Fewer breast patients may need chemo
Fri, 14 Dec 2007 03:14:15 GMTBy MARILYNN MARCHIONE, AP Medical Writer
SAN ANTONIO - Thousands of breast cancer patients each year could be spared chemotherapy or get gentler versions of it without harming their odds of beating the disease, new research suggests.
One study found that certain women did better — were less likely to die or have a relapse — if given a less harsh drug than Adriamycin, a mainstay of treatment for decades.
Another study found that a gene test can help predict whether some women need chemo at all — even among those whose cancer has spread to their lymph nodes, which typically brings full treatment now.
The findings are sure to speed the growing trend away from chemo for many breast cancer patients and targeting it to a smaller group of women who truly need it, doctors said Thursday at the San Antonio Breast Cancer Symposium, where the studies were reported.
"We are backing off on chemotherapy and using chemotherapy more selectively" in certain women, said Dr. Eric Winer of the Dana-Farber Cancer Institute in Boston.
The gene test in particular "will start changing practice nearly immediately," said Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston. "The results are compelling that this test ... helps select patients who will most benefit from chemotherapy."
Breast cancer is the most common major cancer in American women. More than 178,000 new cases are expected this year. Most are helped to grow by estrogen, and hormone-blocking medicines like tamoxifen are used to treat those.
Chemo usually is added if the disease has spread to lymph nodes — a situation faced by about 45,000 U.S. women each year. Doctors know that chemo won't help most of these women, but they have had no good way to tell who can safely skip its cost and misery.
Here's where Oncotype DX, a test that measures the activity of 21 genes and gives a score to predict a woman's risk of recurrence, comes in. Doctors have used it for several years to guide treatment for certain women with early breast cancers, especially those that not spread.
The new study, led by Dr. Kathy Albain of Loyola University in Chicago, looked at whether it accurately predicted chemo's benefit in 367 women whose hormone-driven cancer had spread to lymph nodes.
A decade after these women were treated, those who had low scores on the gene test were found to have had no benefit from chemo. Conversely, chemo did a lot of good for those with high scores.
Because 40 percent of the women scored low, it means that as many as 18,000 women each year might safely skip chemo.
The National Cancer Institute and the test's maker, Genomic Health of Redwood City, Calif., sponsored the study. Albain, Winer and Ravdin have consulted or been paid speakers for the company in the past.
Dr. Kelly Marcom, a Duke University cancer expert with no ties to the company, said the test would give valuable information to guide treatment for more patients in the future. He has used it on about 50 women in the last year.
"I've had it cut both ways" — ruling chemo in and out, Marcom said.
The test is expensive — $3,400 — though many insurers are paying for it because it can avoid even more costly chemo.
Albain plans to discuss using it with Andrea DeRosier, a 49-year-old health care administrator from suburban Chicago whose cancer has spread to a single lymph node.
When a surgeon said she likely would need chemo, "I remember thinking, 'Oh, that's terrible,'" DeRosier said. "I want whatever protocol is going to keep me alive," but not futile treatment, she said.
Chemo's side effects are getting greater attention. One drug commonly used for early breast cancer — doxorubicin, sold as Adriamycin and generic brands — is known to cut the risk of having a recurrence or dying, but raises the risk of heart problems and even leukemia.
Dr. Stephen Jones of Baylor-Sammons Cancer Center tested using Taxotere, a drug not linked to heart problems, in its place in more than 1,000 women with early breast cancer. After seven years, 87 percent of those given Taxotere survived, compared with 82 percent of those given Adriamycin. In addition, those given Taxotere were less likely to have had a recurrence.
The study was sponsored by Taxotere's maker, Sanofi-Aventis SA, a French company with U.S. offices in Bridgewater, N.J. Jones consults for the company.
A study in the New England Journal of Medicine in October showed that another drug, Taxol, does not work for the most common form of breast cancer.
These new studies should lead to less use of chemo, but there has been "intense" pushback from doctors, who fear giving up on a treatment that might help some patients, said Barbara Brenner, head of the advocacy group Breast Cancer Action.
"It's very hard to turn a ship like this," she said. "Adding things never takes much, but removing things takes a mountain of data from the medical community."
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On the Net:
Breast cancer meeting: http://www.sabcs.org
National Cancer Institute: http://www.cancer.gov
Minn. to ban mercury in beauty products
Fri, 14 Dec 2007 03:14:31 GMTBy MARTIGA LOHN, Associated Press Writer
ST. PAUL - The quest for thicker lashes and defined eyes should get safer on Jan. 1, when Minnesota bans mercury from mascara, eye liners and skin-lightening creams.
The state apparently is the first in the nation to ban intentionally-added mercury in cosmetics. When the law takes effect, Minnesota will have a tougher standard than the federal government, which allows small amounts of mercury as a preservative in eye makeup.
Retailers who knowingly sell mercury-containing cosmetics could face fines of as much as $700. Penalties could reach $10,000 for manufacturers who fail to disclose mercury on product labels, according to the Minnesota Pollution Control Agency.
"Mercury does cause neurological damage to people even in tiny quantities," said Sen. John Marty, the Democrat from Roseville who sponsored the ban. "Every source of mercury adds to it. We wanted to make sure it wasn't here."
The cosmetics provision is part of a larger ban targeting better-known sources of mercury, such as thermostats, barometers, industrial switches and medical devices. The law also covers toiletries, fragrances and over-the-counter drugs such as eye drops, nasal sprays, hemorrhoid treatments and antiseptics.
State pollution regulators said they don't know how many beauty products containing mercury are sold in Minnesota.
The new law is intended as a warning to cosmetics manufacturers not to use mercury, said John Gilkeson, with the state Pollution Control Agency's toxics reduction program. Enforcement will happen mainly when consumers complain.
"We clearly don't need this or want this," Gilkeson said.
No other state has specifically gone after mercury in cosmetics, said Stacy Malkan with the Campaign for Safe Cosmetics in Berkeley, Calif. Connecticut, Rhode Island and Louisiana ban products containing more than low levels of mercury, with some exceptions. New York and Illinois prohibit consumer products with mercury, such as figurines, toys and jewelry.
"Personal care products contain many problematic chemicals," Malkan said. "Many ingredients aren't listed on the labels."
Most makeup manufacturers have phased out the use of mercury, but it's still added legally to some eye products as a preservative and germ-killer, said John Bailey, chief scientist with the Personal Care Products Association in Washington. That group doesn't track mercury in beauty products and favors a national approach to regulating cosmetics, instead of laws that vary from state to state.
Federal law allows eye products to contain up to 65 parts per million of mercury. The exposure a person would get from a product used in small quantities around the eyes would not cause a problem, Bailey said.
"It's added at very low levels, and for good reason," he said.
Using eye makeup with mercury is unlikely to cause immediate health problems, but mercury accumulates in the body so consumers should avoid exposure whenever possible, said Carl Herbrandson, a toxicologist with the state Health Department.
"Mercury is bad, basically in all forms that get into the body," Herbrandson said.
Mercury can retard brain development in children and fetuses, who are most vulnerable to the metal's toxic effects. But mercury can also cause neurological symptoms in adults.
Mercury fumes can collect inside a jar of skin cream or a tube of mascara, and a person could inhale them when the container is opened, Herbrandson said.
Imported skin-lightening creams and soaps with high levels of mercury have been found in other states; they are illegal under federal law. Herbrandson said skin products with mercury are more dangerous than mercury-containing eye makeup because people apply larger quantities to their bodies.
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On the Net:
Minnesota mercury ban: http://ros.leg.mn/bin/getpub.php?typelaw&year2007&sn0&num109
CDC Suicides among middleaged spikes
Fri, 14 Dec 2007 03:55:22 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - The suicide rate among middle-aged Americans has reached its highest point in at least 25 years, a new government report said Thursday.
The rate rose by about 20 percent between 1999 and 2004 for U.S. residents ages 45 through 54 — far outpacing increases among younger adults, the U.S. Centers for Disease Control and Prevention reported.
In 2004, there were 16.6 completed suicides per 100,000 people in that age group. That's the highest it's been since the CDC started tracking such rates, around 1980. The previous high was 16.5, in 1982.
Experts said they don't know why the suicide rates are rising so dramatically in that age group, but believe it is an unrecognized tragedy.
The general public and government prevention programs tend to focus on suicide among teenagers, and many suicide researchers concentrate on the elderly, said Mark Kaplan, a suicide researcher at Portland State University.
"The middle-aged are often overlooked. These statistics should serve as a wake-up call," Kaplan said.
Roughly 32,000 suicides occur each year — a figure that's been holding relatively steady, according to the Suicide Prevention Action Network, an advocacy group.
Experts believe suicides are under-reported. But reported rates tend to be highest among those who are in their 40s and 50s and among those 85 and older, according to CDC data.
The female suicide rates are highest in middle age. The rate for males — who account for the majority of suicides — peak after retirement, said Dr. Alex Crosby, a CDC epidemiologist.
Researchers looked at death certificate information for 1999 through 2004. Overall, they found a 5.5 percent increase during that time in deaths from homicides, suicides, traffic collisions and other injury incidents.
The largest increases occurred in the 45 to 54 age group. A large portion of the jump in deaths in that group was attributed to unintentional drug overdoses and poisonings — a problem the CDC reported previously.
But suicides were another major factor, accounting for a quarter of the injury deaths in that age group. The suicide count jumped from 5,081 to 6,906 in that time.
In contrast, the suicide rate for people in their 20s — the other age group with the most dramatic increase in injury deaths — rose only 1 percent.
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On the Net:
Morbidity and Mortality Weekly Report: http://www.cdc.gov/mmwr
US cholesterol average is ideal at 199
Thu, 13 Dec 2007 22:22:19 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - Americans may be too fat, but at least their cholesterol is low. For the first time in nearly 50 years, the average cholesterol level for U.S. adults is in the ideal range, the government reported Wednesday.
Results from a national survey that included blood tests found the total average cholesterol level dropped to 199 last year. Experts consider 200 and lower to be ideal.
The growing use of cholesterol-lowering pills in middle-aged and older people is believed to be a key reason for the improvement, experts said. When the survey began in 1960, the average cholesterol was at 222.
While Americans have gotten much heavier since then, they've been able to lower their cholesterol with powerful drugs that carry few if any side effects. High cholesterol can clog arteries and lead to heart disease.
Doctors' groups have increasingly recommended more aggressive use of these drugs in patients seen to be at risk from heart disease. And screening has become common — two-thirds of men and three-fourths of women had been screened for high cholesterol in the previous five years, according to the Centers for Disease Control and Prevention.
The result? Cholesterol medications are the top-selling class of U.S. drugs, and sales have grown steadily from about $13 billion in 2002 to nearly $22 billion in 2006, according to IMS Health, a Connecticut-based consulting company that monitors pharmaceutical sales.
"There's been an explosion in the use of these medications, and appropriately so in the majority of cases," said Dr. Elizabeth Jackson, a preventive cardiologist at the University of Michigan Medical Center.
The CDC, which runs the cholesterol survey, collects data in two-year intervals. The new results are based on a national sample of about 4,500 people age 20 and older from 2005-06. The new level of 199 compares with 204 in 1999-2000.
Researchers also found that the percentage of adults with high cholesterol, 240 or higher, dropped to 16 percent, down from 20 percent in the early 1990s.
They also reported that the most pronounced declines were in men aged 40 and older and women 60 and over.
"These age groups are the ones most likely to be treated with medication," said Susan Schober of the CDC's National Center for Health Statistics and lead author of the report.
However, there was little change in cholesterol levels for other age groups, prompting some experts to suspect the news may not be all good.
"This is kind of incomplete information," said Dr. Roger Blumenthal, a Johns Hopkins University cardiologist.
Total cholesterol is a summary of HDL, or "good" cholesterol, and LDL, "bad cholesterol, and a measure of triglycerides, a form of fat. Obesity rates in teens and young adults have been shooting up, and it's possible they are experiencing gains in triglycerides and losses in beneficial cholesterol, said Blumenthal, who also is a spokesman for the American Heart Association.
"If you take away the people on medication, I don't think there's been as much of a meaningful improvement as we would like," he said.
Among the best-known prescription drugs for lowering cholesterol are Lipitor, made by Pfizer Inc.; Zocor, by Merck & Co.; and Pravachol, from Bristol-Meyers Squibb.
Another is Mevacor, a product Merck hopes to begin selling over the counter. However, federal health officials worry that some consumers can't be trusted to know if it's appropriate for them.
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On the Net:
National Center for Health Statistics: http://www.cdc.gov/nchs
UKOdd Summary
Thu, 13 Dec 2007 17:27:49 GMTLatvians seeking free Christmas trees anger rangers
RIGA - Latvian authorities have given residents something to cheer about when they invited them to cut their own Christmas trees for free -- only to be chased away by forest rangers. A Riga forestry agency said on Wednesday a state body had invited residents to cut their trees from forests located 50 km or more outside the capital, but people had instead descended on protected areas around the city.
China fines runners out of respect for sponsors
BEIJING - China has punished four of its athletes who failed to properly display a sponsor's trademark on their chests while running in the Beijing Marathon in October. The Chinese Athletic Association fined men's runner-up Ren Longyun 10,000 yuan in a decision made out of &;respect for the sponsor&;, it said on its Web site
Computer programme fakes chatroom flirting
MOSCOW - Internet chatroom romantics beware: your next chat may be with a clinical computer, not a passionate person, trying to win your personal data and not your heart, an online security firm says. A Russian website called CyberLover.ru is advertising a software tool that, it says, can simulate flirtatious chatroom exchanges. It boasts that it can chat up as many as 10 women at the same time and persuade them to hand over phone numbers.
Candidate secretly sniffs out voters
JECHEON, South Korea - If South Korean voters think they can scent victory when they go to the ballot box next week, they are absolutely right. A team of supporters of presidential frontrunner Lee Myung-bak has been secretly spraying a perfume called &;Great Korea&; at his rallies.
FIFA says bionic ball a big hit in Japan
TOKYO - A new &;bionic ball&; being tested at the Club World Cup in Japan could soon be a regular feature at FIFA tournaments, its developers said on Thursday. The technology, involving magnetic sensors that determine if the micro-chipped ball has crossed the goal line, has worked well so far, according to co-designers adidas and Cairos.
Pregnant? Backache? Thank evolution
WASHINGTON - Pregnant women may stand out a mile away with their characteristic backward-leaning stance, but that clumsy-looking position is a unique adaptation that evolved over millennia, anthropologists said on Wednesday. Pregnant pre-humans appeared to have stood the same way. And it may save women from even more back pain than they already have, the researchers report in this week's issue of the journal Nature.
Maradona wants tattoo of Chavez
BUENOS AIRES - Argentine football great Diego Maradona wants to add an image of Venezuelan President Hugo Chavez to his well-known collection of tattoos of leftist leaders. &;I'd like to get some sort of Chavez tattoo, really,&; Maradona told reporters on Wednesday ahead of a celebrity indoor football match.
Sting in the tail for ant aphrodisiac scheme
BEIJING - A Chinese company that raked in billions of yuan raising ants to make an aphrodisiac tonic has filed for bankruptcy, an official Web site said. Thousands of angry investors took to the streets of Shenyang, capital of Liaoning province, last month to demand help getting their money back from Yilishen Tianxi Group, besieging government offices and disrupting traffic.
China court orders baby mix-up pay-off 21 years on
BEIJING - A Chinese hospital has been ordered to pay 500,000 yuan to two families 21 years after they took home the wrong newborn babies, state media reported on Thursday. A woman surnamed Pan, who gave birth to twin boys at a hospital in Beijing in 1986, watched as her &;sons&; became less alike as they grew older, the Beijing Youth Daily said.
Icelandic teenage caller tricks White House
REYKJAVIK - A teenager says he convinced the White House he was Iceland's president and managed to schedule a call with George W. Bush but was found out before he got to talk to the U.S. president. &;My call was transferred around a few times until I got hold of Bush's secretary and managed to book a call meeting with Bush the following Monday evening,&; Vifill Atlason, 16, told Reuters.
