Drug combo helps women with advanced breast cancer
Fri, 16 May 2008 05:25:06 GMTBy MARILYNN MARCHIONE, AP Medical Writer
A combination of two new-generation cancer drugs modestly delayed the time it took for cancer to worsen in a study of 300 women with very advanced disease who had stopped responding to other treatments.
It was the first test of these two highly targeted drugs, Herceptin and Tykerb. Both aim at a protein called HER-2/neu that is made in abnormally large quantities in about one-fourth of all breast cancers. Herceptin blocks the protein on the cell's surface; Tykerb does it inside the cell.
In the study, women getting the combo survived 12 weeks without their cancer worsening compared to eight weeks for those receiving Tykerb alone.
"Really blocking that pathway is an effective strategy. This gives us a new treatment option for patients," said Dr. Joyce O'Shaughnessy of Baylor-Sammons Cancer Center in Dallas.
She led the study and has consulted in the past for its sponsor, British-based GlaxoSmithKline PLC, which makes Tykerb. California-based Genentech and Swiss-based Roche Holding AG market Herceptin.
Side effects were more common with the combo — 5 percent had a modest decrease in pumping power of the main chamber of the heart compared to 2 percent of those taking only Tykerb. That side effect also has been seen with Herceptin.
Liver problems also have been tied to Tykerb, which is currently approved to be used in combination with the chemo drug Xeloda for breast cancer patients who have failed treatment with Herceptin and other drugs.
Results of the study were released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.
Tips on getting vitamin D for cancer prevention
Fri, 16 May 2008 01:01:07 GMTBy MARILYNN MARCHIONE, AP Medical Writer
Evidence is growing that vitamin D, which the skin makes from sunshine, is linked to lower risk of breast cancer and other cancers. But that doesn't mean it's good to get a golden tan — and certainly not a sunburn.
Vitamin D also is in certain foods and supplements, though the effectiveness varies. Here's the lowdown:
Q: How much sun should I get?
A: Many experts believe just 15 minutes a few times a week without sunscreen is sufficient and safe for most light-skinned people, but this is controversial.
Q: I'm black. Does my skin absorb enough ultraviolet rays to produce sufficient vitamin D?
A: In most cases, no. And some experts believe this may be one reason blacks have higher rates of cancer than whites. Nutrition specialists think vitamin D-3 supplements may be especially helpful for dark-skinned people. But you'll have to read the label to find D-3 — most multivitamins don't contain it.
Q: How much do I need?
A: Scientists think adults may need 1,000 international units a day, possibly 1,500 for cancer prevention. The government says 2,000 IUs is the upper daily limit for anyone over a year old. Any more can cause the body to retain dangerous amounts of calcium.
Q. What about food sources?
A. Vitamin D is in salmon, tuna and other oily fish, and is routinely added to milk. But diet accounts for very little of the vitamin D circulating in blood.
Q: For years, we've been told to use sunscreen. Shouldn't we be worried about skin cancer?
A: Sunscreen is advised for longer periods outdoors, to prevent skin cancer. Skin cancer is rarely fatal. Melanoma, the deadliest kind, accounts for less than 2 percent of cancer deaths. The risks posed by other, more common cancers is far greater.
More cancer patients having whole breast removed
Fri, 16 May 2008 01:03:38 GMTBy MARILYNN MARCHIONE, AP Medical Writer
A growing number of women with early stage breast cancer seem to be choosing to have the whole breast removed instead of just the cancerous lump, doctors are reporting.
Mastectomies were standard treatment until 1990, when studies showed that women whose cancers were small and confined to the breast did just as well if they had less radical surgery followed by radiation. That set a trend of more women choosing breast-conserving treatment.
Now, a study of about 5,500 women at the Mayo Clinic in Rochester, Minn., shows that mastectomies are on the rise. Doctors say there are signs this is happening elsewhere around the country, too.
"We really don't have a lot of data on why," said Dr. Julie Gralow, a cancer specialist at the University of Washington in Seattle. However, she said, it may be that newer tests like MRI scans are finding more cancers, or flagging so many suspicious spots that women want the breast removed just for peace of mind.
The study was released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.
In the Mayo Clinic study, about 45 percent of breast cancer patients chose mastectomies in 1997. That declined to only 30 percent in 2003, then started to rise. By 2006, 43 percent were opting for the more radical treatment.
The rise coincided with wider use in the clinic of MRI, or magnetic resonance imaging. Studies show it can detect far more breast abnormalities than ordinary mammograms but it also gives a lot of false alarms.
Women who had MRIs were more likely to choose mastectomy than those who did not have the test, although a rise was seen in both groups.
This could be because MRIs often find additional small tumors in the same breast that had been missed by mammograms, making the more aggressive surgery a better choice, Gralow said.
Women also may choose mastectomy to avoid the need for radiation treatment, which is strongly advised when only a lump is removed. Others may have had genetic testing suggesting they still faced cancer risk. And some may be swayed by better reconstruction techniques available after mastectomy.
However, "even the best reconstructed breast does not have the sensation of the natural breast," said Dr. Nancy Davidson, a cancer specialist at Johns Hopkins University in Baltimore and president of the oncology society.
The study was led by Dr. Rajini Katipamula and Dr. Matthew Goetz at the Mayo Clinic.
Study finds heart risks in young cancer survivors
Fri, 16 May 2008 01:03:12 GMTBy MARILYNN MARCHIONE, AP Medical Writer
Children who survive cancer face a much greater risk of heart problems later in life than their brothers and sisters who did not have cancer, new research shows.
Doctors have long known that certain chemotherapy drugs and radiation can harm the heart, but it has been seen as a relatively small price to pay for beating cancer. Cancer itself may damage the heart. And even though the risk was higher, heart problems still were relatively rare.
The study used a national registry to track 14,358 cancer survivors diagnosed in the 1970s and 1980s, when treatments were harsher than those commonly used today, and compared them to about 4,000 healthy siblings.
The survivors had one of eight forms of the disease, including leukemia, brain tumors, Hodgkin's or non-Hodgkin's lymphoma and kidney tumors.
Compared to their healthy siblings, they had five to 10 times greater risk of heart problems, ranging from clogged arteries to heart failure and valve disease.
The risk often showed up when they were still young adults — an age when few doctors would think to check them for heart problems. The survivors were diagnosed with cancer at an average age of 8, and their average age was 28 when the follow-up study was done.
There are about 270,000 childhood cancer survivors in the United States today, said the study's leader, Dr. Daniel Mulrooney at the University of Minnesota.
"They have to live with the health consequences of having had cancer and having been treated for cancer," he said.
Still, the incidence of problems was low: 2 percent had hardening of the arteries, 4 percent had heart failure, 1 percent suffered a heart attack and 4 percent had a valve problem.
Study results were released Thursday by the American Society of Clinical Oncology and will be presented at the group's annual meeting later this month.
Obesity contributes to global warming study
Thu, 15 May 2008 23:03:18 GMTBy Michael Kahn
GENEVA - Obesity contributes to global warming, too.
Obese and overweight people require more fuel to transport them and the food they eat, and the problem will worsen as the population literally swells in size, a team at the London School of Hygiene & Tropical Medicine says.
This adds to food shortages and higher energy prices, the school's researchers Phil Edwards and Ian Roberts wrote in the journal Lancet on Friday.
"We are all becoming heavier and it is a global responsibility," Edwards said in a telephone interview. "Obesity is a key part of the big picture."
At least 400 million adults worldwide are obese. The World Health Organization projects by 2015, 2.3 billion adults will be overweight and more than 700 million will be obese.
In their model, the researchers pegged 40 percent of the global population as obese with a body mass index of near 30. Many nations are fast approaching or have surpassed this level, Edwards said.
BMI is a calculation of height to weight, and the normal range is usually considered to be 18 to 25, with more than 25 considered overweight and above 30 obese.
The researchers found that obese people require 1,680 daily calories to sustain normal energy and another 1,280 calories to maintain daily activities, 18 percent more than someone with a stable BMI.
Because thinner people eat less and are more likely to walk than rely on cars, a slimmer population would lower demand for fuel for transportation and for agriculture, Edwards said.
This is also important because 20 percent of greenhouse gas emissions stem from agriculture, he added.
The next step is quantifying how much a heavier population is contributing to climate change, higher fuel prices and food shortages, he added.
"Promotion of a normal distribution of BMI would reduce the global demand for, and thus the price of, food," Edwards and Roberts wrote.
Malaysia considers teaching sex to graduates
Wed, 14 May 2008 06:58:54 GMTBy JULIA ZAPPEI, Associated Press Writer
KUALA LUMPUR, Malaysia - Malaysia's government is worried that high school graduates may not know enough about sex.
Authorities in the conservative, Muslim-majority nation are considering teaching sex education to teenagers when they undergo national service after leaving school, Abdul Hadi Awang Kechil, director general of the National Service Department, said Wednesday.
Ng Yen Yen, the minister who announced the proposal, was quoted by the national news agency, Bernama, as saying that sex education, including lectures about preventing AIDS, could shield youngsters from unhealthy activities. Ng's aide confirmed the minister made the comments Tuesday.
Tens of thousands of boys and girls who are typically 17 or 18 years old are selected at random each year to participate in the government's national service training.
The three-month mandatory program aims to instill discipline and patriotism through community service, military-style physical training in jungle camps and other activities.
Sex is often a sensitive subject in Malaysia, where unmarried couples can be fined for kissing and hugging in public.
The Cabinet approved guidelines to teach sex education in schools two years ago, but activists say it has not been implemented. Officials had suggested teaching students how to protect themselves from sexual predators, reckless behavior and sexually transmitted diseases.
Adeeba Kamarulzaman, president of the Malaysian AIDS Council, said Wednesday that students receive inadequate information about sex in public schools, which generally only teach basic facts about reproduction during science courses.
Sex education classes in national service could prove useful because many school teachers are too embarrassed to expound on sex-related topics, she said.
"Better late than never," Adeeba told The Associated Press. "It's a good opportunity. They are at the right age to be receiving this kind of education."
Health Tip Traveling During Pregnancy
Fri, 16 May 2008 03:47:08 GMT-- If you're planning to take a trip while pregnant, you should check with your doctor to be sure it's safe for you to travel. Unless you have complications with your pregnancy, most women can travel safely.
Here are some travel tips to keep you safe and comfortable during pregnancy, courtesy of the American Pregnancy Association:
- Travel during the second trimester is usually most comfortable -- after morning sickness has passed and the fatigue of the third trimester is still ahead.
- Wear comfortable, loose clothing and comfortable shoes.
- Take things to make you more comfortable, like a pillow from home and some snacks that satisfy you.
- If you're driving, stop to get up and stretch often and take plenty of bathroom breaks.
- Always take your prenatal records with you on the road.
- Be safe: Wear your seat belt and follow safety instructions for whatever transportation you use.
Drug ad effects on people need more study FDA
Thu, 15 May 2008 22:15:39 GMTBy Susan Heavey
ROCKVILLE, Maryland - Ads for prescription drugs need to be clear and direct and government needs to study the effects these ads have on consumer behavior, particularly among the elderly and minorities, a U.S. Food and Drug Administration panel of outside experts said on Thursday.
"It's about how it's understood and how it's used. It's impact," panel member Ellen Peters, a researcher from Oregon, said.
Data shows that advertisements for drugs prompt people to see their doctors, but it is not clear if consumers understand potential benefits and risks of the drugs being promoted by pharmaceutical companies.
Panelist Michael Goldstein, associate director at the nonprofit group the Institute for Healthcare Communication, told the FDA that it should find ways to tackle "the woefully inadequate evidence we have about what ... direct-to-consumer advertising is actually doing."
The FDA is seeking input from advisers as it prepares to report to Congress about how ads impact consumers, especially older people and children, blacks, Hispanics and other minorities.
Legislation that took effect in March allows the FDA to ask to review ads before the public sees them and to impose fines if an ad is misleading. It also empowered the FDA to study the effect of such advertising on the public.
Last year, 68,000 promotions including commercials and print ads, magnets and pens, were submitted to the FDA, according to Kristin Davis, deputy director for the FDA's Division of Drug Marketing, Advertising and Communications.
"In an ideal world we'd look at everything," she said, noting that staff levels make that impossible. Instead, the agency tries to target promotions, including ads, that are likely to have the biggest impact.
Drug companies spent nearly $29.9 billion in 2005 on advertising, free samples, and sales staff to promote brand name products, according to a study funded by the National Institutes of Health published last year.
More than $4 billion of that was spent on consumer ads compared to $429 million for ads directed at doctors.
U.S. lawmakers are investigating whether drug companies use marketing tricks to mislead consumers, especially through television commercials. Researchers have said drug companies use gimmicks such as small type, fast speech and flashy graphics to emphasize benefits and downplay risks.
Rep. Bart Stupak, the Michigan Democrat overseeing the House Energy and Commerce subcommittee investigation, wants drug companies to make commercials that are more clear or face tougher regulations and possible restrictions.
Vitamin D deficiency linked to breast cancer in new study
Fri, 16 May 2008 09:48:00 GMTWASHINGTON - Women deficient in vitamin D at the time of a breast cancer diagnosis are more likely to die or see the tumor spread, a Canadian study published in the United States has shown.
Patients low in vitamin D were 94 percent more likely to see their cancer metastasize and 73 percent more likely to die from it, compared to women with normal levels of vitamin D in their blood, researchers found.
And many of the 512 breast cancer patients participating in the research, published Thursday in the American Society of Clinical Oncology, had inadequate vitamin D to begin with.
Some 37.5 percent of the women were "deficient" in vitamin D and 38.5 percent had "insufficient" levels of the vitamin, which is considered key to bone health.
But investigators stopped short of recommending taking vitamin D supplements to reduce the risk of developing breast cancer or dying from it, saying more research needs to be done.
"We were concerned to find that vitamin D deficiency was so common in women diagnosed with breast cancer and that very low vitamin D levels adversely affected patient outcome," said Pamela Goodwin of the University of Toronto, lead author of the study.
"Our results need to be replicated in other clinical studies," she cautioned. "These data indicate an association between vitamin D and breast cancer outcome, but we can't say at this time if it is causal."
Researchers studied 512 women with a median age of 50 diagnosed with breast cancer in Toronto between 1989 and 1995. The women were followed until 2006, over a median period of 11.6 years.
Just 24 percent had adequate blood levels of vitamin D at the time of their diagnosis.
According to Goodwin, a normal level of vitamin D is 80 to 120 nanomoles per liter of blood. Less than 50 nmol/L is considered deficient.
In the group studied, 83 percent of those with adequate levels of vitamin D had not experienced metastases 10 years on, and 85 percent were still alive.
By contrast, 69 percent of women with low levels of vitamin D had not seen their cancer recur, and 74 percent were still alive, 10 years later.
Women deficient in vitamin D were more likely to develop breast cancer before the onset of menopause, to be overweight and to have high levels of insulin in their blood, the researchers said.
Their cancers were also more likely to be aggressive, they said.
Previous studies have shown a link between vitamin D and other types of cancer, notably prostate and colon cancer, as well as cardiovascular disease, Goodwin noted.
The chief source for vitamin D is sun exposure, since the ultraviolet rays of the sun trigger vitamin D synthesis within the human body.
Considered key to bone health, it is naturally present in very few foods, fish, beef liver and egg yolks among them.
But it is added to many foods in the United States, including milk and breakfast cereals, according to the National Institutes of Health.
American Society of Clinical Oncology
