Weight gain hurts breast cancer survival
Sat, 08 Dec 2007 01:38:00 GMTBy MARILYNN MARCHIONE, AP Medical Writer
Breast cancer patients might have a powerful incentive to avoid gaining weight: better odds of surviving the disease. New research suggests that for every 11 pounds a woman gains after being diagnosed with breast cancer, the chances of it proving fatal go up 14 percent.
The study is by no means definitive, but gives the strongest evidence yet that controlling weight — a good idea anytime in life — may be especially important after breast cancer.
"There was a significant trend between increasing levels of weight gain and higher mortality," said Hazel Nichols, a doctoral student at Johns Hopkins Bloomberg School of Public Health. "Lifestyle factors, the things you incorporate after a breast cancer diagnosis such as diet and exercise, do show potential to influence survival."
Nichols led the study and reported results Friday at an American Association for Cancer Research conference in Philadelphia.
Researchers started with 4,021 women in Wisconsin, Massachusetts and New Hampshire who had been diagnosed with breast cancer from 1988 to 2001. They gave information on their height, weight, family history and breast cancer risk factors during telephone interviews.
From 1998 to 2001, all survivors were mailed surveys asking for updated information on these factors and lifestyle habits like exercise and diet.
After an average of six years of followup since their diagnoses, 121 breast cancer deaths and 428 non-breast cancer deaths had occurred. For every 11 pounds of weight gain after diagnosis, the risk of death from breast cancer or other causes increased by 14 percent.
The link remained even after researchers took into account differences in age, menopausal status, smoking and the stage of disease when the women were diagnosed.
For women classified as obese by body mass index — a measure of weight and height — the death risk was more than twice that of women with a normal body weight.
The study was paid for by the Susan G. Komen for the Cure Breast Cancer Foundation.
"It's a large study, it was a very well-conducted study at several centers in the United States" by well-known researchers on this topic, said Joanne Dorgan, a breast cancer scientist at Fox Chase Cancer Center in Philadelphia.
Doctors have long known that women who are overweight when they are diagnosed with breast cancer have poorer prospects.
"They're more likely to relapse and to die of their cancer than women who are thinner," Dorgan said.
Previous research found that women who exercised after being diagnosed with breast cancer cut their chance of dying by as much as one-half, depending on how much exercise they did.
However, it is very common for women to gain weight after being diagnosed with breast cancer. One reason may be that chemotherapy can leave them tired and ill so they don't feel like exercising, Dorgan said.
The new work shows how important it is to get back on track and keep from gaining pounds over the long term.
"It still matters what your weight gain is after diagnosis," said Dr. Craig Thompson, director of the Abramson Cancer Center at the University of Pennsylvania.
NJ parents try to block vaccine mandate
Sat, 08 Dec 2007 01:38:28 GMTBy LINDA A. JOHNSON, Associated Press Writer
TRENTON, N.J. - Parents concerned about possible vaccine dangers and government intrusion are trying to block New Jersey from becoming the first state to require flu shots for preschoolers.
The Public Health Council on Monday is set to consider whether New Jersey should require flu shots as well as three additional vaccines. If approved, New Jersey would become the first state to require annual flu shots for children attending licensed preschool or day care centers.
State health department officials also want to require a pneumococcal vaccine for preschoolers, a booster shot to fight whooping cough for sixth-graders, and meningitis shots for school children as young as 11.
According to deputy health commissioner Dr. Eddy Bresnitz, the new requirements already have been approved by the state health department and Gov. Jon S. Corzine; they are expected to be rubber-stamped by the Council on Monday.
Bresnitz said the federal Centers for Disease Control and Prevention supports the new requirements and that public health officials in other states are watching and likely to follow suit.
Bresnitz said he's convinced the vaccines will reduce the incidence of the diseases, preventable hospitalizations, and the need for parents to stay home with sick children.
"It's a great day for public health in New Jersey," he said.
But some parents say there is inadequate proof the vaccines are safe and effective.
At a Statehouse news conference Friday, about a dozen parents protested the new requirements and urged people to call the governor's office to ask him to stop Monday's vote.
"This will be the first jurisdiction anywhere in the world to make the flu shot mandatory" for school attendance, said Jon Gilmore, a board member of Advocates for Children's Health Affected by Mercury Poisoning, or ACHAMP. He blames his 7-year-old son's autism on vaccines.
Bresnitz said he didn't know whether jurisdictions outside this country have required flu shots for school kids.
Parents on Friday also urged support for a bill that would give parents a right to "philosophical objection" to vaccine mandates. The bill has been sitting in a committee for four years without action.
"It is not right for the government and unelected councils to dictate what we put into our children," said Sue Collins, co-founder of the New Jersey Alliance for Informed Choice in Vaccination.
Corzine, asked about the mandates Friday, said he didn't "want to speak to the specifics."
Several parents noted that unlike other common vaccines, most of the influenza vaccine available contains mercury, a toxic heavy metal that has been widely blamed by parents as a cause of autism, despite the lack of any such evidence.
A few speakers also said there's no research showing that it is safe to give children all the vaccines required today — more than 30 for New Jersey children.
"They're really being treated as guinea pigs, and not all children can handle all vaccines," said Assemblywoman Charlotte Vandervalk, R-Bergen, sponsor of the philosophical objection bill.
The new vaccines New Jersey backs are recommended by the CDC, the American Academy of Pediatrics and other medical groups.
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On the Net:
New Jersey Alliance for Informed Choice in Vaccination: http://www.NJAICV.org
Minn. slaughterhouse workers fall ill
Sat, 08 Dec 2007 01:38:16 GMTBy MARTIGA LOHN, Associated Press Writer
ST. PAUL, Minn. - On the slaughterhouse floor at Quality Pork Processors Inc. is an area known as the "head table," but not because it is the place of honor. It is where workers cut up pigs' heads and then shoot compressed air into the skulls until the brains come spilling out.
But now the grisly practice has come under suspicion from health authorities.
Over eight months from last December through July, 11 workers at the plant in Austin, Minn. — all of them employed at the head table — developed numbness, tingling or other neurological symptoms, and some scientists suspect inhaled airborne brain matter may have somehow triggered the illnesses.
The use of compressed air to remove pig brains was suspended at Quality Pork earlier this week while authorities try to get to the bottom of the mystery.
"I'm still in shock, I guess," said 37-year-old Susan Kruse, who worked at the plant for 15 years until she got too weak to do her job last February. "But it was very surprising to hear that there was that many other people that have gotten this."
Five of the workers — including Kruse, who has been told she may never work again — have been diagnosed with chronic inflammatory demyelinating polyneuropathy, or CIDP, a rare immune disorder that attacks the nerves and produces tingling, numbness and weakness in the arms and legs, sometimes causing lasting damage.
New cases of CIDP occur at the rate of one or two per 100,000 people each year, according to Dr. P. James B. Dyck of the Mayo Clinic.
State health officials said there is no evidence the public is at risk — either from those afflicted or from any food leaving the plant, which supplies Hormel Foods Inc.
The working theory from two Mayo Clinic neurologists treating the workers: Exposure to pig brain tissue scattered by the compressed air triggered the illnesses.
"As we've investigated these patients, we have information that suggests very strongly that the immune system is activated very strongly in a very compelling way," said Dr. Daniel Lachance.
Compressed air could turn some brain matter into a mist that could be inhaled by workers, said Mike Doyle, a microbiologist who heads the University of Georgia's Center for Food Safety. Or the workers may have come into contact with something dangerous and then touched their noses or mouths, he said.
Scientists have yet to figure out if there is something in the brain matter that could be causing the symptoms.
"The hard part will be identifying the causative agent and associating that with the animal, showing that the animal carries it," Doyle said.
Minnesota Health Department spokesman Doug Schultz said the agency is looking into the theory but has not ruled out other causes. Kruse said the company has harvested pork brains on and off for years, depending on demand, but it's not known why workers began getting sick recently.
Quality Pork has not said what it does with the pork brains. Sold fresh and in cans, pork brains are fried and eaten in sandwiches or gravy in some parts of the country. But it is a small market, and the American Meat Institute, which represents most of the nation's pork processors, does not even track sales.
Exactly how many of the plant's 1,300 employees worked at the head table is unclear; Quality Pork's chief executive did not return calls. Kruse said there were 11 workers at the head table on any given shift, but the lineup changed because of turnover or because people were assigned other jobs.
In a rapid-fire process that is noisy, smelly and bloody, severed pigs' heads are cut up at the head table at a rate of more than 1,100 an hour. Workers slice off the cheek and snout meat, then insert a nozzle in the head and blast air inside until the light pink mush that is the brain tissue squirts out from the base of the skull.
Kruse, whose job was to remove meat from the back of the animals' heads, said she doesn't recall any spray or mist from the de-braining. The head-table workers were protected by safety glasses, helmets, gloves and belly guards, but none wore anything over their mouths or noses, she said.
Head-table workers are now required to wear plastic face shields and protective plastic or rubber sleeves, the Health Department said.
The use of compressed air to remove hog brains is relatively uncommon, according to industry officials. That's because many plants don't even remove them. And some of the processors that do extract brains simply split the hogs' skulls open.
Some of the biggest pork processors — Tyson Foods Inc., JBS Swift & Co. and Cargill Inc. — said they don't handle brains because the market isn't big enough. No pork workers at Tyson, Cargill or JBS Swift have reported symptoms similar to those of the Quality Pork employees, the companies said.
CIDP attacks the lining around the nerves, slowing or blocking the brain's signals to the muscles. But exactly what triggers the attack is unknown.
Victims can recover fairly quickly if the illness is caught early, said Dr. Kenneth Gorson, a neurologist at St. Elizabeth's Medical Center in Boston.
In advanced cases, treatment arrests the disease but doesn't reverse its effects, he said. Treatment involves infusions of immune globulin or a plasma-exchange technique that removes antibodies from the patient's blood. Another option is a steroid called prednisone.
American Meat Institute spokeswoman Janet Riley said: "We are watching the situation very closely and we've offered any help that the state health department would need. But certainly if facts came to light that justified the change in practices, you could imagine protecting the workers is critical."
Workers are worried, said Richard Morgan, who heads the union local at Quality Pork.
"The process has stopped, where they assume it was at," he said. "It could have been from something different. Nobody knows at this time. We can talk about gray matter till we're blue in the face."
WHO says victims dad also has bird flu
Fri, 07 Dec 2007 23:50:10 GMTBy AUDRA ANG, Associated Press Writer
BEIJING - The father of a Chinese man who died of bird flu has also been infected with the H5N1 virus that causes the disease, the World Health Organization reported Friday, saying it could not rule out the possibility of human-to-human infection.
Joanna Brent, a Beijing-based WHO spokeswoman, said the father began showing symptoms on Monday and was confirmed as having the virus on Wednesday. She said he has been hospitalized and is being treated.
"Because the possibility of human-to-human transmission cannot be ruled out, we will be monitoring this case closely," Brent told The Associated Press.
"If it is found to be easily passed between humans, we would be concerned," Brent said.
Brent said there was no evidence that the man had been infected by his 24-year-old son, who died on Dec. 2, but said the possibility could not yet be eliminated. Chinese news reports gave the man's age as 52. Both he and his son, who lived in the eastern province of Jiangsu, were identified only by their surname, Lu.
Brent said it was also possible that both men were infected by the same source, or that they were infected separately from different sources.
Jiangsu's Provincial Disease Control and Prevention Center said the son — China's 17th official fatality from bird flu — had not had any known contact with dead poultry, and there were no reported outbreaks of the disease in the province.
Brent said health authorities were monitoring another 68 people who were in close contact with the son, none of whom have so far shown symptoms of H5N1 infection. She said that seemed to indicate that it was unlikely that the virus was being easily passed between humans.
China has not confirmed any cases of human-to-human infection, although the sister of a Chinese boy who was diagnosed with H5N1 in 2005 later became sick and died. Authorities were not able to confirm whether the girl had been infected with H5N1.
Sporadic human-to-human transmission of the highly viral and hard-to-treat H5N1 flu strain has been reported in Hong Kong, Vietnam and Indonesia, but none of the cases have been proven, and officials determined there was no epidemiological significance because the spread was not sustained.
Despite that, Dr. David Nabarro, the U.N. official coordinating the global fight against bird flu, said last month that the risk of a worldwide human-to-human pandemic remains as great today as it was when H5N1 first gained intense media attention in mid-2005.
Bird flu in poultry and wild birds has since spread to 60 nations, but improved responses have limited it mainly to just six nations: Indonesia, parts of Bangladesh, Vietnam, Egypt, Nigeria and China.
Experts say the virus has not been able to commingle its genetic material with that of a human influenza virus and, in so doing, acquire the ability to be transmitted from person to person.
Most people killed by the disease so far have been infected by domestic fowl, and the virus remains very hard for humans to catch; about half the people infected die. But experts fear it could mutate into a form that easily spreads between people, sparking a pandemic that some have said could kill anywhere from 5 million to 150 million.
