K-9 Mold Patrol (March 29, 2004)

CLEARWATER, Fla. (Ivanhoe Newswire)

Whether you love dogs or hate them, there is a good reason to invite this next dog to your house. Here's how man’s best friend can keep us healthy.

Bella is one of only 50 dogs in the United States trained to find mold, an odorless fungus that’s difficult to pinpoint. Homeowner Marilyn Newbould knows firsthand the health problems mold can cause. “[I had] flu-like symptoms, and it just won’t seem to go away,” she tells Ivanhoe.

Newbould suspected mold was the culprit. One study estimates 50 percent of homes have mold problems. That’s where Bella’s powerful nose comes in handy.

“Their sense of smell, as far as scientists can tell, is one part per trillion, which on a football field is the size of one baby’s tear drop,” says Bella's certified handler, Kristina Taylor. Taylor owns K-9 Mold Patrol in Clearwater, Fla.

Bella found mold under Newbould's entertainment center, where there used to be carpeting, and also in a blanket on the bed.

“Apparently, I did not get it cleaned well enough, and there was a little bit of mold in it,” Newbould says.

Taylor says the results Bella has on a home are immediate. “A lot of these cases can be very overwhelming for people to not even know where to start," she says. "The dog gives you an idea of what parts of your home are affected and what parts are not affected.” Bella ultimately saves the homeowner clean up costs, but for her, it’s just another day at work.

The cost of Bella’s search is $0.25 per square foot, which means for a 1,500 square foot home, it would cost $375 for Bella’s inspection. Taylor says Bella gets hired quite often by people who want a home checked for mold before they purchase it.


If you would like more information, please contact:
Kristina Taylor
K-9 Mold Patrol
Owner and Certified Handler
(727) 463-MOLD (6653)
http://www.k9moldpatrol.com

How to Starve Your Fibroid Tumors (March 29, 2004)

(Ivanhoe Newswire)

Twenty percent to 40 percent of American women ages 35 and older have benign tumors in the uterus called uterine fibroids. A new study shows uterine artery embolization, or tumor shrinking, is a safer treatment for these tumors compared to surgically removing them during a myomectomy.

Researchers say this tumor-shrinking option requires shorter recovery time and results in less undesirable events post-op.

During a study presented at the 29th Annual Scientific Meeting of the Society of Interventional Radiology, UAE patients were back to work in 10 days vs. 37 days in the myomectomy group. The UAE patients returned fully to normal activities in 15 days vs. 44 days in the myomectomy group.

The UAE group also showed statistically-significant better symptom relief, including improvement in sleep, less restriction to usual activities, and improved mental health.

Embolization is a minimally invasive interventional radiology treatment that cuts off blood supply to the fibroid tumors, causing them to shrink. It has been widely available in the United States for the past six years as a treatment for fibroids.

UAE is a global treatment, meaning it's effective for multiple fibroids. However, it is often not physically possible to remove all the fibroids through myomectomy because it would remove too much of the uterus. In addition, researchers say up to half of the women who have a myomectomy will have recurrence of their symptoms within five years.

Another benefit of UAE is it has negligible blood loss. In contrast, "Myomectomy surgery can entail significant blood loss, and in about 2 percent to 3 percent of the cases an emergency hysterectomy is required because of it. A woman who chooses myomectomy as a treatment because she doesn't want to lose her uterus, may wake up without one," says John Lipman, M.D., an interventional radiologist and study investigator.

In past studies, UAE has also been shown to be a safe and effective alternative to hysterectomy, still the most common cure of uterine fibroids. "Now we have trials comparing UAE to both surgical treatments, showing UAE to be a good treatment option," Dr. Lipman says. "UAE is another example of the overall trend in medicine to treat disease in the least invasive way possible. It's important for women to ask questions, obtain consults with different types of physicians, and know all of their treatment options."

SOURCE: The Society of Interventional Radiology's 29th Annual Scientific Meeting in Phoenix

Who Pays in the Obesity Battle? (March 29, 2004)

(Ivanhoe Newswire)

According to a New Zealand researcher, intensive lobbying from the U.S. food industry pressures the adoption of a worldwide strategy that recommends reductions in fat, salt and sugar content and increased physical activity.

In a joint report published last year, experts from the World Health Organization and the Food and Agriculture Organization of the United Nations suggested added sugars should be restricted to less than 10 percent total energy.

This provides further justification for a guideline to restrict sugar intake that is already in place in more than 20 countries, according to article author Dr. Jim Mann. Authors of the WHO/UN report concluded sufficient evidence shows sucrose and other free sugars contribute to the global epidemic of obesity.

Mann, from the University of Otago, New Zealand, writes food industries and some governments make claims that evidence on which the recommendations are based is insufficient and other authoritative reports do not concur.

Writers of an accompanying editorial from The Lancet agree that the WHO’s Global Strategy on Diet, Physical Activity and Health is a start toward combating the obesity epidemic. One thing the strategy does not address, however, is the high cost of eating healthy. The authors conclude, “As long as a meal of grilled chicken, broccoli, and fresh fruit costs more and is less convenient than a burger and fries or a peanut butter sandwich, then the battle against obesity will be lost.”

Editorial authors cite the medical costs attributable to obesity in the United States last year alone were $75 billion. This cost amounts to $175 each year for every U.S. taxpayer, who pays for obesity-related illness including heart disease, cancer, diabetes, and gallbladder disease.

SOURCE: The Lancet, 2004;363:1068-1070, 33

Grab a Beer and Fight Cardiovascular Disease (March 29, 2004)

(Ivanhoe Newswire)

A few alcoholic beverages a month may stave off the risk of death from cardiovascular disease in men with high blood pressure, according to new research.

Researchers from the University of Massachusetts Medical School, Worchester, found weekly and daily drinkers in their study had a significantly lower risk of death by nearly 30 percent when compared to nondrinkers. There was also a reduced risk of cardiovascular disease death as alcohol intake increased.

Compared to participants who rarely or never drank, weekly drinkers had a 39-percent lower risk of dying from cardiovascular disease. Daily drinkers had a 44-percent lower risk of death.

Before heading to your favorite bar, consult your physician. Authors of the study say doctor recommendations regarding alcohol use must be made on an individual basis in light of major clinical and public health problems associated with heavy drinking. However, investigators say, “Patients with hypertension who are able to maintain light to moderate alcohol intake have no compelling reason to change their lifestyle and eliminate a possibly beneficial habit."

Researchers studied data from 14,125 male physicians who were enrolled in the Physicians’ Health Study and who reported past or current treatment for hypertension. However, they had no history of heart attack, stroke, cancer or liver disease.

Earlier American Heart Association guidelines recommend no more than two drinks per day for men and one drink per day for women to prevent and treat hypertension.

SOURCE: Archives of Internal Medicine, 2004;164:623-628

Diabetes Patients Could Improve Health With Freebies (March 29, 2004)

(Ivanhoe Newswire)

For diabetes patients, the daily monitoring of sugar levels is important to reduce major complications of the disease. In a new study, Harvard University researchers found patients who received free equipment to monitor their glucose improved their rates of self-monitoring, increased the regularity of medication use and had a reduction in high blood glucose levels.

According to the article, self-monitoring of blood glucose has become a key feature of secondary prevention and treatment of diabetes. The goal is to achieve tight glycemic control, which reduces major complications of diabetes, including retinopathy, neuropathy, and cardiovascular and end-stage renal disease.

However, public and private insurers, including managed care organizations, face challenging decisions regarding the coverage of self-monitoring devices for managing major chronic illnesses such as diabetes. Now, 38 states require managed care organizations and other insurers to cover self-monitoring equipment and supplies.

More than 3,000 diabetes patients who received drug therapy participated in the study. The new policy resulted in a small but significant increase in self-monitoring of blood glucose among insulin-treated patients. In sulfonylurea-treated patients, the monthly initiation rate of self-monitoring blood glucose increased by 14 new patients for every 1000 patients, which is double the expected initiation rate. Test strip consumption increased during the first six months after the policy by about 17 strips per person. The regularity of medication refills also became more frequent in those who received free equipment.

Investigators say their findings provide preliminary support for efforts by HMOs and state legislators to cover home-testing equipment for this vulnerable and high-cost population.

SOURCE: Archives of Internal Medicine, 2004;164:645-652

Open Artery Without Surgery (March 26, 2004)

(Ivanhoe Newswire)

There may now be a safer alternative to opening the artery of high-risk stroke patients.

Up to this point, heart patients with fatty plaque in their arteries were advised to undergo a procedure called carotid endarterectomy. It’s an invasive procedure that requires an incision in the neck.

Researchers presenting at the Annual Scientific Meeting of the Society of Interventional Radiology encourage high-risk patients to undergo carotid artery stenting instead. During this procedure, a physician makes a tiny incision in the groin and inserts a catheter to remove the plaque.

Data from the study, which sampled nearly 350 patients, shows the rate for cardiovascular trauma was much lower in stenting patients (5 percent) than it was in surgical patients (22 percent).

"Patients with severely blocked carotid arteries are at high risk for stroke. These findings offer hope for those patients who need treatment of their carotid artery disease to prevent stroke, but were too high risk to have the surgery. Now we know we can safely offer them carotid stenting," say researchers.

The study is also of significant importance to diabetic patients, who are at greater risk for all vascular conditions.

"This study shows that stenting is far safer than surgery even in this highest risk population. It clearly establishes that all high-risk diabetics should have stenting, not surgery," researchers concluded.

SOURCE: Presented at the 29th Annual Scientific Meeting of the Society of Interventional Radiology, March 25, 2004

Breast Cancer and Aborted Pregnancy not Related (March 25, 2004)

(Ivanhoe Newswire)

Investigators of a major international study say evidence does not suggest any increase in the risk of developing breast cancer for women who have had a spontaneous or induced abortion.

Researchers found the average relative risk of breast cancer was .98 for women whose pregnancies ended in miscarriage and .93 for women who had a pregnancy that ended as an induced abortion. A relative risk of 1.0 or less indicates no adverse effect on the subsequent risk of breast cancer. The number of abortions was also not associated with any change in breast cancer risk.

The Collaborative Group on Hormonal Factors in Breast Cancer re-analyzed data from 53 epidemiological studies in 16 countries. Information was available from 44,000 women who had taken part in studies where any history of abortion had been recorded long before breast cancer was diagnosed. Data on 39,000 women with breast cancer, where women were asked after breast cancer diagnoses about any previous abortions, gave misleading results, on average. Investigators say this may be because women with breast cancer are more likely than other women to disclose any prior induced abortions.

Previous studies show pregnancies that result in a birth reduce a woman’s long-term risk of developing breast cancer.

SOURCE: The Lancet, 2004;363:1007-1016

Women Pass on Breast Cancer Drug (March 25, 2004)

(Ivanhoe Newswire)

Many women at high risk of developing breast cancer are not taking a drug that can reduce their risk by nearly half.

Results of the new study out of Northwestern University show postmenopausal women over age 50 who are diagnosed with a noncancerous condition in which breast cells look abnormal or are diagnosed with abnormal cells in the lobules of the breast (called lobular carcinoma in situ) are more likely to be offered and accept the use of tamoxifen.

Worldwide data shows women with these conditions receive the greatest benefit from the drug. Overall, approximately 2.4 million women are estimated to be eligible to benefit from the drug tamoxifen.

The study also shows premenopausal women, who may benefit from tamoxifen, were less likely to be offered or accept the drug compared to postmenopausal women. Overall, 63 percent of the women studied were offered tamoxifen, and only 26 percent accepted.

Authors of the study conclude that both the practice and attitudes of physicians toward at-risk women are responsible for the low rates of tamoxifen use.

The U.S. Food and Drug Administration approved tamoxifen in 1998 for breast cancer risk reduction in women with elevated risk. The largest American trial to date showed a 49-percent risk reduction in all eligible women.

SOURCE: Published online March 22, 2004 in Cancer

Got Zinc? (March 25, 2004)

(Ivanhoe Newswire)

Up to one in five people worldwide lack sufficient zinc in their diet, while an estimated one-third live in countries considered at high risk of zinc deficiency, reports the International Zinc Nutrition Consultative Group.

The research shows zinc deficiency is linked to child dwarfism, diarrhea and pneumonia, which are among the most common causes of child mortality in developing countries. Researchers note these dangers have been underestimated in the past.

The report shows interventions to improve zinc intake promise to be a relatively low-cost means of improving health and life expectancy among children in poor countries. Zinc supplementation resulted in a 25-percent decrease of diarrhea, a 40-percent reduction of acute lower respiratory infections, a 50-percent reduction in mortality, and significantly increased rates of linear growth and weight gain in children.

The researchers say the worldwide zinc deficiency can be cured with pharmacological supplements, a national program to fortify staple foods like flour, and public education on good dietary sources of zinc, such as meat, seafood, and whole grain cereals and legumes.

Cutberto Garza, M.D., the director of the UN University's Food and Nutrition Program, says, "It is hoped this document will serve to promote greater awareness among key public health decision makers of the importance of zinc nutrition and help governments, international agencies, and private organizations to ameliorate or, ideally, prevent health problems related to inadequate zinc intake."

SOURCE: UN Standing Committee on Nutrition, March 23, 2004

Asthma Taboo Among Blacks (March 24, 2004)

By Stacie Overton, Ivanhoe Health Correspondent

SAN FRANCISCO (Ivanhoe Newswire)

A small study of patients with asthma reveals blacks feel asthma makes them vulnerable, and they often do not let others know they even have the life-threatening illness.

The study shows asthma led to significant psychological distress in most participants, and the stress was intensified among blacks by distrust of their neighbors and communities. Blacks say they feel the community made them feel that asthma made them more vulnerable in an already-unsafe environment.

Researchers from Chicago put together two focus groups: one with 10 black participants and one with nine non-black participants of mixed ethnicities. The men and women in the groups were at least 18 years old from urban neighborhoods. Everyone had asthma or was a caregiver of a child with asthma. All discussions among the groups were recorded and transcribed for the study.

Giselle Mosnaim, M.D., M.S., from Rush University, says, “The two focus groups reported similarities and differences in their use of social support to cope with chronic disease.” One difference, she says, is that “Many blacks said they did not let others know that they or their child has asthma.” She also says: “Their [blacks] sense of community had been eroded. It was not the same as they remember it 20 years ago. They said that supportive caring individuals were a way to cope, but they trusted almost no one but family.”

In particular Dr. Mosnaim says black women said they have a hard time “being allowed to be sick.”

She concludes, “In both groups, asthma is a source of stress, but for African Americans it is intensified by, and adds to, a feeling of vulnerability. While they want support of caring individuals, they feel they must rely almost exclusively on family support.”

SOURCE: Stacie Overton at the American Academy of Asthma, Allergy & Immunology’s 60th Annual Meeting in San Francisco, March 19-23, 2004

Fishing for Allergies (March 24, 2004)

By Stacie Overton, Ivanhoe Health Correspondent

SAN FRANCISCO (Ivanhoe Newswire)

Before you take that first bite of lobster, you might want to make sure you’re not allergic to it. Research shows more than 6 million Americans are allergic to fish and shellfish.

Researchers presented their “seafood allergy update” this week at the American Academy of Allergy, Asthma & Immunology’s Annual Meeting in San Francisco. They found about 2.3 percent of people in the United States report that they are allergic to seafood.

Researchers from the Food Allergy and Anaphylaxis Network in Fairfax, Virginia, and Mt. Sinai School of Medicine in New York interviewed more than 5,500 households to determine the prevalence of self-reported seafood allergy in the United States.

Allergy to some type of seafood was reported for 2.8 percent of adults and less than 1 percent of children younger than age 18.

Multiple allergic reactions were reported by 53 percent of people with fish allergies and 57 percent of people with shellfish allergies, and these symptoms are not innocuous. Medical care was sought by 55 percent of those allergic to fish and 40 percent of those allergic to shellfish.

Researchers say the most common offending fish were salmon, tuna and halibut while the most allergy-causing shellfish were shrimp, crab and lobster. Reactions usually appear within two hours after ingestion, inhaling cooking vapors, or handling seafood. However, some reports show reactions can be delayed as long as 24 hours.

Scott Sicherer, M.D., from Mt. Sinai School of Medicine, says, “Self-reported, physician diagnosed and/or ‘convincing allergy’ to seafood is reported by 2.3 percent of the general population, which is about 6.5 million Americans.”

SOURCE: Stacie Overton at the American Academy of Asthma, Allergy & Immunology’s 60th Annual Meeting in San Francisco, March 19-23, 2004

Stress can Trigger Heart Problems (March 23, 2004)

(Ivanhoe Newswire)

You’ve seen it on television. Someone gets mad and has a heart attack. Now, new research shows scientific evidence that mental stress alone can trigger heartbeat irregularities.

Arrhythmias are disturbances in normal heart rhythm. Researchers studied the variation in heart rhythms while patients were under mental and physical stress. They included patients who were at risk for arrhythmias and healthy patients.

For the study, researchers measured mental stress by having patients recall a recent incident that made them angry and also by having them figure out a math problem while being interrupted and told to improve their performance. Researchers from Harvard Medical School and Beth Israel Deaconess Medical Center in Boston evaluated the scores of the participants.

Researchers found heart rhythm variations increased during both mental stress and exercise. A higher difference was noted in patients who are prone to have arrhythmias, especially during the mental tests. Study authors say mental stress alone is capable of inducing cardiac electrical instability in patients who are vulnerable to arrhythmias, and that it can occur at lower heart rates than with exercise.

Study authors say these findings suggest there is a difference in how the body responds to mental and physical stress. Currently, a larger study is underway to further explore these differences.

SOURCE: To be published in an upcoming issue of the journal Circulation

Protect Your Vessels (March 22, 2004)

PITTSBURGH (Ivanhoe Newswire)

Aneurysms are weak spots in blood vessels that develop slowly and have no symptoms until it's too late. When they're detected early it's often by chance, but taking the chance and not knowing can be deadly. There are some important facts about abdominal aortic aneurysms, and certain people need to take steps to protect themselves.

Like balloons, blood vessel walls can stretch and weaken until they burst. The condition is known as an aneurysm. The warning signs are rare. The result, tragic. "It is estimated that patients who rupture have about a 70 percent to 80 percent chance of dying," says Michel Makaroun, M.D., a vascular surgeon at the University of Pittsburgh in Pittsburgh.

But Dr. Makaroun says detection with a simple ultrasound could prevent ruptures in those at highest risk. He says, "Screening for abdominal aortic aneurysm is cost-efficient in the subset of elderly, male population." That includes men with a family history of aneurysm, smokers, and people with high blood pressure.

In some cases quitting smoking, lowering your blood pressure and taking blood pressure medication called beta-blockers can keep aneurysms small. "The rupture rate is related to the size of the aneurysm," Dr. Makaroun says.

Jack Romel was lucky. His aneurysm was detected by accident. Doctors found it when he went in with hip pain. Romel says: "I didn't immediately try to find out if I should change what the hell I'm doing. Should I do this, don't do that, or whatever." It was still small when it was detected, so doctors were able to repair Romel's aneurysm surgically. Looking back, he realizes how lucky he is. "What the hell? I didn't know about it. Hell, in 2001, you wouldn't be interviewing me right now," Romel says.

The ultrasound test to detect an aneurysm costs around $100. Currently, insurance does not cover it as a screening tool, but Medicare and other insurance companies are considering covering it for some. Anyone who is concerned can go to their doctor and tell him they would like to be checked for an abdominal aortic aneurysm.


If you would like more information, please contact:
Frank Raczkiewicz
University of Pittsburgh Medical Center
Office of Public Affairs
(412) 647-3555
http://raczkiewiczfa@upmc.edu

Mom’s Habit is a Kid’s Disease (March 22, 2004)

SAN FRANCISCO (Ivanhoe Newswire)

Most people know smoking while pregnant is a no-no, but new research shows smoking after pregnancy is just as harmful to kids.

Results from a study presented Saturday at the American Academy of Allergy, Asthma & Immunology’s Annual Meeting show long-term smoke exposure in the womb and after birth increases the risk of airway disorders in a child’s first 10 years.

Michael Kulig, M.D., Ph.D., and colleagues from Charite University Medical Center in Berlin studied the effect of smoke exposure on 1,314 newborns through parental questionnaires and interviews. One-third of the children were at “high risk” for allergies. Researchers studied what effect tobacco exposure had on children in utero as well as after birth. They looked for these airway disorders: allergic sensitization to inhalant allergens (like pollen), allergic rhinitis, wheezing and respiratory infections.

Smoke exposure among kids increased as the kids grew older. Nearly 20 percent of kids had been exposed to second-hand smoke from their fathers only, while about 25 percent had been continuously exposed from their mothers. About 40 percent of the children had never been exposed to smoke from either parent.

In children whose parents had allergies, smoke exposure in the womb that continued after birth significantly increased the risk of allergic sensitization to inhalant allergens and wheezing. However, the risk was only seen in children who had a genetic predisposition to allergy.

In children who had one allergic parent, the combination of pre- and postnatal secondhand smoke increased the risk of allergic sensitization 1.8-fold. When both parents were allergic, secondhand smoke exposure increased that risk 7-fold. Likewise, for wheezing, there was a 2.1-fold increased risk among exposed children with one allergic parent, while there was a 5.7-fold increased risk when both parents were allergic.

Michael Kulig, Ph.D., from Charite University, says, “Long-term passive pre- and postnatal tobacco smoke exposure increases the risk for allergic sensitization or wheezing during the first 10- years of life.”

Statistics show about 40 percent of children under age 5 in the United States are living in homes where they’re exposed to cigarette smoke on a daily basis.

SOURCE: Stacie Overton at the American Academy of Asthma, Allergy & Immunology’s 60th Annual Meeting in San Francisco, March 19-23, 2004

Exercising When You're Sick (March 22, 2004)

MIAMI (Ivanhoe Newswire)

Fitness can be just what the doctor ordered, but if you're not feeling 100 percent, vigorous exercise may do your body more harm than good. There are some times when you should head to the gym and other times when you should stay in bed.

Working out has become a national obsession, but some people don't know when to quit -- even if they're sick. "A lot of times, we see people exercising when they shouldn't be," says Gloria Weinberg, M.D., an Internist at Mt. Sinai Medical Center in Miami.

Dr. Weinberg says there are dos and don'ts to exercising when you're sick. For a cold, with symptoms at neck level or above, exercise at a lower intensity than normal. But for the flu, with symptoms like muscle aches and fever, Dr Weinberg says don't workout. "When you have a fever, your body is saying you have an infection that can be serious."

If you have jet lag, Dr. Weinberg says drink plenty of water, wait a day, and then exercise at half your normal intensity. As for a hangover, you'll want to try a less intense activity, like stretching or yoga. "General guidelines are if you're feeling well, exercise. If your body tells you no, don't," Dr. Weinberg says.

And when you're ready to hit the gym after an illness, Dr. Weinberg says a gradual return to your regular routine is best for your body. If you're taking over-the-counter cold medicines, look at the package. If it contains a warning about hypertension, experts say stay away from the gym because it may speed up your heart rate.

If you would like more information, please contact:
American Council on Exercise
http://www.acefitness.org

 

Better Care for Young Breast Cancer Survivors (March 19, 2004)

(Ivanhoe Newswire)

A new study from Germany shows young breast cancer survivors may suffer from more long-term effects than older patients. Consequently, patients may not be getting the appropriate therapy needed for coping with the aftermath of the disease.

Researchers sampled nearly 200 breast cancer patients who had been diagnosed 10 years ago and asked about their physical symptoms and current therapy treatments.

Results showed that 65 percent of the respondents were still under a physician's care. Over half of them had physical complaints that included arm problems and fatigue.

Interestingly enough, the age of respondents also made a significant difference. Seventy-one percent of women younger than age 50 reported far greater problems than the older patients.

Researchers are considering attributing lower energy levels of younger patients to the fact that many of them are working and running households, whereas older patients are focusing on taking care of themselves and not necessarily working.

"Nowadays all kinds of care programs exist to deal with the physical and emotional problems associated with a new diagnosis of breast cancer. It is important that we make the same kind of facilities available to breast cancer survivors, who despite being free of disease, can still suffer greatly with both physical and psychosocial problems," researchers concluded.

SOURCE: European Breast Cancer Conference

Science Backs Tai Chi Benefits (March 18, 2004)

(Ivanhoe Newswire)

Need a health boost? Try Tai Chi. This traditional Chinese martial art has a long list of health benefits including effects on balance, flexibility and cardiovascular health, according to a new study. Tai Chi also helps reduce the risk of falling among the elderly.

Tai Chi is the combination of deep breathing with relaxation and postures that flow from one to another through slow movements. It has been practiced in China for centuries. While many already swear by the benefits of Tai Chi, now there is scientific evidence to back it up. Researchers from Tufts-New England Medical Center in Boston analyzed 47 research studies on Tai Chi.

Researchers found Tai Chi has many health benefits. They found improvements in patients who had undergone heart bypass surgery as well as in patients with heart failure, hypertension, heart attack, arthritis and multiple sclerosis. Tai Chi also appears to reduce pain, stress and anxiety in people. Benefits in balance, flexibility and strength were also reported.

Recent studies suggest Tai Chi also boosts immunity to the shingles virus among seniors as well as offers benefits to people with Parkinson’s disease.

While the mechanism behind Tai Chi is not fully understood, study authors say it is clear Tai Chi is helpful for those with chronic health conditions. They say another big plus with Tai Chi is it’s an art that can be practiced at any age.

SOURCE: Archives of Internal Medicine, 2004;164:493-501

New Drug Best bet for Breast Cancer (March 18, 2004)

(Ivanhoe Newswire)

New research shows the hormone treatment exemestane may be a better alternative than the gold-standard drug tamoxifen for postmenopausal women with advanced breast cancer.

Researchers from Belgium presented their findings on the world’s only phase III trial to compare the two treatments at the 4th European Breast Cancer Conference. Their results add to findings of a study reported last week in the New England Journal of Medicine. That study showed postmenopausal women with breast cancer are less likely to have their disease recur if they’re treated with exemestane after taking tamoxifen for two to three years.

The current study involved more than 350 patients from around the world. Patients were randomized to receive either exemestane or tamoxifen.

Results of the study show the average disease-free survival was nearly 11 months for women on exemestane, compared to less than seven months for women on tamoxifen. Nearly 8 percent of the women in the exemestane group responded completely to the treatment, and nearly 40 percent responded partially. On the other hand, only about 3 percent of women in the tamoxifen group responded completely, and about 27 percent responded partially.

Researchers say exemestane was a safe and superior alternative to tamoxifen for women in the study. They say exemestane is known to provoke hot flashes and other menopausal symptoms in women, just like tamoxifen does. According to researchers, exemestane may also cause more muscular and joint aches than tamoxifen. However, women on exemestane may have a lower risk of blood clots and endometrial cancer.

Authors of the study say more research is needed to determine whether exemestane can be safely combined with chemotherapy. They say the drug may be a good first line treatment for postmenopausal women with breast cancer and may also be used as a preventive measure for high-risk women in the future.

SOURCE: 4th Annual European Breast Cancer Conference in Hamburg, Germany, March 16-20, 2004

No Safe Level of Alcohol During Pregnancy (March 17, 2004)

(Ivanhoe Newswire)

The cardinal rule of a safe pregnancy is to avoid heavy drinking. However, new research indicates that even light to moderate drinking should be avoided as it may interfere with learning and memory in children as late as adolescence.

"We have known for a long time that drinking heavily during pregnancy could lead to major impairments in growth, behavior, and cognitive function in children," says Jennifer Willford, Ph.D., from the University of Pittsburgh. She says, "This paper clearly shows that even small amounts of alcohol during pregnancy can have a significant impact on child development."

Researchers define light drinking as three or less drinks per week, and moderate drinking is more than three drinks a week, but less than one drink per day. These relatively low levels of alcohol consumption were associated with subtle difficulties with initial learning and memory and recall in 14-year-old children, specifically in the auditory/verbal area. The exposure to alcohol also caused growth delays in these children.

These deficits were specific to alcohol exposure during the first trimester of pregnancy and remained significant after other variables were controlled. The researchers say these cognitive deficits have important implications for intellectual potential, school achievement, and future cognitive abilities.

"There is no safe level of drinking during pregnancy and there is no safe time to drink during pregnancy," says Willford. "Women need this information before pregnancy recognition and their first visit to an obstetrician so that they may make better choices about drinking if they are planning to become, or think that they may be pregnant."

SOURCE: To be published in an upcoming issue of Alcoholism: Clinical & Experimental Research

Fight Fat and Cancer at the Same Time (March 16, 2004)

(Ivanhoe Newswire)

Is it a cancer drug that makes you lose weight? Or is it a weight-loss drug that fights cancer?

It may be both, report researchers from The Burnham Institute who used a sophisticated new scientific technique to look for all the ways a drug called orlistat, also sold as XenicalT, impacts the body.

It turns out the medication, which is known to keep the body from absorbing dietary fat and is used to treat obesity, also keeps prostate cancer cells in check.

Researchers say orlistat works similarly in both situations by targeting the activity of fatty acid synthase, an enzyme that turns the carbohydrates we eat into fat. Prostate cancer cells are also affected by this enzyme, which is why the drug works in both cases.

After identifying the positive impact on prostate cancer cells, the authors of the study screened breast and colon cancer cells and found they, too, were affected by the enzyme, suggesting growth of more types of cancer may be stopped by orlistat.

But the biggest news may be the scientific technique itself. Called activity-based proteomics, it allows researchers to quickly look at a drug to see everything it is up to in the body -- a fact that will help investigators pinpoint good side effects from medications along with the bad before they are tested in animals and humans.


SOURCE: Cancer Research, March 15, 2004

Pass the Yogurt (March 15, 2004)

(Ivanhoe Newswire)

New research suggests you say no to meat and yes to low-fat dairy if you want to avoid gout.

The study showed diets rich in dairy products and low in beef, pork, lamb and seafood may help protect against this painful condition. Gout results when too much uric acid builds up in the connective tissue and causes inflammatory arthritis.

The problem lies in the high purine content of many meats and seafood, report researchers in this week’s New England Journal of Medicine. Doctors have long suspected a link between purine-rich foods and gout, because uric acid is formed when purines break down in the body. But this is the first time investigators have actually found a definite link.

Results showed eating a lot of meat significantly raised the risk for men to develop the condition. Eating a lot of seafood made matters even worse. But men who ate high quantities of dairy products appeared to be protected from the disease.

Surprisingly, researchers say diets high in vegetables containing purine – such as peas, beans, mushrooms, cauliflower and spinach -- did not affect the incidence of gout.

So, if that carton of yogurt didn’t fill you up, pass up the steak and have some veggies instead.

SOURCE: New England Journal of Medicine, 2004;352:1093-11

Stress Of Losing A Child Increases Risk Of MS (March 15, 2004)

In Parents who lose a child have an increased risk of developing multiple sclerosis (MS), according to a study published in the March 9 issue of Neurology, the scientific journal of the American Academy of Neurology.

The study found that parents whose child died were 50 percent more likely to develop MS than parents who did not lose a child.

The results show that psychological stress may play a role in the development of MS. Researchers have believed that stress plays a role in MS, but this is the first study to examine a large group of people beginning before they developed MS and follow them for several years.

"We hypothesized that, if stress causes MS, only severe stresses are likely candidates, because MS is a rare disease," said study author Jiong Li, MD, MSc, of the University of Aarhus in Aarhus, Denmark. "The death of a child is one of the most serious stressors that occurs in a society with low infant mortality, so it serves as an objective indicator that can be studied."

The study found that the risk of developing MS was even greater for parents whose child died unexpectedly. They were more than twice as likely to develop MS as parents who did not lose a child.

"This is more evidence that stress plays a role in the disease, because losing a child unexpectedly is considered to be even more stressful for parents," Li said.

Li said the results could help researchers determine what processes in the body are affected by stress that could lead to MS. "This could help us better understand the disease process and, in the future, develop preventative treatments," he said.

The researchers used Danish national registers for the study. They identified all children under age 18 who died over a 16-year period and their parents. Then they identified 15 times as many parents who did not lose a child, randomly selected from the general population and with the same number of children in the family and of the same ages as the families that lost a child. There were 21,062 parents who lost a child and 293,745 parents who did not lose a child. People who had MS or suspected MS at the start of the study were not included.

The parents were followed for an average of 9.5 years. Over that time, 28 of the parents who had lost a child developed MS and 230 of the other parents developed MS. The risk of developing MS was the same regardless of the age or sex of the child who died. The risk was also the same regardless of the age or sex of the parent.

MS is a neurological disorder that affects young adults. The average age of diagnosis is 30. The cause is not known, but researchers believe that both a genetic susceptibility and environmental factors play a role.

The study was supported by grants from the Danish National Research Foundation, the Daloon Foundation, the Danish Cancer Society, and the Danish Multiple Sclerosis Society.

The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.

Is it Allergies? (March 15, 2004) 

NEW YORK (Ivanhoe Newswire)

In these days of rushed doctors' visits, nearly everyone has had the experience of forgetting to ask the doctor questions and forgetting most of what he does tell you. When it comes to childhood asthma and allergies, as the number of people affected grows so does this problem. Here is some important information your doctor may not tell you about these conditions.

Alex Arifi is a soccer player who, "plays with such skill," says his mother Dana Arifi. This soccer player's biggest opponent is not the other team, but severe asthma and allergies. "When I was little, it was pretty bad. I used to have a nebulizer that would be constant," says Alex. Today, his asthma has improved, but it's still always there. Dana says, "You learn to put controls in place, and you try to keep them safe."

Alex is knowledgeable, but, "Many sufferers have a lot to learn -- including the signs of allergies," says Paul Ehrlich, M.D., a pediatric allergist and asthma specialist in New York. Dr. Ehrlich says, "Children who get repeated infections and have recurrent respiratory infections have allergies."

Trouble sleeping is another sign. Then, there's the "allergic salute" where children quickly swipe their nose with their hand.

Dr. Ehrlich says most important is knowing family history and taking steps to avoid exposure when there's a high risk. Finally, he says when it comes to asthma, there's more to worry about than the lungs. "It's like a balloon. If you can take care of the balloon itself, but the tube where you blow into is not in good shape, you're not going to do well," says Dr. Ehrlick.

Alex never leaves home without his emergency kit and is careful about what he eats. Armed with those tools, allergies are no match for his will to be a normal kid. "If I'm stuck with these things the rest of my life, I'll just deal with them," Alex says.

Dr. Ehrlich also recommends that women who are breast-feeding and who have a family history of allergies should try to avoid highly allergic foods such as eggs, milk, nuts, fish, soy and wheat to prevent their children from developing these allergies.

If you would like more information, please contact:
Allergy and Asthma Network -- Mothers of Asthmatics
http://www.aanma.org

Ginkgo for MS -- Full-Length Doctor's Interview (March 15, 2004) 

In this full-length doctor's interview, Dennis Bourdette, M.D., explains how the use of Ginkgo may improve the cognitive disabilities suffered by many multiple sclerosis patients.
Ivanhoe Broadcast News Transcript with
Dennis Bourdette, M.D., Neurologist,
Oregon Health & Science University, Portland, Oregon, 

What prompted you to start this study with Ginkgo and multiple sclerosis patients?

Dr. Bourdette: The number one reason was we have no treatments for cognitive impairment in multiple sclerosis. This is a major problem for people with MS, and we were interested in trying anything that offered a reasonable hope of providing benefit. There is evidence that Ginkgo can help a modest degree of people who are suffering from Alzheimer's disease. The memory problems of MS are different from those with Alzheimer's, but we reason that if it benefits Alzheimer's patients, it may also benefit MS patients with cognitive difficulties.

Wasn't there also a smaller study with MS patients and Ginkgo that produced good results?

Dr. Bourdette: There was a smaller trial that came out of the University of California, San Diego, in people with MS suggesting Ginkgo would provide some benefit. This gave us added encouragement to proceed with designing this larger trial.

Do you know what the results were of the earlier study? How many patients were in that study, and how well were their cognitive abilities improved?

Dr. Bourdette: There were approximately 20 people with MS that were enrolled, and they noted about a 15-percent improvement when the patients were on Ginkgo.

What does improvement entail? Does that mean that they have better memories, or that they're better at completing tasks?

Dr. Bourdette: What we're hoping to see is improvement in the areas where people with MS commonly have difficulties. These areas are problems with their short-term memory, problems doing multiple tasks at once, and problems with attention and concentration. These are the source of problems that patients encounter with their day-to-day lives. We have objective psychological testing that can measure these different functions. We hope to see an improvement in functions of patients that are taking Ginkgo compared to those taking placebo.

Most people think of MS patients as people who have trouble walking, or someone who might be in a wheelchair. How many of these MS patients are actually affected with these cognitive difficulties?

Dr. Bourdette: Sixty percent of people with MS develop significant cognitive problems. This is often one of the more troubling symptoms. It is the number one reason that these people are unable to be employed. We'll see people, for instance, who have terrible MS affecting just their spinal cord. They are paralyzed and in a wheelchair, but it hasn't affected their brain, and so they have normal cognitive functions. Those people are very often employed and have no major disruption in their social activities. We see others that have a lot of MS affecting their brain but not their spinal cord. They walk normally, but they have significant cognitive difficulties. These people are actually more disabled in that they can't work, and there is disruption in their family and social life. It's a major problem, and neurologists just recently recognized this as a significant problem.

So it doesn't necessarily follow that if you have MS you are eventually going to have cognitive difficulties?

Dr. Bourdette: Absolutely. The best predictor of cognitive impairment in MS is how much of the brain is involved with MS. This prediction is based upon looking at an magnetic resonance imaging scan of the brain. It allows us to visualize the brain and helps assess how much damage MS has caused.

What is actually happening to the brain? What is MS doing to the brain to affect those cognitive abilities?

Dr. Bourdette: The brain and the spinal cord operate by neurons interacting with one another, and they do so by sending electrical wires between each other. The electrical wires are coated with an insulating-type material called myelin. The myelin has electrical wires themselves, which become damaged in bits in the spinal cord. It is that destruction that leads to disability. And we are actually able to visualize these spots in the brain where this destruction has occurred.

Seems like the patient is having the myelin and nerve impulses eaten away so that there's no connection?

Dr. Bourdette: It's like a very complex electrical system; if the electrical wires are being destroyed this can block electrical impulses going down the electrical wire. The electrical wires themselves can be severed, which, of course, permanently blocks the ability to conduct electricity.

Have you seen any preliminary results from this where patients were actually experiencing better cognitive abilities because of taking the Ginkgo?

Dr. Bourdette: This study is a double-blind placebo-controlled trial. Half the patients are given placebo, and the other half is given Ginkgo. All of us that are evaluating the patients are blind as to which patients received what. So we really don't know at this point. I have had some patients with cognitive difficulties, outside of this study, take Ginkgo and report that its provided them benefit. But we really need to complete this study to determine whether or not that's true.

What is it in the Ginkgo that is supposedly improving cognitive ability? And how did someone figure out that you could take these leaves from a Ginkgo tree and help improve your mind?

Dr. Bourdette: Ginkgo has been used for about 1,000 years to improve cognitive performance. There are ancient medical reports of that. It has been used in a number of trials in Alzheimer's disease, particularly in Europe, suggesting benefit. Ginkgo's composed of a large number of different chemicals, and it's not really clear which of those chemicals is the active agent. One big class of those agents, however, is antioxidants. Oxidative injury is important in MS and some of the products that cause oxidative injury can also interrupt electrical activity among the nerves. It's quite possible that the Ginkgo works by dampening down and blocking these chemicals that are interfering with the electrical transmission, and therefore improves electrical transmission and performance.

How long is this study?

Dr. Bourdette: We should have results within a year. If this was a drug and we were doing an FDA- approved trial, then this would be classified as a phase two trial. If we get positive results we'll seek funding to do a much larger multi-center trial to firmly establish that its effective.

How many patients are in the trial?

Dr. Bourdette: There are 60 patients -- 30 patients taking Ginkgo, and 30 patients taking placebo. They are on treatment for three months, and we are studying them for four months. The patients get tested on their cognitive functions on three separate occasions.

Are there any harmful effects of Ginkgo?

Dr. Bourdette: In general no. The one concern or potential side effect is that another set of the chemicals in the Ginkgo leaf interferes with platelet function. Platelets are involved in blood clotting. So there have been reports in a few elderly patients taking Ginkgo of bleeding problems in the brain. That has not been demonstrated in younger individuals. Thus far, we have not seen any evidence of side effects in our study, or evidence of platelet dysfunction.

Some MS patients who hear this might go out and get Ginkgo. Is that something that you would suggest at this point considering it's not regulated? Is it something that is worth a try?

Dr. Bourdette: At this point we really don't have good data to be advocating the use of Ginkgo.

When your patients come in and they're not on the study, do you tell them that the use of Ginkgo is something that's worth a try or do you dissuade them? What is your advice to your own patients?

Dr. Bourdette: We've done a survey here in Oregon, which indicates 20 percent to 25 percent of Oregonians with MS are taking Ginkgo, with or without their physicians recommending it. If I were asked about trying it, I would tell my patients it is safe. I don't have any objection as a physician to anyone trying it. But I would also tell them that it is still being studied.

You stated that there is nothing on the market for the improvement of cognitive abilities in MS patients, so are you encouraged that this might be something? Is there any evidence you have right now that you could say this is encouraging news?

Dr. Bourdette: The only evidence I have are a few of my patients who've taken Ginkgo on their own and have said it helped them. We have the small trial from UC San Diego suggesting some benefit. In terms of our own scientific data, we won't know until we've analyzed it. To show that those individuals taking Ginkgo were doing better than those on placebo will take another year.

How many patients in the United States have MS?

Dr. Bourdette: Three hundred thousand to 500,000 patients.

What are the other symptoms that you might see in an MS patient besides the cognitive disabilities?

Dr. Bourdette: These patients can lose vision in one or both eyes; they can have problems with double vision, problems walking due to poor balance or leg weakness, and problems with bladder control, or use of their hands.

What led you to the point that you wanted to invest so much time and energy in this study?

Dr. Bourdette: This is an important problem and we have nothing to offer patients with MS that are suffering from cognitive impairment to help improve their performance. It's very important that we pursue any avenue for which there is a reason to believe that it might be beneficial.

Winter Babies Beware (March 15, 2004) 

(Ivanhoe Newswire)

People born in the winter season could have reason to worry about their health.

A new study in the journal Heart shows babies born during cold weather are more likely to develop coronary heart disease, insulin resistance, high cholesterol levels, and lung problems later in life.

Researchers from the University of Edinburgh studied the outdoor temperature of birth dates for nearly 4,200 women between ages 60 and 79 years. Women born during the coldest months were found to suffer from coronary and bronchial disease.

Another strong correlation was that women afflicted with heart disease were raised in lower income households. Their fathers were more likely to be unemployed or considered to be blue-collar employees.

The authors write, "Our finding have some consistency with the theory that exposure to cold temperatures around the time of birth leads to increased fat storage and insulin resistance, and thence to coronary heart disease in later life."

Researchers believe the conclusions of this study will help the public understand how the natural environment combined with social and economic factors can have an impact on a person’s health.

SOURCE: Heart; 2004;90:381-388

Behind High Blood Pressure (March 15, 2004) 

(Ivanhoe Newswire)

Trouble sleeping? High blood pressure? The link could just be your doctor.

A new study in the journal CHEST looked at the relationship between high blood pressure and sleep apnea. When Spanish researchers took sleep apnea patients who had been diagnosed with high blood pressure and tested them in a less stressful setting, one-third actually had normal blood pressure. Researchers attribute the high readings to the fact that patients get nervous in the doctor’s office, and their blood pressure rises.

When patients are in a more relaxed environment -- as was the case in this study -- blood pressure returns to normal.

But it is not all good news. The investigators also found patients with so-called “white-coat hypertension” had significantly more trouble falling asleep and longer periods of wakefulness during the night than similar patients with sustained high blood pressure. They also express concern that the connection between sleep apnea and white-coat hypertension could lead to flawed conclusions about the cause of each condition.

SOURCE: CHEST, 2004;125:817-822

Saving Lungs (March 15, 2004) 

NEW YORK (Ivanhoe Newswire)

This year more people will die of lung cancer than breast, colon and prostate cancer combined, making it the deadliest cancer there is. But there is good news. Lung cancer does not have to be a death sentence. If it’s detected early, it can often be treated successfully. Here's how one simple test can potentially save thousands of lives.

Elaine Oliver values the time she has with her family. For 30 years, Oliver smoked a pack of cigarettes a day. Like many smokers, she developed lung cancer. Unlike many, hers was found early.

Radiologist Claudia Henschke, Ph.D., says, “If you find it typically very late, and then the vast majority, some 90 percent or more, will die of it.”

Henschke, of Weill Medical College of Cornell University in New York, says low-dose computed tomography can make the difference. She says, “In a single breath hold, you get all the images from the top of your lungs all the way down to the bottom of your lungs, and that allows you to detect small cancers that are about the size of a grain of rice, rather than finding it when it’s the size of an apple or an orange.”

In fact, Henschke says nearly 85 percent of the lung cancers this 20-second test finds are detected in their most curable stages. “Eighty-five percent of them were missed on the chest X-ray," she says. "I think that you could reduce the deaths by some 50 percent is our best projection.”

Armed with information about lung cancer and a clean bill of health, Oliver has given up smoking and is ready to live a healthier life. She says: “Not having cigarettes, not eating the chocolate, I’m doing away with all my bad habits. I don’t know, they’re going to give me a halo, I think.”

Based on these findings, Henschke recommends anyone over 50 who smoked the equivalent of a pack a day for 10 years should be screened for lung cancer.

If you would like more information, please contact:
Lung Cancer Screening Program
(212) 746-1325

Got Vitamin D? (March 15, 2004) 

MIAMI (Ivanhoe Newswire)

Vitamin D is a powerful substance, but it's not really a vitamin. It's a hormone that our body makes on its own when sunlight hits our skin. We can also get it from the food we eat or the daily supplements we take. But many people do not get enough of this powerful vitamin, and there are risks to not having enough vitamin D.

Most people know the benefits of vitamins C and E, but what about vitamin D? Researcher Kerry Burnstein, Ph.D., a cancer researcher at the University of Miami, says it does a lot more than keep bones strong. "Vitamin D affects a variety of other tissues and organs, so vitamin D deficiency may put people at risk for several different diseases," Burnstein says.

A recent study shows women with high levels of vitamin D intake were 34-percent less likely to develop rheumatoid arthritis than those with low levels. A second study shows women taking vitamin D supplements had a 44-percent lower risk of multiple sclerosis. "Immune cells can be regulated by vitamin D. Since there appears to be an immune component to diseases such as multiple sclerosis and rheumatoid arthritis, the thought is that maybe vitamin D can protect," Burnstein says.

Experts say people in northern states -- with less sunlight -- have higher risks of some diseases. Tom Beer, M.D., a medical oncologist at the Oregon Health & Science University in Portland, Ore., is studying vitamin D to fight prostate cancer. "In the lab, vitamin D by itself has activity against cancer," Dr. Beer says. He found about 80 percent of men with prostate cancer responded to vitamin D when combined with chemotherapy.

Glen Bartz has prostate cancer, and he says, "When I started the treatment, my [prostate-specific antigen] was 18.7. "After treatment, Bartz's level dropped to nearly zero, which shows a return to health.

Burnstein says vitamin D deficiency puts people at higher risk of prostate, colon and breast cancer. So how can you ensure you're getting enough? "It really takes only about 15 minutes of sun -- nothing near what would give you a sunburn," says Burstein. But don't worry, if that seems impossible to get, 400 international units of vitamin D a day will also work.

Those 400 units a day are for adults under 70. Children need less and people over 70 should take 600 international units a day. Burnstein says it's extremely difficult to get so much vitamin D from the sun or supplements that it causes harm. Vitamin D deficiency may also put people at higher risk for type one diabetes and high blood pressure.


If you would like more information, please contact:
Omar Montejo
Director of Media Relations
University of Miami School of Medicine
omontejo@med.miami.edu

Quit Smoking Without Gaining Weight (March 11, 2004) 

(Ivanhoe Newswire)

Quitting smoking is often a double-edged sword. It means improved health, but many also gain weight. Now, new research shows a drug may help smokers successfully target both of these problems.

Researchers from the University of Cincinnati College of Medicine studied nearly 800 smokers. Patients received either the drug rimonabant, which goes by trade name Acomplia, or a placebo.

Participants who took 20 milligrams of the drug were twice as likely to quit smoking than those on placebo. Nearly 40 percent of this group quit smoking for a prolonged period, while only about 20 percent on placebo experienced the same success.

Researchers say overweight patients lost weight while taking the drug. Overweight smokers who took 20 milligrams of rimonabant lost about one pound, while those on placebo gained about two pounds. Obese smokers also lost more than a pound while on the drug, compared to obese smokers in the placebo group who gained nearly three pounds. Researchers say normal- weight smokers kept their weight consistent while on the drug.

Authors of the study conclude, “Since these two studies show that rimonabant treats obesity and related metabolic disorders in overweight/obese patients, and also helps people to quit smoking without significant post-cessation weight gain, we may have a very promising approach for managing two major and preventable risk factors for cardiovascular disease with one and the same drug.”

SOURCE: American College of Cardiology’s 53rd Scientific Sessions in New Orleans, March 7-10

Breaking News on Breast Cancer (March 10, 2004) 

(Ivanhoe Newswire)

Postmenopausal women with breast cancer seem to fare better on a drug other than tamoxifen. A new study shows exemestane -- a hormonal therapy -- may be more effective than the gold standard drug tamoxifen two to three years after patients begin treatment.

Researchers from London studied more than 4,000 women who were taking tamoxifen for two to three years. Patients were assigned to either continue with tamoxifen therapy or to start on exemestane. Exemestane is a drug that helps reduce the amount of estrogen produced in the body.

Results show after about two and a half years, nearly 270 women in the tamoxifen group had their cancer recur or spread, while only about 180 women in the exemestane group met the same fate. Researchers say women in the exemestane group had about a 30-percent reduction in risk of recurrence.

The overall survival rates between the two groups were not significantly different. However, researchers say more than double the number of patients in the tamoxifen group developed breast cancer in the opposite breast.

Authors of the study conclude, “Exemestane therapy after two to three years of tamoxifen therapy significantly improved disease-free survival as compared with the standard five years of tamoxifen treatment.”

SOURCE: New England Journal of Medicine, 2004;350:1081-1092

Coffee Cuts Diabetes Risk (March 10, 2004) 

(Ivanhoe Newswire)

New research shows consuming more coffee may lower a person’s risk of developing type 2 diabetes.

Researchers from the National Public Health Institute studied more than 14,000 men and women living in Finland -- a country with the highest coffee consumption per capita in the world.

Researchers found the risk of developing diabetes decreased as daily coffee intake increased.

Women who drank between three and four cups of coffee a day had a nearly 30-percent reduced risk of diabetes. Those who drank 10 or more cups a day had a nearly 80-percent reduced risk of developing the disease.

Men who drank between three and four cups of coffee a day also had a nearly 30-percent reduced risk of diabetes. Men who drank 10 or more cups had a 55-percent lower risk.

Coffee is the most consumed beverage in the world, and researchers say they are uncertain why it lowers diabetes risk.

The authors conclude, “This study revealed unequivocal evidence for an inverse and graded association between coffee consumption and type 2 diabetes, independent of other risk factors for type 2 diabetes.”

SOURCE: Journal of the American Medical Association, 2004;239:1213-1219

Fertility After Cancer (March 9, 2004) 

(Ivanhoe Newswire)

Help may be right around the corner for women who suffer from infertility caused by cancer treatments. A new study shows a technique may help these women gain back their fertility -- even after going into menopause.

Cancer treatments such as chemotherapy, radiation and radical surgery can cause a woman to experience premature menopause and diminish her chance of getting pregnant.

Researchers from New York-Presbyterian Hospital/Weill Cornell Medical Center froze a 30-year-old woman’s ovarian tissue to determine if they could preserve her fertility. The woman suffered from breast cancer before experiencing chemotherapy-induced menopause. Researchers transplanted the tissue beneath the woman’s abdomen six years after she underwent cancer treatment.

The woman’s ovaries began to function again three months after the procedure. The woman also underwent in-vitro fertilization, which resulted in the development of a four-cell embryo. The embryo was implanted, but she did not become pregnant.

Researchers say their results are promising. Kutluk Oktay, M.D., lead author of the study, says: “This research represents a potentially significant reproductive advancement in two respects: First, women can preserve their fertility by freezing their ovarian tissue, and second, pregnancy may be possible even after the tissue remains frozen for a long time.”

An accompanying editorial warns that freezing ovarian tissue may pose risks. Johan Smitz writes, “In light of the current uncertainty about the effectiveness and safety of ovarian cryostorage and grafting, the whole procedure should still be presented as experimental to patients.” Smitz says more studies need to be conducted in order to assess the risks and benefits of the technique.

SOURCE: The Lancet, Published online March 9, 2004

Pregnancy Problem Boosts Cancer Risk (March 9, 2004) 

(Ivanhoe Newswire)

Women with a history of preeclampsia have future concerns to be aware of. New research shows the condition brings with it an increased risk of cancer of the stomach, breast, ovary, lung and larynx.

Israeli researchers compared the incidence of cancer among more than 37,000 women. The incidence of breast cancer was significantly higher for preeclamptic women. The risk of cancers of the stomach, ovary, lung or larynx were also significantly increased after adjusting for age. Researchers found women who went on to develop cancer were older and were more likely to be non-Jewish or of European origin. In addition, women of west Asian origin and lower social status were most likely to have preeclampsia.

Authors of the study suggest certain environmental and genetic factors may contribute to the development of both preeclampsia and cancer in Middle Eastern populations. Also, diet, insulin resistance, smoking or patterns of infection may be common initiators of both conditions. However, the evidence is inconsistent.

Preeclampsia is the condition of high blood pressure in pregnant women and is a common complication of pregnancy. Previous studies have shown either no association or have suggested a protective association between preeclampsia and cancer.

SOURCE: To be published in an upcoming issue of British Medical Journal

Seniors Underestimate Colorectal Cancer Risk (March 8, 2004) 

(Ivanhoe Newswire)

Advancing age increases the risk of cancer but researchers say that’s even more of a reason for seniors to pay attention to the factors that may increase that risk.

A new study published in the journal Cancer shows age-related factors, such as income, quality of life, and social support, may enhance the risk of colorectal cancer in older patients by creating barriers to healthy lifestyle changes.

Investigators used data from the Project Prevent study, a multicenter, randomized trial including more than 1,200 patients. It was designed to reduce behavioral risk factors for adults who had at least one colon polyp removed. Compared with middle-aged adults, researchers found older adults were less concerned about developing colorectal cancer risk, less motivated to reduce their risk, and less confident that their effort to change their behavior would succeed.

Older adults were also more likely to perceive that developing risk in their lifetime was unlikely or very unlikely. Researchers also found evidence for enhanced risk in older patients with multiple ailments, low social support, and perceptions of inadequate income.

Colorectal cancer is the second-leading cause of cancer deaths in the United States and the first leading cause among people ages 75 and older. Previous studies show the incidence of cancer in adults ages 65 and older is expected to double from 1.3 million to 2.6 million between 2000 and 2050.

Researchers say efforts to reduce the cancer burden in older populations will require attention beyond early detection and surveillance to interventions that account for the unique physical and psychosocial characteristics of older adults.

SOURCE: Cancer, 2004;100:1085-1094

Exercise As Good As Angioplasty For Some Heart Patients (March 8, 2004) 

(HealthDayNews)

Twenty minutes a day on an exercise bike is better and cheaper than angioplasty in easing the chronic chest pain called angina for people with narrowed heart arteries -- if they have the discipline to choose that alternative, a German study finds.

Cardiologists at the University of Leipzig gave men 70 years and older with stable coronary artery disease a choice between lifestyle changes, including the daily exercise program, or angioplasty, in which a flexible tube called a stent is implanted to maintain blood flow.

"If you ask such patients, about 30 percent are willing to make full lifestyle changes," says Dr. Rainer Hambrecht, a professor of medicine at Leipzig and leader of the group reporting the finding in the March 9 issue of Circulation.

Hambrecht and his colleagues got 101 men who accepted the offer. All had at least a 75 percent narrowing of one artery.

To test the effectiveness of the two approaches, 51 of the men had stents implanted, and the other 50 started an exercise program, spending 20 minutes a day on an exercise bike. The two groups were matched for major heart risk factors including blood cholesterol, blood pressure, smoking history and diabetes.

At the end of a year, 88 percent of the men who completed the exercise program had no heart attacks or other adverse events, while the event-free survival rate for the stented men was 70 percent.

And the exercise program saved money. Chest pain in the participants was graded on a three-class scale. The medical cost of a one-class improvement for men who got stents averaged $6,956, compared to $3,429 for those who exercised.

The benefits have persisted long since the official end of the study, Hambrecht says. "Over two years, and now five years, there has been a very high compliance rate, and the event rate is still significantly different," he says.

As a result, the exercise option is being offered to all patients who meet the study criteria at Lepizig, and the program has been expanded to five centers in Germany and other European centers, with further expansion planned, Hambrecht says.

It's a program that "makes excellent biological sense" for the kind of patients enrolled in the Leipzig program, those with narrowed coronary arteries but no major symptoms other than angina, says Dr. Richard A. Stein, chief of medicine at Beth Israel Medical Center Singer division in New York and a spokesman for the American Heart Association.

"For people with an unstable syndrome, angioplasty is beneficial," Stein says. "But it does not reduce the incidence of heart attacks; it changes them from fatal to nonfatal."

A heart attack happens when a fatty plaque in an artery ruptures, Stein explains, and invading the artery to put in a stent, while beneficial overall, can lead to rupture of a plaque.

Several programs using noninvasive tactics -- combining exercise with cholesterol-lowering drugs, for example -- have gotten good results in patients with stable angina, Stein says.

"But the major challenge is compliance," he says. "Generally, within six months of starting a program, half of the patients are no longer with you. By a year, you settle down to a third." The Leipzig approach of asking patients to volunteer led to better numbers, Stein says, since "the more you screen people for an initial level of enthusiasm, the more you predict compliance."

But for too many people, he says, the exercise bike "ends up being a good thing to hang clothes on."

More information

The cardiac benefits of exercise and the way to obtain them are explained by the American Heart Association, while the National Heart, Lung, and Blood Institute explains angina.


SOURCES: Rainer Hambrecht, M.D., professor, medicine, University of Leipzig, Germany; Richard A. Stein, M.D., chief, medicine, Beth Israel Medical Center Singer Division, New York City; March 9, 2004, Circulation

Losing a Child Increases MS Risk (March 8, 2004) 

(HealthDayNews)

Parents who suffer the death of a child are 50 percent more likely to develop multiple sclerosis than parents who don't go through that agony.

That's the conclusion of a Danish study in the March 9 issue of the journal Neurology.

The findings suggest psychological stress may play a role in the development of MS. While that belief is not new, this is the first study to examine a large group of people before they developed MS and follow them for several years.

The risk of developing MS was even greater for parents whose child died unexpectedly. The MS risk for those parents was more than twice that of parents who did not experience the death of a child, the study found.

"This is more evidence that stress plays a role in the disease, because losing a child unexpectedly is considered to be even more stressful for parents," study author Dr. Jiong Li, of the University of Aarhus, says in a prepared statement.

The study findings may help lead to a better understanding of what processes in the body are affected by stress and how that could result in multiple sclerosis, Li says. That could lead to development of treatments to prevent MS.

The study included 21,062 parents who lost a child and 293,745 parents who did not lose a child. The parents were tracked for an average of 9.5 years.

More information
The National Multiple Sclerosis Society has more about MS.

SOURCE: American Academy of Neurology, news release, March 5, 2004

Implant for Headaches (March 8, 2004) 

CHICAGO (Ivanhoe Newswire)

Most people know the pain of a headache, but for many, the symptoms come and go or are short-lived. But, there are some people who have constant, chronic headache pain that simply does not respond to standard therapy. Often brought on by a traumatic head injury or after brain surgery, there has been little to offer these patients, until now.

Thirteen years ago, Eric Phillips was on his way to being a lawyer. Then, a single flight of stairs changed everything. “The top step had ice, and I went straight over backwards," he says. "I wasn’t found for three hours, and when they found me, I had blood coming out of my ears and my nose.

I don’t have a personal recollection for two and a half years after that moment.”

Eric suffered a massive head injury. "My pain just got worse and worse, until I couldn’t stand it. I mean, it was so sharp, I didn’t know what to do. It was really hard to deal with life,” he says.

Eric's wife, Rebecca, says, “There were days that I was afraid I was going to lose him. Then, along came this answer.”

That answer came from Sandeep Amin, M.D., a pain specialist at RUSH University Medical Center in Chicago. “These are the patients who fall into this category of headaches that are extreme in nature. They’ve had them for a number of years, and no treatments have worked. It’s very common after brain surgery or after injuries," he says.

To relieve the pain, electrodes are connected to nerves that exit the brain. An implanted battery then sends signals through the neck to turn off the pain. Dr. Amin says: “Each nerve has a positive and negative charge to it, and by stimulating those nerves, you can kind of reverse the polarity of the nerves. In patients who are good responders, this is a lifesaver."

“Everybody said they could just see me all of a sudden just start smiling, my smile getting bigger, and my whole face relaxed,” Eric says. Rebecca says: “You could tell that for the first time in years, he was feeling comfort. That was an overwhelming experience, to see that.”

“It’s given me a whole new life," Eric says. "I feel like I started all over.”

Dr. Amin says this procedure is not meant for patients who have headaches for just a few months. It’s for patients who have had headaches for years and have been resilient to conventional treatments. He says some patients who have been diagnosed with migraine headaches actually have the type of headache that Eric has and could greatly benefit from this procedure.

If you would like more information, please contact:
Rush Physician Referral Service
(888) 352-RUSH
http://www.rush.edu

Acupuncture for Brain Cancer (March 8, 2004) 

LOS ANGELES (Ivanhoe Newswire)

According to the American Cancer Society, more than 18,000 people in the United States are diagnosed with brain cancer each year. Patients with this type of cancer typically undergo grueling treatments that bring on a long list of negative side effects. Now an alternative therapy may help some patients find relief.

Nearly 10 years ago, Evan Ross, L.Ac., was a record producer. Then, his life took an unexpected turn. He says, "In 1995, I was diagnosed with a grade four glioblastoma multiforme," a brain tumor that should have given him only months to live. He continues, "There is some percentage of people who are going to survive, so I just believed from the beginning, 'Why couldn't I be one of those people?'"

Ross did survive, and now, he's traded in music production for a new career as a board-certified acupuncturist. "I've had this experience. I've walked the path that they're on," he says. Now Ross is a doctor of Oriental medicine at Cedars-Sinai Medical Center in Los Angeles.

Bruce Gaetz was diagnosed with a brain tumor more than a year ago. He routinely comes to Ross for acupuncture. He says: "It's increased my energy level. It's taken away some of the side effects that the chemotherapy causes."

Acupuncture is also a stress reliever. The tiny needles lower blood pressure and release endorphins and chemicals like dopamine into the body to relieve stress. It can even induce hormones, which reduces swelling -- an inevitable result of brain tumors.

"If the cancer patients are doing a chemotherapy regime, we do the acupuncture a certain way. If they're having radiation, we do it a certain way. If they're on maintenance, we do it a certain way," Ross says. He says it helped him get through an aggressive chemotherapy treatment nine years ago. Today, it's helping Gaetz.

"I thought it was hocus-pocus. I never got into it before, but now I'm a believer," Gaetz says. And he says he'll keep coming to Ross until his body is healed.

Ross gets referrals from doctors and surgeons at Cedars-Sinai, UCLA, MD Anderson, Duke and other highly acclaimed research centers and universities. Ross also uses Chinese herbs, nutrition, breathing exercises and guided imagery to help his patients heal.

If you would like more information, please contact:
Cedars-Sinai Physician Referral Line
(800) CEDARS-1
American Academy of Medical Acupuncture
http://www.medicalacupuncture.org

Caring Kids (March 8, 2004) 

ORANGE COUNTY, Calif. (Ivanhoe Newswire)

More than 1 million people will be diagnosed with cancer this year. Many of those people will have children who often feel as if they're all alone when they learn of their parent's illness. Now, kids can help other children cope by offering pint-size shoulders to lean on.

A cancer diagnosis is an incredible burden for a 6-year old, but in this room, Lesley Smith knows she's not alone. This is Kids Konnected -- a support group run by kids for kids whose parents have cancer. "I needed to talk to kids who knew what it was like to have a parent with cancer," says Jon Wagner-Holtz, co-founder of Kids Konnected, in Orange County, Calif.

Wagner-Holtz was just 11-years-old when he asked 12-year-old Kelly Hill to help bring his idea to life. Both had mothers with breast cancer and no one to talk to. "I said, 'Yes, absolutely.' I had to go through this alone, and it was tough. I didn't want any other kids to have to do that," says Hill, co-founder of Kids Konnected.

With donations, they turned Kids Konnected into more than a support group. Today it throws parties, provides a summer camp, and runs a 24-hour hotline. Hill says: "We do want to be informed. Maybe we don't have to know everything, but do tell us something and on a level we can understand."

Wagner-Holtz and Hill went on to college, but with groups in several states, Kids Konnected lives on. "If your mom or dad died, they help you feel better," says Lesley Smith, who lost her mother to cancer.

These two are proof you don't always need a Ph.D. in psychology to provide support. The support groups always include a psychologist or social worker. For more information on starting a Kids Konnected program in your community, call (800) 899-2866. One other note, the two kids that started this program -- Wagner-Holtz and Hill -- both have mothers who are survivors of breast cancer.

If you would like more information, please contact:
Carol Reed, Executive Director
Kids Konnected
2701 Cabot Road
Suite 102
Laguna Hills, CA 92653
(800) 899-2866
http://www.kidskonnected.org

Inhaled Steroids Safe for Pregnant Women With Asthma, The drugs don't lead to low birth weight babies, a new study says. (March 8, 2004) 

(HealthDayNews)

Pregnant women prescribed inhaled steroids to control their asthma don't have to worry that the medications will limit their baby's growth in the womb, a new study says.

While pregnant women with asthma often are anxious about continuing to use their medication, the new research in the March issue of the Journal of Allergy and Clinical Immunology found the inhaled steroids did not lead to smaller-than-average babies in the nearly 400 women studied.

"None of our data points to adverse effects on intrauterine growth," says study author Dr. Michael Schatz, chief of the allergy department at Kaiser Permanente in San Diego.

The topic is important because up to 8 percent of pregnant women now have asthma, Schatz says. Going off the medications during pregnancy could result in abnormally low levels of oxygen in the mother-to-be, and that lack of oxygen could actually hurt the fetus, he adds.

Schatz's group evaluated 396 pregnant women from 99 different allergists' practices in 35 states, noting the type of medication each was taking, the dose, and then their babies' birth weights.

They found the incidence of infants with low birth weight, early births and birth defects was not greater than what is statistically expected in the general population, regardless of the dose used.

In the study, 7.1 percent of the babies were born at a low birth weight, below the 10 percent expected in the general population.

Schatz's team defined low birth weight as those babies who were in the less-than-10th percentile of weight for their age, compared to other infants the same gestational age.

Babies who are low birth weight are at increased risk for other health problems, Schatz says, including early death while still a newborn.

Previous studies evaluating asthma medications' effects on birth weight have produced mixed findings. And some studies have found pregnant women with asthma have an increased risk of giving birth early and of having infants with a low birth weight, compared to women without asthma.

Schatz's study looked at five inhaled steroids -- beclomethasone, budesonide, flunisolide, fluticasone and triamcinolone. Other experts endorse the new study.

"This study should, in fact, ease the worry of pregnant women," says Dr. Sheldon Spector, a clinical professor of medicine at UCLA's David Geffen School of Medicine. He was one of the 99 physicians who referred patients for the study.

The timing of the study is excellent, Spector adds, because inhaled steroids such as those evaluated in the study are now the "mainstay" therapy for persistent asthma.

It's also reassuring, Spector says, that a variety of inhaled steroids were evaluated, and no association was found between any of them and low birth weight babies.

Dr. Frank Virant, a clinical professor of pediatrics at the University of Washington, says, "I'd view this as a relatively positive study."

He advises pregnant women to choose budesonide and fluticasone because they are metabolized more rapidly than some of the other medications, so overall exposure is lower.

Schatz advises pregnant women with asthma to work with their allergy and asthma specialists and follow their advice about whether they need to take inhaled steroid medications.

More information
To learn more about asthma treatment during pregnancy, visit the American Academy of Allergy Asthma & Immunology. For more on asthma, see the American Lung Association.

Vitamin Keeps Stroke Patients Alive (March 8, 2004) 

(Ivanhoe Newswire)

Folic acid helps women reduce their risk of birth defects. Now, new research shows the vitamin may also keep stroke patients alive.

In 1996, The Food and Drug Administration required enriched grains to be fortified with folic acid to help reduce the risk of neural tube defects in newborns.

Results of this study show the number of stroke deaths were 10 percent to 15 percent lower in the three years after the FDA required fortification, compared to the three years before fortification. In 1997, stroke death rates declined by about 1 percent per year, but after 1997, they declined by more than 4 percent per year.

Researchers say about 31,000 stroke-related deaths and about 17,000 heart disease-related deaths may have been prevented each year since fortification was implemented.

Folic acid lowers homocysteine levels. People with higher homocysteine levels are at an increased risk for stroke and heart disease. Lorenzo D. Botto, M.D., from the Centers for Disease Control and Prevention, says, “We think homocysteine somehow causes an insult on the vascular wall, weakening the vessel and making it more prone to damage.”

Researchers say their results show the reduction in homocysteine levels was associated with fewer deaths due to stroke and cardiovascular disease. Dr. Botto concludes, “If folic acid fortification is responsible for the improvement in stroke-associated mortality, the public health benefits are substantial.”

SOURCE: American Heart Association’s 44th annual Conference on Cardiovascular Disease Epidemiology and Prevention in San Francisco, March 3-6

Overweight Teens: An Expanding Generation (March 8, 2004) 

(Ivanhoe Newswire)

Researchers at the 44th American Heart Association’s Annual Conference say today's teenagers are gaining weight at twice the rate of their parents.

"We expected that today's teens would be somewhat more obese but were surprised by the magnitude of the change," says study author Patricia H. Davis, M.D., a professor of neurology at the University of Iowa.

Researchers in Iowa compared the body mass index, a measure of obesity, of 228 adolescents between ages 15 and 18 to the BMI of their parents. Both groups were analyzed at the same age, but 20 years apart. Studying teenagers and their parents allowed the researchers to remove some of the genetic components that could be responsible for the variability in obesity.

A BMI of normal weight is between 18.5 and 24.9. Between the generations, the BMI increased from 22.97 to 24.24 among boys, and 21.9 to 24.4 among girls. Therefore, the rate of weight gain during current teen years is double what it was 20 years to 30 years ago.

The study also shows cholesterol and blood pressure are more strongly related to obesity in teens today, putting them at greater risk for cardiovascular disease.

"Obese children are at higher risk for diabetes, strokes and heart disease later in life," says Dr. Davis. "If we don't do something about this disturbing trend, the health of the nation will decline as these children get older."

SOURCE: American Heart Association's 44th annual Conference of Cardiovascular Disease, Epidemiology and Prevention in San Francisco, March 3-6

Get Angry, Gain Weight (March 5, 2004) 

(Ivanhoe Newswire)

Teenagers who do not practice healthy anger or stress management may be at risk for weight gain.

Researchers from the University of Texas Health Science Center studied nearly 160 adolescents, ages 14 to 17, for three years. In addition to providing their body mass index, patients participated in the State-Trait Anger Expression Inventory, which measured different anger levels.

"Anger in" referred to the lack of expressing anger, while the aggressive way of releasing anger, by either yelling or slamming doors, was coined "anger out."

Researchers used the anger control score to calculate the level of maturity and healthy expression of feelings. They found adolescents who had healthy high levels of anger control scores also weighed less.

William H. Mueller, Ph.D., lead author of the study, says, "Unhealthy ways of expressing anger are associated with overweight. 'Anger control' is a healthy way of expressing anger."

He suggests further examination of factors leading to adolescent weight gain, not just limiting studies to diet and exercise.

"We need to look at the broader sociological picture. If they feel good about resolving interpersonal stress and learn to decrease conflict, these skills will spill over into their general lifestyle," Dr. Mueller says.

According to past research, stress can also lead to adolescent weight gain.

Research shows cortisol is released by the body in a "fight or flight" response to stress, and can sometimes remain at highly elevated levels. The secretion of cortisol triggers fat and carbohydrate metabolism for energy, as well as stimulating the release of insulin and heightening appetite.

In addition to weight gain, high levels of cortisol can also impair learning, memory and sleeping patterns in teens.

SOURCE: Presented at American Heart Association's 44th Annual Conference on Cardiovascular Disease Epidemiology and Prevention

Hormone Therapy and Colorectal Cancer (March 4, 2004) 

(Ivanhoe Newswire)

The short-term use of estrogen plus progestin, a combination treatment frequently used as hormone replacement therapy, is associated with a decreased risk of colorectal cancer in postmenopausal women, according to new study. However, the study once again identified more overall health risks than benefits of taking HRT.

In the Women’s Health Initiative trial, 16,608 postmenopausal women between ages 50 and 79 with an intact uterus were randomly assigned to .625 milligrams per day of estrogen combinations plus 2.5 milligrams per day of medroxyprogesterone acetate or a placebo. Researchers found 43 invasive colorectal cancers in the hormone group and 72 in the placebo group.

However, colorectal cancer in women who took estrogen with progestin was diagnosed at a more advanced stage than in women who took a placebo. Women in the hormone group had a greater number of positive lymph nodes and more frequent vaginal bleeding than those in the placebo group. Some bleeding was reported during the first year of the study by 58 percent of women the hormone group compared to 7 percent in the placebo group. Since rectal bleeding is usually an indicator of colorectal cancer, the vaginal bleeding may have delayed assessment and accounted for the higher incidence of advanced cancer in the hormone group. By the fourth year, the frequency of vaginal bleeding in the hormone group declined to less than 20 percent.

Investigators recommend wider implementation of bowel screening among postmenopausal women taking hormone therapy. Statistics show colorectal cancer is the second leading cause of cancer deaths in the United States.

SOURCE: New England Journal of Medicine, 2004;350:991-1004

Physical Side Effects of Breast Cancer Treatment (March 4, 2004) 

(Ivanhoe Newswire)

New research shows most women report good emotional and mental health immediately following primary treatment for breast cancer. However, they also report decreased physical functioning. This is especially true for women who have had a mastectomy or who have undergone chemotherapy.

Over the last 20 years, psychosocial research has examined the mental and physical experiences of newly diagnosed breast cancer patients and long-term breast cancer survivors. However, limited information exists on the health status and quality of life in women during the transitional period between the end of primary treatment and survivorship, when they must move beyond cancer and re-establish a normal life.

More than 550 women were enrolled in this study within one month after surgery. Women completed surveys to assess their quality of life, mood, physical symptoms and sexual functioning. The outcomes of the surveys were analyzed as a whole and also according to the type of treatment received -- mastectomy with and without chemotherapy and lumpectomy with and without chemotherapy.

The researchers found mood and emotional functioning to be similar among all women immediately following primary treatment. There was little evidence of depressed mood or of a negative effect. A wide variety of physical symptoms were reported among all patients such as hot flashes, night sweats, aches and pains, fatigue, forgetfulness and vaginal dryness. Women who had mastectomies reported the poorest physical functioning, and women who received chemotherapy reported the worst sexual functioning, regardless of the type of surgery.

"In general, oncology clinicians prepare women for the acute toxicities of breast cancer treatments [nausea, vomiting and fatigue], ... but clinicians have had only limited data on the physical and psychosocial sequelae of primary treatments," says lead author Patricia A. Ganz, M.D., of the University of California at Los Angeles. From this study, Dr. Ganz says it is clear that more attention must be paid to this transitional period for breast cancer survivors to be able to prepare for the possibility of physical side effects and yet look forward to emotional well-being.

SOURCE: Journal of the National Cancer Institute, 2004;96:376-385

Warning About Estrogen Therapy (March 3, 2004) 

(Ivanhoe Newswire)

The National Institutes of Health has advised women participating in the estrogen-alone portion of the Women’s Health Initiative study to stop taking their pills. Researchers say the estrogen pills do not reduce the risk of heart disease and can lead to an increased risk of stroke.

The NIH sent letters to all 11,000 postmenopausal women who participated in the study. Researchers say their results show
estrogen alone does not appear to increase or decrease the risk of heart disease as combination hormone therapy is believed to do. Estrogen also does not appear to affect a woman’s risk of developing breast cancer. Researchers say the hormone does appear to decrease the risk of hip fractures, yet, they found estrogen increases the risk of stroke, and preliminary data shows it may also increase the risk of dementia.

The finding that estrogen increases the risk of stroke is similar to what was found in the WHI study of estrogen plus progestin, which was stopped in July 2002. In that study, women who took estrogen and progestin had about eight more strokes for every 10,000 women per year than those on placebo. The previous study also showed estrogen plus progestin increased the risk of breast cancer, heart disease and blood clots.

Researchers from the NIH say subjecting healthy women to a possible increased risk of stroke is not acceptable. They say this is especially true if estrogen alone does not affect heart disease, which appears to be the case.

The current trial was expected to end in 2005. Researchers say they have enough data to assess the overall risks and benefits of estrogen. This arm of the study involved women ages 50 to 79 who had a hysterectomy.

Researchers say patients and doctors should weight the risks and benefits before using estrogen or estrogen with progestin to treat postmenopausal symptoms.

SOURCE: National Institutes of Health, March 2, 2004