Archive for the ‘Cancer / Oncology’ Category

Earlier this month the US Preventive Services Task Force (USPSTF), an independent panel of respected experts in primary care and prevention, caused an uproar when they presented evidence that routine mammogram screening for breast cancer should not begin until the age of 50. The group based their recommendation on evidence showing that the “additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age”.  Essentially, the number of women we need to screen in order to extend one woman’s life is far higher for the group between the ages of 40 to 49 than for the group aged 50 to 59. However, current US Health and Human Services secretary, Kathleen Sebelius, issued a statement yesterday stating that there will not be any changes to government policy on mammography: screening mammograms should continue to start at the age of 40. [via Medical News Today]

Additional USPSTF recommendations include:

• Regular biennial screening mammography for women aged 50 to 74.
• No teaching of breast self-examination (BSE).
• There is not enough evidence to assess whether clinical breast examination (CBE) does more harm than good, beyond screening mammography in women 40 years or older.
• Current evidence is not enough to assess whether digital mammography or magnetic resonance imaging (MRI) would be better or worse than film mammography.

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The journal Cancer reports on a new study which shows that women previously treated for breast cancer have a higher risk of cancer recurrence if they have highly dense breasts. Women who were classified as having highly dense breasts had a 21% chance of cancer recurrence, compared to 5% among women with low-density breasts. Because of this the study authors suggest that women with highly dense breasts may benefit from additional therapies, such as radiation, after breast and lymph node surgery. [via Medical News Today]

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The FDA recently announced the approval of a second HPV vaccine for the U.S. market. Cervarix, manufactured by GlaxoSmithKline, is the sole competitor to rival vaccine Gardasil, produced by Merck & Co. The vaccines differ in the strains of HPV they guard against, but both will fight the two most common strains that cause 70% of cervical cancers. At the same time, however, the FDA also granted approval for Merck’s Gardasil to be used in preventing genital warts (not genital cancer) in boys and men ages 9 through 26. But, do our children need yet another vaccine? You be the judge. Both vaccines are expected to net their respective companies over $1 billion per year in the coming years. [via ABC News]

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A new law, which took effect last Friday, is allowing U.S. college students to take up to one year away from school for medical reasons while remaining on their family’s health insurance plan. “Michelle’s Law” is named after college student Michelle Morse who decided to remain a full time student, against the recommendation of her doctors, while undergoing chemotherapy for colon cancer because she could not afford to be dropped from her parents’ health insurance policy. Previously, students between the ages of 19-24 could continue their health coverage under their parent’s policy as long as they remained as a full-time student (12 credits). If they became too ill to continue as a full time student they would either lose their insurance or could continue their coverage under the C.O.B.R.A. portion of the parent’s policy for an additional premium. By law C.O.B.R.A. can be as much as 102% of the premium for up to 36 months; many families cannot afford this expense.  Michelle Morse was an aspiring teacher who died six months after she graduated from college at the age of 22. [via Businessweek]

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Some researchers believe the popularity of indoor tanning among adolescent girls in recent years may be behind a recent increase in melanoma rates among U.S. women aged 15-39. Melanoma is a dangerous type of skin cancer. This has prompted the FDA to recommend to indoor tanning operators that teenagers be limited to three or fewer sessions in the first week of tanning. However, a new study published in the Archives of Dermatology shows that only about 11% of operators followed these guidelines, and 71% of tanning bed operators said they would allow a teen to tan seven days a week. “Exposure to UV radiation from indoor tanning lamps has been linked with both melanoma and squamous cell cancer, and first exposure before age 35 years may increase melanoma risk by as much as 75 percent,” said the study authors. [CBS News]

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Since the introduction of their Gardasil vaccine (marketed for the prevention of cervical cancer in women), pharmaceutical giant Merck has been wanting to expand the vaccine’s use to include males. Currently, the vaccine is approved for use in girls and women between the ages of 9 and 26. If Merck has its way Gardasil will be used in boys and men ages 9 to 26 as well. In documents posted online, the FDA said the vaccine prevented genital warts in males 90 percent of the time. Based on this the FDA’s Vaccines and Related Biological Products Advisory Committee is supporting the use of Gardasil in males. However, it is unlikely that the use of the vaccine will prevent a significant amount of penile and anal cancers, compared with cervical cancer. Cancer of the penis and anus are extremely rare, with less than 2,000 cases reported annually. Gardasil was approved for women in 2006 and had sales over $1 billion last year. [via CBS News]

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A new study published in the Proceedings of the National Academy of Sciences may lead to exciting discoveries regarding prostate cancer. By analyzing samples of prostate cancers scientists discovered that 27% of them contained xenotropic murine leukemia virus-related virus (XMRV). XMRV is a virus that is known to cause leukemia and tumors in animals. Even though it has been found in association with human prostate cancer, there’s not evidence that it is the specific cause of the disease. However, it is an important question that needs to be answered. Another well-known virus that can cause human cancers is the human papilloma virus (HPV). Prostate cancer is the second most common cancer among men, after lung cancer, killing approximately 250,000 men annually. [via ABC News]

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I’ve had quite a number of patients come in lately for general check-ups because they will soon be losing their job-sponsored health insurance coverage. I commend them for coming in. After all, late is sometimes better than never. Therefore, for today’s post I’d like to share some tips on things you should consider when your coverage is about to end.

1. Get an annual physical exam, including a skin check for possible skin cancers. It could get pricey should you need a biopsy and subsequent treatment.

2. Get your routine tests done. Those over 50 years of age should get a colonoscopy every 10 years. Women over 40 should have an annual mammogram. Women should also get annual pap smears.

3. Know your numbers: check your blood pressure, cholesterol, basic chemistries, urine analysis.

4. If you’re a smoker, speak to your doctor about ways to help you quit. Quitting smoking greatly reduces your risk of cancers and cardiovascular disease.

5. Ask your doctor about your risk for osteoporosis. In general all women over the age of 65 should get a DEXA bone densitometry scan at least once.

6. Speak to your doctor about weight loss. Keeping your weight under control can reduce your risk of diabetes, heart disease, high blood pressure, osteoarthritis, and high cholesterol, among a multitude of other diseases.

7. Get a flu shot and update your vaccinations. For adults these may include hepatitis A and B, herpes zoster (shingles), Tdap, chickenpox. If you are aged 65 or older you should have a pneumovax vaccination as well.

8. Refill your medications. Depending on the medicine, it may be possible for your physician to give you more refills. Similarly, if you are diabetic make sure your doctor gives you plenty of refills for glucose testing supplies.

*There are always exceptions to the rules. These are only general guidelines. Speak to your doctor to find out what is appropriate for you.

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A report was released yesterday by the International EMF Collaborative entitled “Cellphones and Brain Tumors: 15 Reasons for Concern, Science, Spin and the Truth Behind Interphone.” Interphone was a multinational, government and industry-funded study that began in 1999 to determine whether cellphone usage increases a user’s risk of brain cancer. According to this current report, the Interphone study greatly underestimated brain tumor risk due to design flaws that included the exclusion of children and young adults in the study (the most vulnerable population), exclusion of those who died or were too ill to be interviewed due to their brain cancers, as well as the exclusion of many types of brain cancers. US Scientists that have endorsed this viewpoint, that the Interphone study had serious design flaws, include faculty at the University of Pittsburgh Cancer Institute, Columbia University, and the University at Albany. This report was sent to government leaders today by the International EMF Collaborative, who is urging all to take a second look at the public health implications of cellphone usage. [via Business Week]

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The FDA has released an analysis of electronic cigarettes which shows that they contain a variety of dangerous toxins, some of which are found in real cigarettes. E-Cigarettes are battery-operated devices, some of which are made to look like real cigarettes, complete with glowing red LED lights and simulated puffs of smoke. When turned on, they heat up a solution of nicotine in propylene glycol to deliver a fine mist of nicotine to the smoker. The problem is that many contain nitrosamines (the same carcinogen found in real cigarettes), as well as diethylene glycol, the poisonous ingredient in antifreeze. E-cigarettes are available at thousands of retail stores. Over this past year their sales have grown from about $10 million to $100 million, according to the Electronic Cigarette Association, the industry’s trade group. They come in a variety of flavors, including chocolate, mint and apple, which could make them appealing to children and adolescents. [via the Houston Chronicle]

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