentoring, growing, and building representatives. Most of all quit accepting excuses for bad overall performance from your self and your agent, lift up your expectations and implement a rigorous accountability procedure. This starts along with your staff production-if you're not satisfying requirements. how could you expect you'll hold your representatives responsible?. In management generally, that you do not get what you need - you simply get everything expect and inspect. Remember, you handle things - you lead folks.
Training: Tapes, books and something -day seminars tend to be fine for intellectual understanding or exterior motivation, but if you want to be an improved golfer, pianist - or an improved sales person, you have to exercise and develop additional skills. Selling is an art that can be taught, learned, and mastered eventually.
Phone scripts and rebuttals tend to be designed to help in going your management and sales career forward or enabling you to boost you current amount of business.
Remember they are only meant to be sales resources, they don't work, you have to work them.
The key is to do an adequate amount of the proper things, an adequate amount of the time.
Give success time to happen-and make a move today to make it work!
The time clock starts NOW!
[ad_2] Supply by Lloyd Lofton
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Are You Headed Toward Bankruptcy? Don’t Touch Your Retirement Savings & Other Considerations!
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If you, like so many Americans right now, are struggling with job loss or other financial stressors, you may be considering the prospect of bankruptcy. While bankruptcy may be an option of last resort, many Americans think that they can avoid bankruptcy by cannibalizing their retirement accounts or making other moves that simply forestall the inevitable.
In the current economic climate, bankruptcies are to be expected. Congress is attempting to stem the tsunami of bankruptcies that will clog up the American courts, but no one knows whether the funds extending unemployment and stimulus checks will be there a few months down the road. This has many Americans worriedly looking over their finances and planning financial moves for their future.
While planning for the future is generally a good thing, you don’t have to rob the future to pay the present. In this article, we’ll discuss what you should and should not do if you are one of the nearly 40 million Americans who are unemployed right now.
Talk to a Bankruptcy Lawyer Now
Even if there’s a chance that you aren’t heading toward bankruptcy, the financial advice that bankruptcy lawyers provide is much different than the type of advice credit counselors or financial planners provide. We can tell you how to divest your liabilities while hanging onto your assets. In other words, we can help leave you in a better financial position than you were before you entered bankruptcy.
Of course, there’s a caveat to that. Your credit could take a hit. This is one of the several factors that bankruptcy attorneys will discuss with you when you meet with them. The best thing about many bankruptcy attorneys (and in particular Butcher Law Office, LLC) is that they provide you with a free hour-long consultation. There is no need to file for bankruptcy or commit to settling your debts in that manner. So getting a free consultation and listening to what we have to say may provide you with a firmer foundation to make your next move. That doesn’t mean that you should rush to file for bankruptcy. But knowing all of your options helps you make a more informed decision.
Do Not Touch Your Retirement Savings!
Your retirement savings are protected under bankruptcy law. In other words, creditors cannot usually use that money to recover some of the debts you owe.
Unfortunately, many Americans are raiding their retirement savings right now. Why? Because the federal government is allowing Americans to borrow from their retirement accounts while minimizing certain penalties. The money withdrawn is taxable, and can be repaid within a three-year period without incurring a tax liability. But most prognostications find that Americans who borrow from their retirement savings now will not be able to pay them back in the future. That money will just be gone.
A Chapter 7 bankruptcy filer can protect IRAs and 401(k)s using Chapter 7 exemptions. The amount of money you can protect in the account may be capped in certain cases, but chances are good that you will be able to protect all the money in the account. So if you use that money to pay debts you can discharge in Chapter 7, you are taking a double loss.
Don’t mortgage your future by using your retirement funds to pay off debts that can be erased in bankruptcy!
Roth IRAs and Bankruptcy
Because retirement accounts offer broad scale protection from bankruptcy, they can be useful for protecting assets. Yet many frugal-minded Americans will simply let cash pile up in their bank accounts as a buffer for bills and other debts that are piling up.
You shouldn’t do that. Firstly, you can only protect so much money in Chapter 7 and that includes savings and checking accounts. The more money that you protect in your bank accounts, the less money you have to protect other assets.
Similarly, if a creditor files a lawsuit against you to recover a debt and wins the judgment, the creditors can levy these bank accounts to recover the debt. They cannot, however, levy a Roth IRA.
There are certain precautions to be taken in using a Roth IRA to help protect assets, however. An experienced bankruptcy lawyer can discuss using a Roth IRA to help protect a set amount of money in the context of bankruptcy.
Don’t Liquidate Your Assets (Yet)
Most folks, when they meet financial turmoil, will find assets they can sell off to stabilize their situation. This may work in the short term, but if the situation doesn’t change, you can find yourself without any assets, still making payments on those same debts.
If you’re considering bankruptcy, then the bankruptcy trustee through the court could void asset transfers that occurred recently for which you did not receive equal or fair market value as exchange. This is especially true if the court thinks you’re moving these assets simply for the purpose of protecting them. That would be considered fraud.
So before you start divesting yourself of valuable assets, discuss the matter with a bankruptcy attorney.
Forbearance Options Can Help
Federally-backed mortgages now qualify for forbearance. This means that you won’t incur a penalty for not paying on your mortgage, at least for now. What it really means is that lenders can’t foreclose on your home during this time. That could change in several months when the legislation protecting borrowers expires and they find themselves in a position of owing several months’ worth of mortgage payments. Lenders may likely offer options to roll arrearages into a current monthly payment ideally.
If lenders will not work with you after the forbearance, there is always the possibility of filing a Chapter 13 bankruptcy — to catch up on the missed mortgage payments over a 5 year period.
Schedule a Free Consultation with a Eugene, OR Bankruptcy Lawyer Today
Talking to a bankruptcy attorney about your options heading into the coming months is a wise idea if for no other reason than we can help you make a smarter and better informed decision. Call Butcher Law Office, LLC today to schedule your free consultation with Tom.
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unixcommerce · 5 years
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Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips
When businesses become overleveraged, bad things happen. When businesses are able to maintain financial flexibility, they’re far more likely to enjoy long-term success. Where does your business land on this spectrum? And what does it look like to move from overleveraged to flexible?
What Does it Mean to be Financially Flexible?
Every CFO and finance guru will have his or her own opinion on what it means to be financially flexible, but it’s ultimately a company’s ability to quickly access new funds to satisfy major business needs that arise suddenly as the result of an opportunity or crisis.
According to an academic study on the effect of financial flexibility on financial behavior of publicly traded companies, firms with financial flexibility are able to stand against financial pressures in an unexpected situation and seize a profitable opportunity. This means they’re able to come up with the cash needed without incurring negative financial circumstances in the present or the future.
In other words, financial flexibility is the measure of an organization’s ability to do what it wants when it wants without compromising the larger financial picture. The benefits of which include:
Quick response. When a business is financially flexible, the company is able to make quick decisions on how to react to situations that demand a rapid response. In certain industries, this can mean the difference between seizing market share and becoming obsolete.
Future stability. Companies that lack financial flexibility often pursue present opportunities at the expense of future growth and sustainability. When you have flexibility, you don’t have to mortgage the future away.
Better focus. Think about how much time and energy goes toward figuring out the best way to finance a major business decision. For firms with a high degree of financial flexibility, less energy has to be given to this part of the decision. Instead, focus can be directed toward creativity and execution. Money is still an important issue, but it isn’t the primary
Greater adaptability. Financial flexibility gives a business the ability to adapt, pivot, and evolve with relative ease. There’s far less friction involved in the process, and you’re able to do more with less.
Less volatility. When money is tight and there are questions about how certain expenses and projects will be financed, business leaders often feel like they’re being tossed around in a pinball machine. But when a firm is financially flexible, there’s far less volatility. A sense of calmness leaches into the company culture and everyone feels at ease.
Financial flexibility means different things to different business leaders, but it’s something every company should strive for. With it, there’s far more potential and peace of mind.
5 Tips to Achieve Optimal Financial Flexibility
Financial flexibility sounds great, but how do companies achieve it? That’s a question that business leaders and corporate executives have asked for decades – and one that doesn’t have a perfect response. But if you want to increase your organization’s chances of enjoying greater financial flexibility, here are some practical steps you can take in a positive direction:
1. Use Profits Wisely
Let’s start by talking about profitability. For businesses with healthy bottom line profit margins, there’s ample opportunity for financial flexibility. Unfortunately, many of these organizations squander the profits in a selfish and/or unsustainable fashion. Don’t let your company experience a similar demise.
For young companies, in particular, there’s a temptation for business owners and executives to quickly turn profits into cash bonuses and salary increases. (Naturally, the folks making the money want to pocket some of the harvest.) But consider whether or not this is the best approach.
When profits are immediately turned into year-end bonuses, the business remains stagnant. While the company has grown, cash reserves haven’t. Eventually, too much growth without healthy increases in cash will create an imbalance and profits will fall – at which point (ironically) there won’t be any way practical way to build up those cash reserves.
It’s okay for business owners and executives to take some small bonuses when profits exceed expectations, but do so sparingly. The majority of profits should be reinvested into the business by bolstering a cash emergency fund or paying down debt (which ultimately improves future cash flow). In doing so, you’ll ensure that the business model is sustainable for years to come (yielding greater personal financial benefit down the road).
2. Develop Better Budgets
Now that we’ve discussed profits and how they should be handled, let’s dig into the topic that nobody likes to discuss: budgeting.
If you’re serious about achieving financial flexibility, you need a budget — a detailed budget that tells your money where to go. Only then can you maximize your revenue, reduce expenses, and put your business in a position to afford the investments that are needed to flourish.
The key with a budget is to avoid expense creep. If you aren’t careful, expenses will slowly get tacked on to your budget month after month. It’ll look like $25 here, $300 there, and $100 over there. In the grand scheme of things, this might not seem problematic. But suddenly you look up and two years from now your expenses are $2,000 higher per month than they were when you drafted your initial budget.
Budgets fluctuate, but expenses shouldn’t creep up on you. Plan ahead and take charge. This will leave you with a healthier profit margin, which will yield greater flexibility. 
3. Use Strategic Financing
Financial flexibility isn’t about having cash to pay for everything. Very few large organizations are totally debt-free (nor should they be). Debt is a powerful instrument that serves a distinct purpose. The key is to use financing strategically.
Instead of taking on a bunch of debt just for the sake of having debt, be purposeful about which types of financing you use and what purpose they serve. The key is to have access to funds without paying interest on funds you don’t need. This is why many organizations turn to a business line of credit — and perhaps you should too. It improves cash flow on an as-needed basis and basically serves as an insurance policy that can be tapped in times of opportunity or need.
“The amount of funding accessible to your business, along with the repayment terms, depends on a variety of factors including your credit rating, revenue stream, longevity, and other financial variables,” Business Line of Credit Hub explains.
Be careful not to overestimate your need for credit. Run some estimations and calculations to determine the type of scenarios that would require you to tap into this line and how much you’d need in a worst-case scenario. This will help you zero in on a figure that’s adequate for your needs.
4. Diversify Your Revenue Streams
We’ve spent the bulk of this article discussing ways to manage money with intelligence so that your organization can enjoy a greater degree of flexibility. However, it’s also smart to think about how you’re producing revenue.
For optimal flexibility, look for ways to diversify your revenue streams. This will ensure you’re able to weather storms, crises, recessions, and other painful circumstances.
“What separates brands who survived the financial crisis from those that were swallowed whole by it, is the flexibility in their business models to offer value to multiple demographics and customer segments,” entrepreneur Tahnee Elliot explains.
When you have a wide customer demographic, a single negative economic condition isn’t going to run your business into the ground. You’re poised to weather turbulent conditions and can let other revenue streams prop up the areas of your business that are struggling. 
5. Avoid Crippling Mistakes
Maintaining financial flexibility isn’t just about doing the right things — it’s also about avoiding mistakes that can otherwise cripple your business and handcuff your finances.
Excessive debt on depreciating assets is one surefire way to kill your cash flow and limit your ability to pivot in situations that call for action. You should also avoid hiring people who go against your financial ideology. Too much friction among financial decision makers will lead to sloppy mistakes that are hard to recover come. 
Give Your Business a Strong Foundation
One of the first things an entrepreneur learns in business school is the importance of staying focused on the present. If you get too caught up in the past, you’ll miss out on what’s happening in the moment. And if you daydream about the future, you’ll fail to seize opportunities as they emerge. But having said all of this, you can’t ignore where your business is going. Your organization needs a strong foundation upon which you can facilitate future growth.
Financial flexibility allows you to accomplish both at once. You can make intelligent decisions in the present and simultaneously set your business up for future success through smart financial choices and sustainable strategies that maximize profitability at every step along the way.
Heed the advice outlined in this article and figure out how it aligns with your current business strategy. Start with the low-hanging fruit and focus on making incremental progress. Your momentum will eventually carry you into bigger and more transformational undertakings.
Republished by permission. Original here
Image: Due.com
This article, “Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips” was first published on Small Business Trends
https://smallbiztrends.com/
The post Creating Financial Stability for Your Business Doesn’t Have to be Hard: Read these 5 Tips appeared first on Unix Commerce.
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