Mold Patrol (March 29, 2004)
CLEARWATER, Fla. (Ivanhoe
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:
K-9 Mold Patrol
Owner and Certified Handler
(727) 463-MOLD (6653)
to Starve Your Fibroid Tumors (March 29, 2004)
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
Pays in the Obesity Battle? (March 29, 2004)
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
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)
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
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
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
SOURCE: Archives of Internal Medicine, 2004;164:623-628
Diabetes Patients Could Improve Health With Freebies (March 29, 2004)
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)
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,"
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)
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
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
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)
Many women at high risk of
developing breast cancer are not taking a drug that can reduce their risk by
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
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
Zinc? (March 25, 2004)
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
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
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
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)
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
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
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:
University of Pittsburgh Medical Center
Office of Public Affairs
Mom’s Habit is a Kid’s Disease (March 22, 2004)
SAN FRANCISCO (Ivanhoe
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
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
Better Care for Young Breast Cancer Survivors (March 19, 2004)
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
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
"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
SOURCE: European Breast Cancer Conference
Science Backs Tai Chi Benefits (March 18, 2004)
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
Drug Best bet for Breast Cancer (March 18, 2004)
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
SOURCE: 4th Annual European Breast Cancer Conference in Hamburg, Germany,
March 16-20, 2004
Safe Level of Alcohol During Pregnancy (March 17, 2004)
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 &
Fight Fat and Cancer at the Same Time (March 16, 2004)
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
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)
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
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
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
"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
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.
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
Ginkgo for MS -- Full-Length Doctor's Interview
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
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
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
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
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
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
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
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
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
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
NEW YORK (Ivanhoe
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
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
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:
Director of Media Relations
University of Miami School of Medicine
Quit Smoking Without Gaining Weight
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
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
SOURCE: New England Journal of Medicine, 2004;350:1081-1092
Coffee Cuts Diabetes Risk
New research shows
consuming more coffee may lower a person’s risk of developing type
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
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
SOURCE: Journal of the American Medical Association,
Fertility After Cancer
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
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
SOURCE: The Lancet, Published online March 9, 2004
Pregnancy Problem Boosts Cancer Risk
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
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
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
Seniors Underestimate Colorectal Cancer Risk
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
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
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
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."
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,
Losing a Child Increases MS Risk
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.
The National Multiple Sclerosis Society has more about MS.
SOURCE: American Academy of Neurology, news release, March 5,
Implant for Headaches
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
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
Acupuncture for Brain Cancer
LOS ANGELES (Ivanhoe
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
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
American Academy of Medical Acupuncture
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
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
2701 Cabot Road
Laguna Hills, CA 92653
Inhaled Steroids Safe for Pregnant Women With Asthma, The drugs
don't lead to low birth weight babies, a new study says.
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
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
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.
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
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
Heart Association’s 44th annual Conference on Cardiovascular
Disease Epidemiology and Prevention in San Francisco, March 3-6
Overweight Teens: An Expanding Generation (March
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
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
Angry, Gain Weight (March
Teenagers who do not
practice healthy anger or stress management may be at risk for
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
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
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
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
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
SOURCE: Journal of the National Cancer Institute,
Warning About Estrogen Therapy
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
SOURCE: National Institutes of Health, March 2, 2004