Archive for June 7th, 2006
CHICAGO, Illinois (AP) — Younger black women who get breast cancer are far more likely than other afflicted women to have a particularly aggressive and lethal form of the disease, a study found.
The findings suggest that biology may help explain why breast cancer is deadlier in black women younger than 55 than it is in white women in the same age group. Other studies have blamed inadequate screening rates.
Since 1990, the average annual breast cancer death rate for younger black women in the United States has been 15.4 deaths per 100,000 population, versus 9.3 per 100,000 for younger white women.
“It’s been long known that breast cancer in African American women is a far less common disease than in white women. But when it occurs, it seems to be more aggressive and harder to treat,” said study co-author Dr. Lisa Carey of the University of North Carolina’s Lineberger Comprehensive Cancer Center.
In the study in Wednesday’s Journal of the American Medical Association, researchers identified cancer types by looking for certain proteins in tumor tissue taken from 496 women in the Carolina Breast Cancer Study. The women’s cancer had been diagnosed between 1993 and 1996.
A quick-spreading form of breast cancer called the basal-like subtype appeared in 39 percent of premenopausal black breast cancer patients. It accounted for 14 percent of breast cancer cases in older black women, and 16 percent of those in non-black women of any age.
Genetic profiling of cancer subtypes has led to a new generation of targeted drugs that have shown startling success. But for the basal-like subtype, no targeted therapies yet exist and doctors must use more conventional chemotherapy.
The research may lead to a better understanding of what causes the aggressive subtype of breast cancer, said Dr. Eric Winer, director of the breast oncology center at Dana-Farber Cancer Institute in Boston. Massachusetts. He was not involved in the study.
He said it is unclear whether this subtype is occurring because of an inherited predisposition or because of something in the environment that black women are more likely to be exposed to. He added that disparities in access to treatment still probably account for much of the higher mortality rate among young black women.
In the study, death rates remained higher for younger black women even when the basal-like subtype cases were removed from the data. That suggests that other factors such as access to screening and treatment also play a role in the disparity.
“Biology is only part of the puzzle,” Carey said. “Access to health care is very important.”
Margaret Rosenzweig of the University of Pittsburgh School of Nursing, who was not involved in the UNC study, said black women may be less likely than white women to follow through on their treatment.
Rosenzweig and her colleagues, in a small study presented in Atlanta, Georgia, last week at the annual meeting of the American Society of Clinical Oncology, showed that poor black women with breast cancer had more difficulty understanding and accepting their treatment than other racial and income groups.
“Clinicians in cancer care need to make a concerted effort to make sure black women understand why they’re getting the treatment they’re getting and following through with it,” Rosenzweig said.
Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.
June 7th, 2006
ATLANTA, Georgia (AP) — Women going through treatment for breast cancer felt better when they tried yoga, according to one of the first scientific studies of its kind.
“Our belief is something as simple and brief as a short (yoga) program would be very useful” at combating side effects from cancer treatment, said Lorenzo Cohen, a psychologist who led the pilot study.
Yoga incorporates meditation, relaxation, imagery, controlled breathing, stretching and physical movements. Although the study was small and preliminary, it’s one of the few to try to rigorously measure the benefits of this form of exercise, Cohen said.
Researchers at the University of Texas M.D. Anderson Cancer Center focused on 61 women who had surgery for breast cancer and now were getting six weeks of radiation treatment. Thirty women were assigned to a test group that took twice-a-week yoga classes. The others did not.
At the end of six weeks, study participants filled out detailed questionnaires grading their ability to lift groceries, walk a mile and perform other physical activities. They also were asked about feelings of fatigue, their sense of well-being and other aspects of their quality of life.
Their scores were converted to a scale that ranged from 0 to 100. The researchers found the yoga group consistently had higher scores in almost every area. It was most pronounced in physical function — the yoga group had a mean score of about 82, compared with 69 for the other group.
Participants said they were in better general health, were less fatigued and had fewer problems with daytime sleepiness. But the researchers found no differences between the groups in measurements of depression or anxiety.
The researchers drew blood and took saliva samples in an effort to measure the participants’ immune system function and stress levels, but those results are not finished yet, said Cohen, who presented the results at a medical conference in Atlanta held by the American Society of Clinical Oncology.
A future study will have one group do stretching and another yoga, to see if there is a difference in the result, Cohen said.
Traditionally, such scientific approaches have been lacking in the assessment of yoga’s medical benefits, said Alan Kristal, an epidemiology professor at the University of Washington School of Public Health and Community Medicine.
Due in part to increased federal funding for research into alternative therapies, more rigorous studies have emerged in the last three or four years that attempt to provide harder proof, Kristal said.
Recent studies have demonstrated the benefits of yoga for cancer patients and people with carpal tunnel syndrome. Kristal co-authored a study last year that found middle-aged people who regularly did yoga lost weight over 10 years while a non-yoga group gained, on average, more than 13 pounds.
The National Cancer Institute recently awarded Cohen and his team $2.4 million to study the effects of Tibetan yoga on women with breast cancer undergoing chemotherapy. It was the largest ever federal grant for the study of Tibetan yoga in cancer patients.
Teresita Ladrillo, 52, a Houston breast cancer patient currently taking yoga classes at M.D. Anderson, said the stretching helped her regain flexibility in her right arm, which was limited by scarring from surgeries and other treatments.
Learning to control her breathing through yoga has helped her to calm and sleep, she said.
“Whenever you do yoga, the first thing they tell you is forget everything else and just focus on your breathing,” she said. “There’s something to be said for being still.”
Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.
June 7th, 2006
A closer look at research shows why you need calcium, vitamin D
Karen Collins, R.D.
For a long time, the need for eating calcium to strengthen bones was almost unquestioned.
But when results from the Women’s Health Initiative (WHI) trial were released earlier this year, some people wondered whether trying to increase calcium consumption was worth the effort.
A more detailed look at the results provides several take-home lessons. Giving up calcium is not one of them.
In the WHI studies, more than 36,000 women aged 50 to 79 were randomly assigned to take either a supplement of 1,000 milligrams (mg) of calcium and 400 International Units (IU) of vitamin D or a placebo each day for about seven years. Although the hip bone density of the women who took supplements improved only slightly and their risk of fractures was the same, the data revealed important lessons.
1. More calcium helps only if you don’t get enough. Half of all older American women eat less than 650 mg of calcium from food each day, although 1,200 mg is recommended for all adults after age 50. At the beginning of this study, however, almost one-third of the women in both groups took calcium supplements of at least 500 mg daily.
Researchers did not ask the women to stop. “Since the women in the supplement and placebo groups both started the study consuming about 1,150 mg of calcium a day,” notes Jeri Nieves, PhD, Assistant Professor of Epidemiology at Columbia University, “this ended up being a comparison of 1,000 mg versus 2,000 mg of calcium a day not inadequate versus adequate calcium.”
2. You may need more vitamin D. Current federal recommendations for adults aged 51 to 70 still call for the 400 IU daily used in these studies. Yet research now shows that 700 to 1,000 IU of vitamin D a day appears necessary to reach the most healthy blood levels of vitamin D. A daily intake of 400 IU is now considered inadequate to prevent fractures.
3. You need consistently high nutrients for benefits. By the end of the trial, only 59 percent of women were still taking their pills as instructed. The women who actually took their calcium and vitamin D supplements had 29 percent fewer hip fractures.
4. Develop a cancer-protection strategy you can follow. Although no significant difference was seen in cancer risk, tumor characteristics, or reports of polyps in this study, a seven-year study is not enough time to see the effects on a disease that typically develops over 10 to 20 years. It should be noted, however, that women who started the study with low blood levels of vitamin D developed more than twice as much colorectal cancer as those with the highest blood levels.
This evidence supports the idea that long-term vitamin D status may affect our risk for this cancer. The women with the lowest blood levels of this vitamin also tended to show the most benefit from supplements.
Longer usages and higher doses than now recommended might have produced truly significant effects in the women who lacked vitamin D.
Another new study of more than 45,000 Swedish men supports adequate consumption of calcium. Men in the top half of calcium consumption were 27 to 32 percent less likely to develop colorectal cancer than those who consumed less. Although a few but definitely not all studies have linked excessive calcium or dairy product consumption with a possible increase in prostate cancer, the colorectal protection in this study occurred when men ate at least an average of the currently recommended 1,200 mg per day.
5. For bone health and lower colon cancer risk, meeting current recommendations for calcium and vitamin D is a good start. For optimal wellness protection, add regular exercise, weight control, limited sodium intake and a balanced, mostly plant-based diet with plenty of fruits, vegetables and whole grains to your daily habits.
Nutrition Notes is provided by the American Institute for Cancer Research in Washington, D.C.
© 2006 MSNBC Interactive
June 7th, 2006
Live smarter and you can live to be older
It’s been said that a man dies simply because he doesn’t know how to live longer. Well, thank goodness for progress.
People are living longer these days. According to the Centers for Disease Control, in 1920 the average life expectancy was 54. Today, people can expect to live to 78.
Feel free to speculate about why — better food supply, better medical care, better hygiene or any number of other factors. It’s not totally clear to scientists how they all add up. But what we do know is that studies are finding genetics don’t tell the whole story when it comes to which diseases will likely kill us.
“There’s a saying that genetics load the gun, but it’s the environment that pulls the trigger,” says Dr. David Fein, medical director at the Princeton Longevity Center, a clinic in Princeton, N.J., which focuses on quality of life and prolonging it. “You can have the gene for a certain disease, but it doesn’t mean you’re going to get it.”
Take heed: Your lifestyle choices are very significant. While there is no way to ultimately defy death, that isn’t an excuse to start indulging in vices and neglecting your health. There are plenty of ways to keep the grim reaper at bay — and many of these “secrets” result in an improved quality of life.
If you really want to live longer, then start with your attitude. Your way of thinking not only improves your outlook on life, but also how long you actually live. In 2002, researchers at the Mayo Clinic in Rochester, Minn., found that optimistic people decreased their risk of early death by 50 percent compared with those who leaned more toward pessimism.
“The exact mechanism of how personality acts as a risk factor for early death or poorer health is unclear,” says Dr. Toshihiko Maruta, the main investigator in the study. Most likely, it has to do with the fact that pessimists have an increased chance for future problems with their physical health, career achievements and emotional stress — particularly depression. “Yet another possibility could be more directly biological, like changes in the immune system,” Maruta adds.
Besides looking through rosier-colored glasses, there other personality traits that can help us live longer, healthier lives. According to Dr. Howard Friedman, a psychologist at the University of California, Riverside, conscientiousness is related to mortality in a significant way. The Terman Life-Cycle Study, which ran from 1921 to 1991, examined an array of factors like personality, habits, social relations, education, physical activities and cause of death.
“Those low on adult conscientiousness died sooner,” Friedman concluded. Conscientiousness does not mean looking both ways before crossing the street, it means looking both ways when the light turns green so you don’t accidentally run down a slow-moving pedestrian. Beyond that, a conscientious person’s long-living qualities probably have to do with the fact that they are predisposed to constructively reacting to emotional and social situations, and are more likely to create work and living environments that promote good health.
There are also more traditional practices that the aspiring centenarian can take. People should stop smoking, eat a balanced diet and maintain a healthy weight. While these may sound “nanny-ish,” they are factors that cannot be overlooked. This might not sound like much fun, but it’s a lot more fun than being dead.
Research shows that obesity, for example, contributes to a slew of medical conditions, including diabetes, heart disease and various cancers. So powerful are certain lifestyle choices that recommended diets along with maintenance of physical activity and appropriate body mass can, over time, reduce the incidence of cancer by 30 percent to 40 percent, according to the American Institute for Cancer Research.
Animal lovers will be happy to know that having a pet can add years to your life, as well. One of the first studies in this arena, which appeared in Public Health Reports in 1980, showed that the survival rates of heart-attack victims who had a pet were 28 percent higher than those of patients who didn’t have an animal companion. “The health effects seem to be very real and by no means mystical,” says Alan Beck, director of the Center for the Human-Animal Bond at Purdue University. “Contact with companion animals triggers a relaxation response,” he says.
Rebecca Johnson, a professor of gerontological nursing at the University of Missouri, Columbia, showed that interaction with pets does, in fact, reduce levels of the stress hormone cortisol. The ability of companion pets to reduce our overall stress level probably accounts for most of their life-extending qualities. “For many people, pets also provide a reason to get moving,” adds Johnson. How many people, after all, would actually get any exercise if it weren’t for overenthusiastic dogs?
To many people, quality of life is equally as important as life span. It is a good thing, then, that many of the factors that can improve your longevity can also improve your quality of life. After all, who really wants to live forever when they can have a life that ended perfectly?
© 2006 Forbes.com
June 7th, 2006
Biological difference may explain why disease is rarer but more aggressive
Younger black women who get breast cancer are far more likely than other afflicted women to have a particularly aggressive and lethal form of the disease, a study found.
The findings suggest that biology may help explain why breast cancer is deadlier in black women younger than 55 than it is in white women in the same age group. Other studies have blamed inadequate screening rates.
Since 1990, the average annual breast cancer death rate for younger black women in the United States has been 15.4 deaths per 100,000 population, versus 9.3 per 100,000 for younger white women.
“It’s been long known that breast cancer in African-American women is a far less common disease than in white women. But when it occurs, it seems to be more aggressive and harder to treat,” said study co-author Dr. Lisa Carey of the University of North Carolina’s Lineberger Comprehensive Cancer Center.
In the study in Wednesday’s Journal of the American Medical Association, researchers identified cancer types by looking for certain proteins in tumor tissue taken from 496 women in the Carolina Breast Cancer Study. The women had been diagnosed between 1993 and 1996.
A quick-spreading form of breast cancer called the basal-like subtype appeared in 39 percent of premenopausal black breast cancer patients. It accounted for 14 percent of breast cancer cases in older black women, and 16 percent of those in non-black women of any age.
Genetic profiling of cancer subtypes has led to a new generation of targeted drugs that have shown startling success. But for the basal-like subtype, no targeted therapies yet exist and doctors must use more conventional chemotherapy.
The research may lead to a better understanding of what causes the aggressive subtype of breast cancer, said Dr. Eric Winer, director of the breast oncology center at Dana-Farber Cancer Institute in Boston. He was not involved in the study.
He said it is unclear whether this subtype is occurring because of an inherited predisposition or because of something in the environment that black women are more likely to be exposed to. He added that disparities in access to treatment still probably account for much of the higher mortality rate among young black women.
In the study, death rates remained higher for younger black women even when the basal-like subtype cases were removed from the data. That suggests that other factors such as access to screening and treatment also play a role in the disparity.
“Biology is only part of the puzzle,” Carey said. “Access to health care is very important.”
Margaret Rosenzweig of the University of Pittsburgh School of Nursing, who was not involved in the UNC study, said black women may be less likely than white women to follow through on their treatment.
osenzweig and her colleagues, in a small study presented in Atlanta last week at the annual meeting of the American Society of Clinical Oncology, showed that poor black women with breast cancer had more difficulty understanding and accepting their treatment than other racial and income groups.
“Clinicians in cancer care need to make a concerted effort to make sure black women understand why they’re getting the treatment they’re getting and following through with it,” Rosenzweig said.
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June 7th, 2006