Articles filed under 'CANCER'
The FDA is re-evaluating its position as to the safety and effectiveness of LASIK surgery. Millions of Americans have had successful outcomes from LASIK, in which a laser reshapes the eye’s cornea and reduces or eliminates dependence on glasses or contact lenses. However, members of the U.S. regulatory agency on healthcare issues are currently considering the testimony of 140 patients who are complaining of serious side effects. These individuals had LASIK procedures performed between 1998 and 2006.
Approximately 700,000 Americans elect to undergo laser surgery for vision correction each year. The majority who are selected as appropriate candidates can see with 20-20 vision or better after vision correction surgery. Unfortunately, about 25 percent of those who consult LASIK surgeons for the procedure are not appropriate patients. Those persons should clearly understand the risks they are taking if they decide to proceed with LASIK, which generally costs about $2,000 per eye.
With the LASIK procedure, doctors cut a flap in the cornea, the eye’s clear covering, and aim a laser underneath it. The laser quickly and painlessly zaps and reshapes the cornea to achieve sharper vision. Cutting the corneal flap severs the nerves responsible for tear production. If these nerves heal well, dry eye is only temporary. Some individuals endure long-lasting dry eye and intense pain which can sometimes be improved by additional surgery to help the eyes retain moisture.
Those with overly large pupils, thin corneas, severe nearsightedness, or who have difficulty with dry eyes should not be considered good candidates for LASIK. Some surgeons can be faulted for not giving adequate information on potential problems and for not ruling out those who do not meet appropriate criteria for the surgery.
About 95 percent of patients who undergo LASIK are satisfied with their outcome. In the 5 percent or less who have poorer outcomes, it is unknown how many suffer with troublesome daily side effects. It is estimated that less than 1 percent have severe complications that leave them with poor vision.
Among the complaints aired at the hearings are reports of unremitting eye pain, blurred or double vision, painful dry eyes, and poor vision even using glasses. For others, their problems leave them unable to drive at night due to glare or fuzzy vision. Headlights from approaching cars may look like huge “starbursts” of light. In extreme cases, an individual may become despondent and resort to suicide. In one testimony, a father told of his son’s suicide note in which he described his deep depression over his reduced vision and years of intolerable side effects.
Among the suggestions the FDA is hearing: (1) use photographs to illustrate the effects of poor outcomes; (2) explain how often patients suffer from side effects such as dry eyes (almost half experience this condition even months after LASIK); (3) communicate clearly the conditions that should disqualify someone from having the eye surgery; (4) explain to young persons with extreme nearsightedness that they would be guaranteed to need reading glasses in middle age if they have the eye surgery. Without LASIK, they might avoid the need for glasses in later life, as eyes become more far-sighted with age.
Although the FDA agrees with eye surgeons’ studies indicating that only about 5 percent of patients are dissatisfied, they do not yet know how many individuals suffer lasting severe problems and how many simply didn’t have the degree of vision correction they expected.
Sources: San Francisco Chronicle, AP reporter Lauran Neergaard, 4/26/08;
Yahoo News, 4/25/08; Susan Heavey,
New York Times
April 27th, 2008
For those who have experienced chemotherapy, or watched their loved ones go through it, the idea of an effective cancer treatment with NO side effects seems like a dream come true. Dreams can be a long time in coming, however. The brain child of American inventor John Kanzius may one day be the answer to the prayers of cancer patients. First, his Kanzius Machine must be rigorously tested in laboratory animals before clinical trials are approved for cancer patients. Preliminary lab testing has shown great promise.
The potential new treatment that Kanzius envisioned was featured on CBS’ “Sixty Minutes” (April 13, 2008). In theory, it involves gold or carbon nanoparticles injected into the bloodstream or into a cancerous tumor. These metallic-laced nanoparticles, already FDA-approved, attract radio waves. Once the diseased cells are properly targeted, radio waves would heat them to an optimal temperature to eradicate them. The idea is to destroy cancer cells, leaving healthy cells undamaged. Nanoparticles are so tiny that trillions of them can be contained in a test tube. The chief problem is finding a delivery system in which the nanoparticles would bind only to cancer cells.
How did a man without a medical degree or credentials as a lab scientist come up with a revolutionary idea to treat cancer? Diagnosed with liver cancer six years ago, John Kanzius had endured thirty-six rounds of chemotherapy. During his treatments at a renowned cancer center, he was touched by the faces of young cancer patients, children with teddy bears, fighting for their lives. It was then that he vowed to try to find a better way to fight cancer.
One sleepless night, the retired radio and TV executive envisioned using radio waves to treat cancer. In his childhood, he had built radio sets. He understood that radio waves could harmlessly pass through a living organism but were attracted by metal. Once his primitive tests showed promise, the senior citizen built radio-wave equipment and conducted experiments in his garage. He invested $200,000 of his own money to build prototypes of his radio frequency (RF) equipment. Support and funding for his efforts have since materialized from many sources. His Kanzius RF Machines are now selectively placed in laboratories at the University of Pittsburgh and at MD Anderson Cancer Center in Houston, Texas.
At MD Anderson, Dr. Steven Curley, a surgical oncologist, began to work closely with Kanzius on his invention. Dr. Curley believes the potential treatment to be the most exciting new development he has seen in twenty years of working in oncology. Like an “ultimate weed killer” able to kill weeds without harming grass, the treatment is designed to destroy only the cancer cells. The ability to eliminate solid tumors injected with gold nanoparticles has already been demonstrated in rats and rabbits. The ultimate goal is to be able to target microscopic cancer cells that have circulated throughout the body. Curing metastatic cancers would not be possible without such a selective delivery system. If a way is found to precisely target and destroy only cancer cells, then the potential to cure many types of cancers is tremendous – and with no pain and distress.
John Kanzius is working with the Lee Memorial Health System in southwest Florida to coordinate tentative clinical trials after approval is granted. He hopes to live to see his dream realized some three or four years down the road.
Sources:
http://en.wikipedia.org/wiki/Kanzius machine; http://60minutes.yahoo.com/segment/159/the_kanzius_machine
April 17th, 2008
Some women in their 40s can still get pregnant without assistance from fertility clinics. That’s good news for those who have postponed motherhood, but for women who have completed their family, continuing fertility can be problematic. Today, the Pill and the IUD (intra-uterine devices) are both considered good options for some women in their fourth decade. These two methods are much safer than, for example, in the 1960s and 1970s. In the past, most women over age 40 underwent a tubal ligation (a fallopian tube-tying procedure), or relied on condoms or vasectomy with their male partner.
Sterilization is now easier for women, thanks to a non-surgical method of tubal treatment called Essure. The new technique was approved by the U.S. government in 2002. No cutting of the abdomen or tying of the tubes is involved. Instead, the doctor works through the cervix, using a thin tube to insert small devices into the ends of the fallopian tubes. These “plugs” in about three months produce scarring to block the woman’s tubes, thus preventing ovulated eggs from reaching the uterus.
Women over 40 should continue to use birth control until well into menopause. This age group has been shown to have high abortion rates, similar to those of adolescents. Under certain conditions, the Pill is now safe for “older” women. The dosage of estrogen in today’s Pill is greatly reduced and considered by many physicians to be a good alternative for lean, healthy women over 40. The Pill has other benefits besides contraception for appropriate women. It can help to control irregular menstrual bleeding and hot flashes, reduce hip fractures and cases of ovarian cancer. Yet, some physicians urge caution even in lean and healthy women who are approaching menopause.
If a woman over 40 is significantly overweight, has high blood pressure or diabetes, the Pill would not be a good option. For them, the chances of dangerous blood clots rise sharply. Middle-aged women who are obese, who smoke, have migraine headaches or other identified risk factors might instead consider IUDs or progestin-only treatments termed “mini-pills.” Although higher breast cancer rates have been found in older women taking estrogen-progestin pills to control menopausal symptoms, women 35 and older taking oral contraceptives have not shown an increase in breast cancers.
Another birth control product called Implanon, FDA-approved in 2006, is a matchstick-sized plastic rod that is implanted under the skin of the upper arm. Implanon is similar to the earlier Norplant and can last up to three years.
Today’s IUDs are safer and more effective than those used by women in the 1970s. The earlier Dalkon Shield version resulted in a number of serious medical problems due to its defective design. A large class-action lawsuit was filed and millions in payouts were made over the years. American women and their physicians are again considering the IUD as a simple and effective method of birth control.
Women should discuss with their OB-GYN physician their preferences for contraception, the appropriateness for their age group and their individual health risks. New options in birth control methods and technologies greatly reduce the risk of an unwanted pregnancy.
San Francisco Chronicle, Mike Stobbe, AP story, April 5, 2008
http://www.msnbc.msn.com/id/23954260/
April 8th, 2008
In recent years, several large studies have shown that quicker and cheaper “virtual colonoscopy” is a viable alternative to traditional colonoscopy. Although still considered “experimental” and not covered by most insurance for routine screening, the noninvasive X-ray procedure is available for those willing and able to pay the $1,100 cost. Traditional colonoscopy, the “gold standard” for many years, costs roughly $3,000.
Colonoscopy is recommended for persons 50 and over, but most don’t get them unless they are symptomatic. Instead, a sigmoidoscopy may be offered which checks only the lower bowel or intestine by inserting a flexible tube. Perhaps the most unpleasant part of any technique to explore the colon for polyps is drinking laxatives or using enemas to purge the bowel before the procedure.
Colon cancer is the second leading cause of cancer death in the U.S. and is largely avoidable by detecting and removing small polyps before they grow and become cancerous. Each year about 52,000 Americans die of the disease.
The latest study compared two groups of approximately 3,000 persons in each group. One group received traditional colonoscopy and the second one the virtual procedure. Approximately the same number of advanced polyps were found in each group (123 compared to 121).
With virtual colonography, a CT scanner takes a series of X-rays of the colon and creates a computerized 3-D image. A small tube is inserted in the rectum to inflate the colon for better viewing. There is no sedation or recovery time. If polyps are seen, they cannot be removed using this technique. Any significant polyps are then removed the same day using a traditional colonoscopy.
In traditional colonoscopy, a gastroenterologist uses a flexible, thin tube and snakes it through the large intestines. Any polyps spotted are removed in the process. There is a tiny risk of a perforated colon using the traditional procedure, and prompt surgical repair is needed.
The virtual colonoscopy avoids sedation and the risk of colon perforation, but the patient is exposed to radiation. In addition, small, benign polyps cannot be removed. They must be watched and will need to be removed if they grow significantly or become malignant.
If colon cancer screening guidelines are changed as is expected, virtual colonoscopy may be covered by insurance companies in the future. The less invasive procedure may encourage more patients to get checked when they should. Usually, intervals of ten years between examinations are recommended if no polyps are found.
Source: MSNBC
October 8th, 2007
A large study conducted over 24 years at Kaiser Permanente Medical Care Program in Oakland, California, concluded that having three or more alcoholic drinks a day can increase a woman’s risk of breast cancer by 30%. Those who drank one to two drinks per day had an increased breast cancer risk of 10%. Women who drank less than one drink per day showed no significant increased cancer risk. According to researchers at Kaiser, the risk of heavy drinking is roughly equivalent to smoking a pack of cigarettes a day or taking estrogenic hormones well beyond the menopause.
Of the 70,033 multi-ethnic women who supplied information during their health exams between 1978 and 1985, roughly 3,000 of them had been diagnosed with breast cancer by 2004. It mattered not what type of alcohol was consumed – wine (red or white), beer, or spirits – the end result was the same. Results were similar for all ages and ethnicities. Heavier drinking was related to breast cancer risk in each group (classified by the type of alcohol consumed).
Breast cancer is known to vary between populations, and only a small proportion of women are heavy drinkers. However, women who are heavy drinkers may translate to an extra 5% of all U.S. women developing breast cancer due to this lifestyle factor. The study provides more evidence to influence women who are heavy drinkers to cut back or quit. Those with a strong family history of breast cancer should consider eliminating alcohol entirely or drinking only on special occasions.
Source: Science Daily
September 28th, 2007
A German study indicates that women at high-risk for breast cancer can benefit from magnetic resonance imaging (MRI) scans by detecting a nonmalignant tumor called ductal carcinoma in-situ (DCIS). If the pre-cancerous growth is discovered and removed before it becomes malignant, breast cancer could be prevented. Almost all malignant breast cancer is believed to begin with DCIS.
Because MRI is expensive, about $1,000 to $1,500 per scan, the technology does not yet make sense as a routine screening tool for all women. However, for women who have a strong family history of cancer or a genetic mutation found through testing, MRI can be especially effective. Apart from the expense, MRI has a high rate of false positives – often detecting lesions that are harmless. MRI scanning of breasts should always be paired with mammography, which finds things that MRI doesn’t.
The German study of 7,319 women took place over a five-year period. MRI scanning found DCIS in 90% of the 167 high-risk women discovered to have the condition, while mammograms detected only 56% of DCIS cases.
Two Dutch researchers involved with the study published their findings and recommendations in Lancet medical journal. They suggested that MRI be tested in more women to determine whether the technology should be used as a standard screening tool. They also noted that autopsy results show 9% of women have undetected DCIS.
The American Cancer Society recommends for women at high risk that MRI screening be performed annually in conjunction with mammography starting at age 30.
About 1.2 million cases of breast cancer are diagnosed annually, and each year 500,000 women (and a small percentage of men) die of the disease.
Source: Yahoo News
August 11th, 2007
Ovarian cancer is one of the most difficult female cancers to find early. The symptoms are often vague, illusive, or nonexistent until the cancer has spread beyond the ovary and into the abdominal cavity. As a result, only 45% of all women with the disease survive at least five years after diagnosis.
When ovarian cancer is found early enough to be surgically removed before spreading, as in only 19% of cases, some 93% of patients are alive five years later. This year about 22,430 new cases are expected to be diagnosed and more than 15,000 women will die of the disease.
Recently, cancer experts identified a set of health problems that could be early symptoms of ovarian cancer. They urge women who have these symptoms consistently for more than a few weeks to see their doctors. Ovarian cancer grows so rapidly that even a few months’ delay can mean the difference in survival. Tumors can spread quickly to the intestines, liver, diaphragm, and other organs.
Potential warning symptoms are bloating, pelvic or abdominal pain, difficulty eating, feeling full quickly, and frequent urges to urinate. A woman experiencing any of those problems almost every day for three weeks is urged to see a gynecologist, especially if these symptoms are new or markedly different from the usual. We aren’t talking about transient bloating that often accompanies menstruation or a lifelong history of indigestion. A bladder infection that persists after treatment would be a cause for concern.
Too often, women with advanced ovarian cancer were originally given a wrong diagnosis, such as depression or irritable bowel syndrome. Some are told they are just growing old or going through the change of life. It is important to be persistent and seek out a specialist if your concerns are dismissed by your general practitioner.
Any woman with persistent symptoms as cited should see a gynecologist for a pelvic and rectal exam. A doctor can feel the ovaries through the rectum. A transvaginal ultrasound to check ovaries for abnormal growths, and a CA125 tumor marker blood test are also steps that can be taken to get an accurate diagnosis.
Anyone with suspicious findings on tests should be referred to a gynecologic oncologist, a surgeon who specializes in female reproductive system cancers. The woman may be monitored for a while or advised to undergo a CT scan or MRI. When cancer is strongly suspected, urgent surgery should be done. Needle biopsies cannot be done as in breast cancer, as any escaping cancer cells could spread the malignancy throughout the abdomen. The entire ovary or abnormal growth on it must be removed and the rest of the abdomen be examined for cancer.
When more extensive cancer is found, the gynecologic oncologist removes as much cancerous tissue as possible while the patient is still on the operating table. When such “debulking” is done, followup chemotherapy works better and improves survival.
In the absence of a definitive screening tool or test to find ovarian cancer before it has symptoms, women need to be vigilant and see their doctors for any persistent symptoms identified recently as early signs of the disease.
Source: New York Times
June 13th, 2007
Many people take vitamin supplements daily, believing they will be healthier in the process. No studies have ever shown a true benefit from taking multivitamins and minerals. Some studies have indicated that vitamin A and iron are toxic at high levels. And Beta-carotene can increase the risk of lung cancer in those who smoke.
Taking vitamins will not help those most at risk for prostate cancer to keep from getting it. In fact, a recent study shows it can have the opposite effect.
Researchers followed nearly 300,000 men over a five-year period to uncover a potential link between multivitamins and prostate cancer. They found no relationship with slow-growing prostate cancer. However, men who took an excessive amount of multivitamins were found to have developed aggressive prostate cancer that had spread beyond the gland or had proved fatal. This association was strongest in men who had a family history of prostate cancer and men who also took selenium, beta-carotene or zinc supplements.
About a third of the men studied took a daily multivitamin, while 5% were heavy users taking more than the recommended doses. Overall, no link was found between multivitamin use and early stage prostate cancer. The theory is that high-dose vitamins have little effect until a tumor appears, but that their intake then encourages cancer’s rapid growth.
Those who took more than the prescribed dosage on the bottle, one multivitamin a day, increased their risk of aggressive prostate cancer by one-third, and the risk of fatal prostate cancer doubled compared to men who did not take multivitamins.
This year over 250,000 men will be diagnosed and 30,000 will die of prostate cancer.
This study was published in May 2007 and appears in the Journal of the National Cancer Institute.
Sources: Associated Press; MSNBC
May 17th, 2007
Individuals who are of average height appear to receive more protection from air bags than those who are especially short or tall. In a study of over 52,000 drivers and 14,000 drivers involved in crashes from 1995-2000, most weren’t seriously injured when air bags were involved. However, about 2.5% of drivers and 2.6% of passengers sustained serious injuries to any part of the body.
The physician in charge of the study at Oregon Health & Science University concluded that modest protection is provided for front-seat passengers between 5’3” and 5’11” tall. Air bags seem to increase the risk of injury for adults of large or small stature.
Drivers who measured 6’3” or taller had a 5% greater risk of serious injury, and those shorter than 4’ll” had a 4% higher risk of the same.
Distance from the air bag is considered to be the most important factor in preventing serious injury. No hard and fast guidelines may be used, however, as air bags differ greatly and deploy using various forces.
The National Highway Transportation Safety Administration advises taking these precautions:
• Wear your seatbelt
• Sit as far from the air bag as possible, allowing it to deploy properly
• Short drivers are cautioned to move the driver’s seat back and tilt the seat slightly backward to create more space between the driver’s chest and steering wheel.
• Drivers should not lean forward while driving.
• It is advisable for drivers to held steering wheels from the side when possible in order to not interfere with the air bag deploying.
Source: WebMD
May 16th, 2007
A new test for prostate cancer, believed to be much more accurate than the PSA test, is expected to be approved soon. The test, currently undergoing large-scale clinical trials, measures the blood protein EPCA-2. Not only can it detect prostate cancer more effectively than measurement of prostate specific antigens (PSA), it also can determine the aggressiveness of the cancer and whether it has already spread.
In recent studies of 385 men, those with elevated EPCA-2 test results were found to have cancer 94% of the time, compared with 19% of those showing elevated PSA results. Only 3% showed false positive results and about 6% of existing cancers were missed using the new EPCA-2 blood protein markers. These results compare more favorably than the PSA test, which misses about 15% of existing cancers and gives a high level of false positives.
Every year, about 1.6 million men have unnecessary biopsies because of elevated PSA scores, whereas only about 230,000 of them actually are shown to have cancer. The digital rectal exam (DRE) is also not definitive in detecting this common cancer of men.
Prostate cancer is diagnosed in 230,000 new cases annually, and about 27,000 men die of the disease. The current PSA and DRE detection procedures are also deficient in that they cannot distinguish between cancer’s aggressive form, which is frequently fatal, and a slow-growing variety where “watchful waiting” may be the best strategy.
The new test could revolutionize the treatment of prostate cancer. It could save many lives and spare men with the slow-growing form of cancer from having unnecessary treatments in the future. Its manufacturer Onconome Inc., a Seattle Biomedical company, is developing the EPCA-2 test and expects the FDA to approve it by early next year.
Source: San Francisco Chronicle; Sunday, April 26, 2007; reporter Susan Brink of the Los Angeles Times
May 10th, 2007
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