Category: news-perspectives

Many cancer doctors refer their patients to palliative care only very late in the disease process, a study from Canada shows. The study was based on a survey of 603 oncologists. Most of the doctors practiced in hospitals that had access to palliative care. This is a type of care that focuses on pain relief and the overall well-being of patients and their families. It may include psychological, social and sometimes spiritual care. About one-third of oncologists said they referred patients for this type of care when they found that a cancer had spread. Such cancers often can be treated but not cured. Another one-third of the doctors said they waited to refer to palliative care until chemotherapy was stopped. This often occurred just a few weeks or months from death. Palliative care is designed to benefit patients throughout treatment, not just at the end.

Cigarette smoking robs women of more than 10 years of life, on average, a long-term study of British women has found. But quitting early greatly reduces that risk — up to 97% for women who quit by age 30. The numbers come from the Million Women Study, which started in the late 1990s. Women were 50 to 65 when the study began. Therefore, they were part of the generation of women most likely to smoke. Smoking for women peaked in the 1960s. Women filled out questionnaires when the study began. They showed that 20% were smokers, 28% ex-smokers and 52% had never smoked. Women answered the same questions 3 and 8 years later. During 12 years of follow-up, about 6% of the women died. Women still smoking 3 years after the study began were 3 times as likely to die as women who never smoked.

Almost 80 million Americans don’t have low vitamin D levels after all, an expert group says. The new, lower guidelines on vitamin D come from the Institute of Medicine. This is an independent group that provides research-based advice on medical care. Current guidelines don’t agree on what blood level of vitamin D is too low. For example, the Endocrine Society says that people should have at least 30 nanograms of vitamin D per milliliter of blood (ng/ml). Anyone with lower levels may need vitamin D pills, the group says. The new Institute of Medicine guidelines say that 20 ng/ml is enough. An estimated 78.7 million American have levels between 20 and 30. The new study included more than 15,000 adults. Information about them came from a major health survey. This was compared with a national death registry.

Aspirin may help to treat colon cancer among people who have a particular gene mutation, a new study suggests. The study focused on 964 people with colon cancer. As participants in 2 long-term health studies, they recorded what medicines they took. Researchers looked at the genes in people’s colon cancer tumors. They focused on a gene called PIK3CA. This gene is involved in one pathway that promotes the growth of cancer. Aspirin seems to interfere with this pathway. Researchers found that some people in the study had a mutation in the PIK3CA gene. In the first 5 years after diagnosis, 2 of the 62 regular aspirin users with the mutated gene died. In contrast, 23 of 90 people who had the mutation but did not take aspirin died. Researchers also looked at longer-term survival.

A new study suggests that more use of colonoscopy has helped to reduce U.S. rates of colorectal cancer. Colonoscopy looks at the upper and lower colon. It uses an instrument that can remove as well as find cancers. It also can snip out polyps before they turn into cancers. In 2001, Medicare began to pay for people to get a screening colonoscopy every 10 years. Colonoscopies greatly increased after this decision. Surgeries for cancer in the upper colon were steady until 2002. Then they dropped 3.1% a year through 2009. Colonoscopy is the only test that looks at the upper colon from the inside. Surgeries for cancer in the lower colon also fell faster after 1999. In the next decade, they dropped by 3.8% per year. Researchers said the increase in colonoscopies may be one cause. Taking out polyps may have prevented many cancers, especially in the upper colon.

American boys, like girls, may be entering puberty earlier than they did 30 to 40 years ago, a new study finds. Based on prior research, doctors have considered 11½ to be the average age of puberty for boys. In the new study, the average was about 10 for whites and Hispanics. The average was 9 for blacks, about 2 years earlier than prior studies showed. The new study was based on exams of more than 4,000 boys. Their ages ranged from 6 to 16. Doctors in 41 states recorded information during well-child visits. They took note of pubic hair, genital size and testicle size. Growth of testicles is considered the first sign of puberty for boys. Other research has shown that puberty in girls is starting sooner. This may lead to a higher risk of breast cancer. It’s unclear why early puberty may be happening in boys, researchers said.

A study of diabetics has been stopped early because an intensive diet and exercise program did not reduce their risk of heart attack or stroke. Adults with type 2 diabetes have twice the risk of these problems as other adults. The study included 5,145 overweight or obese adults with type 2 diabetes. They were randomly divided into 2 groups. One group followed a strict diet. People were limited to 1,200 to 1,800 calories a day. They also did 175 minutes a week of moderate exercise. The other group just received general diabetes education and support. People in the first group lost about 10% of their weight at first. They kept off about 5% for at least 4 years. Other research has shown that a 5% weight loss can reduce factors that affect heart and stroke risk. People in the second group lost about 1% of their weight. After 11 years, U.S.

Behavior symptoms may return if people with Alzheimer’s disease stop taking a medicine that has helped them, a new study suggests. Some people with Alzheimer’s disease have symptoms of psychosis. For example, they may hear or see things that aren’t there or have false beliefs (delusions). Some may become anxious, angry or violent. Some people get symptom relief from risperidone (Risperdal) or other anti-psychotic drugs. But other research has found that Alzheimer’s patients taking such drugs may die sooner. U.S. drug guidelines recommend careful monitoring of these patients. The new study included 110 people with Alzheimer’s. All of them had taken risperidone for 4 months and had responded well. They were randomly divided into 3 groups. One group kept taking the drug for 8 months. One continued for 4 months, then switched to placebo (fake) pills.

U.S. drug regulators have expanded their investigation of a pharmacy linked to an outbreak of meningitis. The New England Compounding Center of Framingham, Mass., has been shut down since last month. At least 250 cases of meningitis caused by a fungus have been linked to steroid shots made at the pharmacy. Most of them were linked to a fungus called Exserohilum rostratum. The infections have caused at least 20 deaths. The Food and Drug Administration (FDA) confirmed October 18 that this fungus was found in one lot of steroid vials made by the company. The FDA also said it is looking into the cause of infections among 3 people who received other kinds of drugs made by New England Compounding. The fungus involved in the steroid injections is commonly found in nature. FDA still is looking into how it could have contaminated the drugs used to produce the steroid shots.

A daily multiple vitamin may slightly reduce cancer risk in older men, a new study suggests. Many studies have found no benefit from high doses of single vitamins. But the new study looked instead at standard multivitamins. The study included 14,641 male doctors age 50 or older. They were randomly divided into groups. One group took a daily multiple vitamin. The other group took a placebo, or fake pill. After an average of 11 years, researchers compared cancer rates. Men who took the multivitamin were 8% less likely to be diagnosed with a new cancer than those who took the placebo. About half of the cancers were in the prostate. Most of them were early stage, with high odds of survival. There was also little difference in prostate cancer rates between the two groups. So researchers decided to look just at other cancers.