Don’t Tell Me to Stop Squeezing My Boobs!

By Anne Krueger

No doubt you’ve seen the headline: Breast self-exams (BSEs) to check for breast cancer don’t work.
I was pretty annoyed to find out that not only was the occasional halfhearted boob mauling that I did a waste of medical and diagnostic time, but worse, the guilt I felt over not mauling regularly was totally unnecessary too. Read More

Cancer Survival Depends on Where You Live

(HealthDay News) -- Your odds of surviving cancer depend on which country you live in. And, in the United States, it also depends on whether you're black or white, a new study finds.

Economic differences among countries, access to health care, and the availability of cancer treatments feed the disparities in survival, the report said.

"There is a very wide global range in the odds of survival after a cancer diagnosis," said lead researcher Michel Coleman, a professor of epidemiology at the London School of Hygiene and Tropical Medicine in Great Britain. "Some of the range is understandable on the basis of the relative wealth of these countries," he added.

The study also confirms the disparity in cancer survival among blacks and whites in the United States, Coleman said. "The differences are large across the U.S.A., and even in different metropolitan areas," he said.

Coleman believes the differences among countries -- and within regions of countries -- is directly related to access to health care. "This is not a question of the competence of doctors in any particular country," he said. "This is an issue of the overall effectiveness of health services."

The report was published in the July 17 online edition of The Lancet Oncology.

For the study, called the CONCORD study, Coleman's team collected data on 1.9 million cancer patients in 31 countries. Using cancer registries from each country, the researchers compared the five-year survival rates for breast, colon, rectal and prostate cancer.

The United States has the highest rates of survival for breast and prostate cancers, while Japan has the highest survival rates for colon and rectal cancers among men. France has the highest survival rates for colon and rectal cancer among women, the report found.

In addition, Canada and Australia also have very high survival rates for most cancers. The lowest rate of survival among both men and women was seen in Algeria.

In the United States, the lowest survival rates are in New York City, except for rectal cancer in women, where Wyoming scores worse. The best survival rate for cancer in the United States is in Hawaii, the researchers found.

Idaho also has a high survival rate for rectal cancer, and Seattle has the highest survival rate for prostate cancer.

But, there's a big disparity in cancer survival rates between whites and blacks in the United States, and it favors whites. The differences range from 7 percent for prostate cancer to 14 percent for breast cancer. This disparity is most likely due to differences in the stage of cancer when it is diagnosed, the researchers said.

There's also a significant difference in cancer survival rates between the United States and Europe, with survival rates 10 percent and 34 percent higher in the United States for breast cancer and prostate cancer, respectively, the study found.

In Europe, France has the highest survival rate for rectal and colon cancers. Sweden has the highest survival rate for breast cancer, and Austria has the highest survival rate for prostate cancer.

The worst performing European countries are Poland and Slovakia.

Coleman said he hopes that political leaders will use the findings to provide better cancer diagnosis and treatment.

"Where the system is either slow in diagnosis, has too few doctors, has very few radiotherapy machines or in some countries, none, you would expect differences in outcome, and that's what these overall survival estimates are helping us provide," he said.

Dr. Elmer Huerta, president of the American Cancer Society's National Volunteer Board of Directors, said the study provides evidence for what has long been suspected -- namely, that where you live plays a role in cancer survival.

"The world needs to wake up to the fact that cancer is the second leading cause of death all over the place," he said. "Policymakers don't really put the weight to cancer care."

Huerta thinks more emphasis needs to be placed on the prevention, diagnosis and treatment of cancer.

"The world needs to smell the coffee and realize cancer can be prevented, and cancer can be cured if found early," he said.

More information
For more on cancer, visit the American Cancer Society.

Lots of Sex May Prevent Erectile Dysfunction

(HealthDay News) -- Frequent sexual intercourse may cut down on a man's chances of developing erectile dysfunction, Finnish researchers report.

"This is the same as any other part of the body. It's what we in vascular surgery refer to as the 'use it or lose it' concept," said Dr. Hossein Sadeghi-Nejad, an associate professor of urology at UMDNJ New Jersey Medical School Hackensack University Medical Center. "Sexual activity will promote maintenance of normal erectile function down the line."

The report was published in the July issue of The American Journal of Medicine.

In the study, led by Dr. Juha Koskimaki, from Tampere University Hospital's Department of Urology, researchers collected data on 989 Finnish men aged 55 to 75 years old.

The researchers found that men who said they had sexual intercourse less than once a week had twice the risk of developing erectile dysfunction, compared with men reporting having sexual intercourse once a week.

Among men who had sexual intercourse less than once a week, there were 79 cases of erectile dysfunction per 1,000 men. That number dropped to 32 cases per 1,000 among men who said they had sexual intercourse once a week, and it dropped even further, to 16 per 1,000, among men who said they had sexual intercourse three or more times a week, the researchers reported.

The frequency of morning erections was not associated with the incidence of moderate erectile dysfunction, the researchers noted.

However, the development of complete erectile dysfunction could be predicted from the frequency of morning erections. Among men with less than one morning erection a week, the risk of developing erectile dysfunction was 2.5-fold greater than among men who had two to three morning erections per week.

"Regular intercourse has an important role in preserving erectile function among elderly men, whereas morning erection does not exert a similar effect," Koskimaki said in a statement. "Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to coital frequency."

Sadeghi-Nejad said there is a scientific basis for this finding, and it also has implications for rehabilitation of patients after prostate cancer treatment.

"What is very hot these days is what we can do to rehabilitate people who develop erection problems after prostate cancer surgery or radiation therapy," Sadeghi-Nejad said. "Anything you can do to increase oxygenation in the penis will help get patients back to normal."

If one can naturally engage in behaviors that increase blood flow to the penis, it will have a positive effect in preventing erectile dysfunction, Sadeghi-Nejad said.

Sadeghi-Nejad noted that the study only addressed intercourse, and not masturbation. "This is essentially the same concept," Sadeghi-Nejad said. "Anything you can do to bring blood to the penis is beneficial," he added.

More information
For more about sexual dysfunction, visit the U.S. National Library of Medicine.

Barefoot Lifestyle Has Its Dangers

(HealthDay News) -- Going barefoot is one of the simple pleasures of summer, but some who doff their shoes and socks suffer injuries such as cuts and puncture wounds. In some cases, those injuries develop infections that require surgery.

If you do go barefoot, check out these safety tips from the American College of Foot and Ankle Surgeons:

• Make sure you're vaccinated against tetanus. Teens and adults should get booster shots every 10 years.
• Apply sunscreen to the tops and bottoms of your feet to protect them from sunburn. Rare, but deadly, skin cancers can develop on the feet.
• Wear flip-flops or sandals around swimming pools, locker rooms and beaches. They'll help protect against cuts and abrasions from rough anti-slip surfaces and sharp objects hidden in beach sand, and prevent contact with viruses and bacteria that can cause athlete's foot, plantar warts and other foot problems.
• Use common sense. Every year, people lose toes while mowing the lawn barefoot and others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Remember that murky rivers, lakes and ponds can conceal sharp objects underwater.
• People with diabetes should never go barefoot, even indoors, because they may not "feel" a foot injury.
• If you suffer a puncture wound in your foot, see a doctor within 24 hours. A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications such as tissue and bone infections or damage to tendons or muscles in the foot.
• Inspect your feet on a routine basis for skin problems such as warts, calluses, ingrown toenails, suspicious moles, spots or freckles. The sooner a condition is detected, the easier it is to treat.

More information

The American College of Foot and Ankle Surgeons has more about puncture wounds.

Doctor-Patient Talks Affect Use of Breast Reconstruction Surgery

(HealthDay News) -- A lack of patient-doctor discussion may contribute to socioeconomic, age and race-related disparities in the use of breast reconstruction after mastectomy, says a study by researchers at Brigham and Women's Hospital and the Dana-Farber Cancer Institute in Boston.

The study also found that breast reconstruction was more likely to occur after a surgeon discussed options with a patient, which suggests the need to increase and improve these conversations, the researchers said.

They analyzed data on 626 patients who underwent mastectomy for breast cancer. Of those patients, 253 (40.4 percent) received breast reconstruction, and 249 (39.8 percent) had a documented discussion about the option with a doctor.

About 70 percent of those who had a discussion about breast reconstruction had the procedure. But the researchers found that increasing age and lower levels of education were associated with lower rates of a documented discussion. Hispanic patients, those born outside of the United States, and those whose primary language wasn't English were less likely to undergo reconstruction after discussing it with a doctor.

The study was published in the April issue of the Journal of the American College of Surgeons.

The decision to have breast reconstruction is a complex one that's influenced by access to care, patient preference and a doctor's interaction with the patient, the researchers noted.

"Patient preferences should be respected, but an informative discussion of reconstruction is required to help patients understand and weigh the risks and benefits of this procedure," Dr. Caprice C. Greenberg, Instructor of Surgery in the Center for Surgery and Public Health at Brigham and the Center for Outcomes and Policy Research at Dana Farber, said in a prepared statement. "We learned that physicians need to improve communications with all women undergoing a mastectomy, regardless of age, race or socioeconomic status."

She and her colleagues said doctors should systematically address the issue of breast reconstruction with all patients undergoing mastectomy. Doctor-patient discussions could include interpreters and educational materials to ensure an informative discussion regardless of a patient's primary language, ethnicity or education level.

More information

Roshini Raj, MD, Explains Common Flu Symptoms on the "Today" Show

"Health" contributor Dr. Raj on the "Today" show Feb. 13, discussing tips on fighting the flu
by Ross Weale

In the following segment, Roshini Raj, MD, of Health magazine describes flu symptoms and talks about whether you can still get that shot.



DR. ROSHINI RAJ
Roshini Raj, MD, a Health magazine contributor and part of the magazine's Health Expert Network, is board-certified in gastroenterology and internal medicine with degrees from the New York University School of Medicine and Harvard University. Currently Dr. Raj is an attending physician at NYU Medical Center's Tisch Hospital in New York City. She also serves as an assistant professor at the NYU School of Medicine, and she has a special interest in women's health and cancer screening. She has also published several research articles on colon-cancer screening.

Dr. Raj has discussed health topics on numerous television outlets including NBC's Today show, ABC's Good Morning America, CNN, FOX News, and Discovery Health. She has been quoted in publications such as the New York Times, the Wall Street Journal, Men's Health, Women's Health, and Fitness on the state of health care and other health news of the day. Dr. Raj is often called upon to explain and demystify complicated health topics.

more discussion: Forum· Addiction Forum · Ask the Doctors Forum · Ayurveda Forum · Ayurvedic & Thai Herbs Forum · Colon Cleansing Forum · Dental Forum · Diabetes Forum · Diet Forum · General Cleansing Forum · Hepatitis A, B. C Forum · Integrated Medicine Forum · Live Blood Analysis Forum · Ozone-Oxygen-Forum · pH - Alkaline - Acidity Forum · Weight Loss Forum

5 Ways to Boost Your Metabolism and Lose Weight

Magnesium, interval training, and other tricks to burn more calories
by Ross Weale

Health magazine contributor Samantha Heller shows how to burn more calories, during an interview on the Today show, March 10.



SAMANTHA HELLER

Samantha Heller, RD, is the nutrition coordinator at the Fairfield Connecticut YMCA. A certified dietitian/nutritionist and exercise physiologist, Heller earned her master's degree in nutrition and applied physiology from Teachers’ College, Columbia University. She served as the senior clinical nutritionist and exercise physiologist at NYU Medical center in New York City for almost a decade and created and ran the outpatient nutrition program for the NYU Cardiac Rehabilitation Program. She has also been a fitness instructor for 15 years. Heller specializes in nutrition, wellness, stress management, and fitness for people who are fighting heart disease, diabetes, cancer, and obesity.

A contributing editor to Health magazine, her writing has also appeared in numerous other magazines, including Men’s Fitness, Men’s Health, and Glamour, as well as sites such as Fitness.com.

Will Your New House Make You Sick?

The one we almost bought harbored cancer-causing gas and toxic mold. What buyers must check before their dream home turns into a nightmare
by Amy O'Connor

It was love at first sight. My husband and I couldn’t believe our luck. We met The One so early in our home-hunting process; the house was everything we’d ever dreamed of and more: neat and tidy, wrapped up in a bow.

Or so we thought when we offered asking price and had it accepted. We even bonded with the sweet little-old-lady seller, whose grandmotherly demeanor filled us with confidence about our impending purchase. I envisioned our closing date through a Vaseline-coated lens, complete with baked-from-scratch chocolate chip cookies provided by her and a group hug with both attorneys. Continue reading »

A Bone Marrow Disease With a Brighter Prognosis

(HealthDay News) -- Blood is life. And the rare disease known as aplastic anemia robs the body of life by robbing the body of blood.

The aplastic anemia patient's blood thins as the bone marrow slows its production of blood cells. The results can range from chronic fatigue to heart disease or from endless infections to cuts that won't clot, depending on the type of blood cells that are lacking.

But there's hope: Considered fatal as recently as two decades ago, aplastic anemia is becoming a far more manageable disease. Advances in drug therapies and improvements in the field of transplantation have slashed the death toll, allowing patients to live longer, fuller lives.

"We are getting better at treating aplastic anemia, either in getting rid of it or treating its symptoms," said Dr. Jaroslaw P. Maciejewski, with the Cleveland Clinic's Department of Hematologic Oncology and Blood Disorders.

And those advances are helping doctors gain greater insights into other, more prevalent, health conditions, such as heart disease and leukemia.

An estimated 50,000 people develop aplastic anemia in the United States each year, according to the U.S. National Institutes of Health. (A related blood disorder, myelodysplastic syndrome, or MDS, occurs when the bone marrow begins to produce poorly functioning or immature blood cells. About 20,000 to 30,000 new cases of MDS occur each year.)

It's important to note that many symptoms of aplastic anemia, such as fatigue and infection, can also be caused by other diseases, said Dr. Ronald Paquette, a blood disease researcher with the University of California, Los Angeles' Jonsson Comprehensive Cancer Center.

"If everyone who was fatigued thought they had aplastic anemia, we'd be swamped," Paquette said.

Bone marrow -- the spongy material inside bones -- produces stem cells that normally develop into the three main types of blood cells -- red blood cells, white blood cells, and platelets.

"Essentially, the bone marrow is a factory of blood," Maciejewski said.

In patients with aplastic anemia, the stem cells have been damaged, slowing or stopping the production of all blood cells.

The cause of the damage to stem cells remains unknown in more than half of people with aplastic anemia. Some research has suggested that stem cell damage occurs when the immune system attacks the body's own cells by mistake, according to the National Institutes of Health.

Aplastic anemia has also been linked to exposure to toxins such as pesticides, arsenic and benzene. Some infectious diseases also can cause the disorder, including hepatitis, Epstein-Barr virus, cytomegalovirus, parvovirus B19, and HIV, as well as autoimmune diseases like lupus and rheumatoid arthritis. Finally, some genetic disorders have been linked to it.

Symptoms vary depending on the type of blood cells in shortage:

• Too few red blood cells can mean not enough oxygen is carried to the body, according to the NIH. People who have a low red blood cell count often feel tired. Because the heart has to work harder to pump blood to get enough oxygen to the body's organs and tissues, heart disease can develop over time.
• Too few white blood cells weaken the body's defense against infection. The patient may become ill more often, and the illness can be severe.
• Too few platelets hamper the blood's ability to clot. Patients with a low platelet count may bruise or bleed easily, and their bleeding may be hard to stop.
• Once aplastic anemia is detected, swift treatment is essential, Paquette said. "Because it's a rare disease, it's important to be treated at a specialized center," he said. "The most important thing is to be seen by someone with a lot of experience treating the disease early on."

For patients younger than 30, stem cell transplantation is often the preferred treatment. For those with a matched sibling donor, stem cell transplantation replaces the defective bone marrow with healthy cells, and as many as 80 percent of patients enjoy a complete recovery, according to the Aplastic Anemia & MDS International Foundation Inc.

Advances in stem cell research and anti-rejection drugs have meant that transplantations from unrelated donors also are becoming more successful, Paquette said.

One promising avenue of treatment involves transplantation using stem cells harvested from the umbilical cord of new mothers. "The cells can be cryopreserved [frozen] and saved, then given to unrelated donors," Paquette said. "It's quite encouraging."

For these patients, again, speed is of the essence. "The data show the earlier you do a transplant, the better the outcome," Paquette said.

Patients whose transplants fail, or for whom transplantation is not an option, often receive successful immunosuppressive therapy with agents like anti-thymocyte globulin and cyclosporine. Response rates typically range from 70 percent to 80 percent, according to the Aplastic Anemia & MDS International Foundation Inc.

Blood transfusions from matched donors also are used to keep blood counts high and help relieve symptoms, although they are not an effective long-term treatment.

"Whether we cure the disease or not, patients are getting better across the board," Maciejewski said. "We now can maintain life, keep these patients alive longer."

More information
To learn more, visit the Aplastic Anemia & MDS International Foundation Inc.

Pain Relief for Osteoporosis Patients With Fractures

(HealthDay News) -- In osteoporosis patients with spinal fractures, vertebroplasty provides significant pain relief and helps decrease disability, according to a new study.

Vertebroplasty involves injection of medical-grade bone cement into a fractured vertebra to shore up the fracture and provide pain relief. It's used to treat painful vertebral compression fractures that don't respond to conventional medical therapy with analgesics or narcotics.

The study followed 884 patients for five years who were assessed before and after vertebroplasty. Their average pre-treatment pain score on an 11-point scale decreased from 7.9 (+/- 1.5) before treatment to an average of 1.3 (+/- 1.8) after treatment.

The patients' ability to manage everyday tasks such as washing and dressing was measured using the Oswestry Disability Questionnaire. The patients' scores went from an average of 69.3 percent (+/-13.5) a month before treatment to 18.8 percent (+/- 6.9) a month after treatment.

"These data provide good news for physicians and osteoporosis patients. Many osteoporosis patients with compression fractures are in terrible pain and have a greatly diminished ability to perform basic daily activities, such as dressing themselves," Dr. Giovanni C. Anselmetti, an interventional radiologist at the Institute for Cancer Research and Treatment in Turin, Italy, said in a prepared statement.

The study also found that vertebroplasty didn't increase the risk of fracture in nearby vertebra.

"Vertebroplasty is already known to be a safe and effective treatment for osteoporotic vertebral fractures. Osteoporosis patients remain susceptible to new fractures, which often occur in the contiguous vertebra to an existing fracture. Our large-scale study shows that vertebroplasty does not increase the risk of fracture in the level contiguous to previously treated vertebra and that these new fractures occur at the same rate as they would in osteoporosis patients who did not have vertebroplasty," Anselmetti said.

The study was to be presented Tuesday at the annual scientific meeting of the Society of International Radiology.

Osteoporosis affects about 10 million Americans and causes about 1.5 million vertebral fractures each year, according to the U.S. National Institutes of Health. Multiple vertebral fractures can cause chronic pain, disability, loss of independence, stooped posture, and compression of the lungs and stomach.

More information
The American College of Radiology/Radiological Society of North American has more about vertebroplasty.

One in 4 Teen Girls Has a Sexually Transmitted Disease

(HealthDay News) -- More than 3 million teenaged girls have at least one sexually transmitted disease (STD), a new government study suggests.

The most severely affected are African-American teens. In fact, 48 percent of African-American teenaged girls have an STD, compared with 20 percent of white teenaged girls.

"What we found is alarming," Dr. Sara Forhan, from the U.S. Centers for Disease Control and Prevention, said during a teleconference Tuesday. "One in four female adolescents in the U.S. has at least one of the four most common STDs that affects women."

"These numbers translate into 3.2 million young women nationwide who are infected with an STD," Forhan said. "This means that far too many young women are at risk of the serious health effects of untreated STDs, including infertility and cervical cancer."

These common STDs include human papillomavirus (HPV), chlamydia, herpes simplex virus and trichomoniasis, Forhan said.

Forhan announced the results as part of the CDC's 2008 National STD Prevention Conference, in Chicago.

"These findings are really giving us a lot of pause about how we provide care to adolescent girls who are sexually active," said Dr. Elizabeth Alderman, an adolescent medicine specialist at Children's Hospital at Montefiore in New York City and chairperson of the Executive Committee of the Section of Adolescent Health of the American Academy of Pediatrics. "The numbers are really astonishing."

Forhan noted that most of the burden of STDs falls on young African-American women. "Among African-American teenagers, about one in two were affected compared to one in five white teens," she said.

In terms of the racial disparity, "it's what we've always seen, which is very unfortunate," Alderman said.

In the study, Forhan's team collected data on 838 girls aged 14 to 19 who took part in the 2003-2004 National Health and Nutrition Examination Survey. The study did not include syphilis, gonorrhea or HIV, as earlier studies found very low prevalence of these diseases in this age group.

HPV and chlamydia are the most common STDs found among teenage girls, Forhan said. "Almost one in five overall had a strain of HPV associated with cervical cancer or genital warts," she said.

"We need to be screening adolescent girls who are sexually active and providing them with HPV vaccine," Alderman said. "The recommendations are to screen sexually active girls, but many girls don't disclose to their health-care provider that they are sexually active, even when asked," she said.

As for chlamydia, 4 percent of teenaged girls had this STD, Forhan said. "The majority of chlamydia infections do not have symptoms. If left untreated, it can lead to pelvic inflammatory disease, which leaves these young women at risk for atopic pregnancy, chronic pelvic pain or infertility," she said.

In addition, the study found that 2.9 percent of young women had trichomoniasis, and 2 percent were infected with genital herpes, Forhan said.

According to Forhan, about 50 percent of the teens reported having sex, and the prevalence of STDs in this group was 40 percent. "Even for young women with only one reported lifetime sexual partner, one in five had an STD," she noted.

"If you choose to be sexually active, you need to protect yourself and be screened for these infections," Alderman said. "And all girls between the ages of 11 and 26 should get vaccinated for HPV."

Among women with an STD, 15 percent had more than one infection, Forhan added.
"These data provide a clearest picture to date of the overall burden of STDs in adolescent women in the United States," Forhan said. "The study also underscores the importance of addressing racial disparities in STD rates among young women."

Race itself is not a risk factor for STDs, Forhan said. However, factors such as limited access to health care, poverty, community prevalence of STDs, and misperceptions about individual risk are some of the reasons that STD rates are particularly high among African-Americans, she said.
More information
For more on STDs, visit the U.S. Centers for Disease Control and Prevention.

Earlier Colon Cancer Screens Urged for Smokers

(HealthDay News) -- Smokers and people with significant exposure to secondhand smoke should start getting screened for cololon cancer five to 10 years earlier than the current recommended age of 50, a new study says.

Researchers at the University of Rochester Medical Center in New York analyzed the cases of 3,450 colon cancer patients and found that current smokers were diagnosed with the cancer an average of 6.8 years earlier than people who never smoked, while former smokers who'd quit less than five years before were diagnosed 4.3 years earlier than people who never smoked.

People who'd quit more than five years before were the same as never-smokers.

People who started smoking before age 17 and those who were heavy smokers (one pack or more a day) were most likely to be diagnosed with colon cancer at a younger age.

The study also found that people exposed to secondhand smoke, especially early in life, tended to be younger when they were diagnosed with colon cancer.

The findings were published online in the Journal of Cancer Research and Clinical Oncology.
"The message for physicians and patients is clear: When making decisions about colon cancer screening, you should take into account smoking history as well as family history of disease and age," study author Luke J. Peppone, a research assistant professor of radiation oncology, said in a prepared statement.

Smoking has long been recognized as a major risk factor for many kinds of cancers, but it's only been recently that researchers have linked smoking with colon cancer, which is one of the most common kinds of cancer in the United States.

More information
The U.S. National Cancer Institute has more about colorectal cancer screening.

Born to Be Obese?

(HealthDay News) -- The brain circuitry that controls appetite might be wired differently in some people, and that could predispose them to obesity, California researchers suggest.

The study was conducted in rats, not humans, and yet it could ultimately lead to novel obesity treatments, said Philip Smith, director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases.

"It is not just about drugs that modify short-term appetite," he said, "there may be drugs that stimulate development of the appropriate neural pathways. So, it is an exciting, but very early, time in this field."

The study was published in the February issue of Cell Metabolism.

Sebastien Bouret, an assistant professor of neuroscience at the University of Southern California, and his colleagues examined neural circuits emanating from the appetite, hunger and body-weight control center of the brain -- the so-called arcuate nucleus of the hypothalamus (ARH) -- in a series of rats bred to be either prone to, or resistant to, obesity.

The team found fewer neural connections projecting from the ARH in obesity-prone animals than in their leaner counterparts. Surprisingly, Bouret said, this deficiency developed very early in life, before the animals became obese, and appeared to extend into adulthood.

"Somehow, these animals are programmed to become obese," Bouret said. "The obesity is hard-wired into the brain."

When the researchers then looked at why the brains of obese rats differed from their normal-weight counterparts, they found that the neurons from obesity-prone animals were less responsive to leptin, a hormone that controls the development of these circuits, and which also signals the body's energy status and controls metabolic rate.

"This paper presumes to say, these animals must be leptin-resistant, and that is why the pathways are not developing," said Smith.

But that doesn't mean they are doomed to a life of severe obesity, said Dr. Barbara Kahn, chief of the Division of Endocrinology, Diabetes and Metabolism at Beth Israel Deaconess Medical Center, in Boston. How they live their lives also matters.

"It is important not to 'blame' the obese person or imply that he/she is responsible for being obese," Kahn noted. "Having said that, reasonable, healthy caloric restriction and a safe and sustainable program of physical activity can help limit weight gain and often bring about some degree of weight loss. In addition, healthy eating and regular exercise can reduce the complications of obesity such as type 2 diabetes and cardiovascular disease."

At the same time, she added, not everyone can wear a size 4.

"There is a certain aspect of genetics that sets somebody in a certain range of possible body weights, and then how that person lives his or her life will determine whether they are at the bottom or top of the range," she explained.

Human obesity has both genetic and environmental roots. The rats used in this study, like most humans, developed obesity when fed a high-energy diet. On a normal diet, they were heavier than normal rats, but not yet obese.

"This is quite an exciting paper," said Smith, "because it links more closely to human behavior than most rodent models we have seen."

The findings also suggest a possible therapeutic approach to combating human obesity. If drugs could be designed to influence the formation of neural circuits during development and targeted to at-risk pregnancies, Smith said, "there is a good likelihood we could have successful interventions that improve the health of the mother, and which have a major impact on disease risk for the infant, during pregnancy."

A related study from Boston University researchers in the same journal found that bulking up muscle mass can lead to a general metabolic improvement in obese individuals. "Interventions designed to increase skeletal muscle mass in at-risk human populations may prove to be critical weapons in the fight against obesity and obesity-related comorbidities, including diabetes, heart disease, stroke, hypertension and cancer," an accompanying editorial stated.

More information
For more on obesity, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Hyperthermia Treatment For Breast Cancer

Oxy-Powder® Complete Cleansing System $147.75 [ learn more ] Complete Cleansing System with Livatrex™, Oxy-Powder®, Latero-Flora™, and two bottles of ParaTrex®.

Terriers Join Fight Against a Killer Disease in Humans

(HealthDay News) -- A feisty breed of terrier could stop scientists from barking up the wrong tree as they research a deadly lung disease in humans.

The illness, called idiopathic pulmonary fibrosis (IPF), affects 128,000 Americans, is typically fatal within three years of diagnosis, and kills more than 40,000 people in the United States annually -- a death toll equivalent to that of breast cancer.

A fatal condition that looks remarkably like IPF also strikes the diminutive West Highland White terrier ("Westie"), however. And recently, medical scientists from the human and veterinarian worlds met for the first time to share information and pool resources against a mysterious killer.

"People may be a little startled at first to learn about this idea -- 'You're kidding me, you actually think there's promise in studying this dog to help my Dad with this disease?' And the answer is -- 'Yes'," said Mark Shreve, chief operating officer of the patient advocacy group Coalition for Pulmonary Fibrosis, based in San Jose, Calif.

Because the Westie is so tightly bred, and because the illness progresses faster in dogs than humans, it is conceivable that dog-based research might yield valuable clues to the genetics or environmental factors that trigger pulmonary fibrosis in both species, experts explained.

"And if it transpires that it is the same disease, then obviously the options are limitless as to how we can look at information from dogs and use it to understand the disease in humans and vice versa," said Dr. Brendan Corcoran, director of the Hospital for Small Animals at the University of Edinburgh, Scotland, and a pioneer in researching pulmonary fibrosis in Westies.

According to Shreve, most people find it hard to believe that a disease like IPF even exists amid the wonders of modern medicine.

"We are dealing here with one of the few diseases left on the planet for which there are no proven causes and no treatments," he said.

Idiopathic pulmonary fibrosis occurs spontaneously, although certain factors -- such as smoking or exposure to airborne toxins -- do raise risks for the illness. "IPF is a progressive scarring process in the lungs that gradually robs a person of the ability to breathe," Shreve explained.

Some sort of signaling seems to go awry at the cellular level, he said, converting normal, expansive lung tissue into stiff, fibrotic scar tissue.

"Once it starts in patients with IPF, your body just never sends a signal to stop that scar tissue from being produced," Shreve said. "This scar tissue is obviously not lung tissue that is able to process oxygen."

There have so far been very few promising leads in discovering the root causes of IPF, said Dr. Jesse Roman, one of the country's leading researchers in the disease and a professor of medicine at Emory University in Atlanta.

"Studies do suggest very specific [cellular] pathways, and there's a number of molecules that everybody is tuned into," he said. "But how you block them and how they relate to what happens in humans, that's less clear."

So, scientists are turning to creative new ways of looking at IPF.

Cross-talk between scientists worldwide led to the first-ever summit on the disease that included both veterinary and human medical researchers. The meeting was held in October on the campus of Purdue University in West Lafayette, Ind., and was attended by Corcoran, Roman and others. It was sponsored by the Westie Foundation of America and the American Kennel Club (AKC) Canine Health Foundation.

Westies, which grow to just under a foot in length, are described by the AKC as "courageous and self-reliant, but friendly."

"They're a very popular pet because of their size and their nature," Corcoran said.

However, pulmonary fibrosis does pop up in the breed with regularity, first revealing itself as excessive panting and shortness of breath. The illness also tends to develop in the terriers' late middle-age (about eight or nine years), mimicking its typical onset in humans at about age 50 to 60.

Westies inevitably succumb to the lung fibrosis about a year and a half after their diagnosis, Corcoran said.

Still, "there's still the contentious issue of whether this is the same disease as occurs in humans," he said. The exact prevalence of the disease among Westies is also unclear, he added. That means the first aim of Westies-centered research will be epidemiological -- studying disease prevalence and gathering a core of dogs and their owners that researchers might follow going forward.

Getting postmortem samples of canine lung tissue will also be crucial to a better understanding of the causes of the disease, Corcoran said. But that has its own challenges, he added.

"Getting owners to volunteer their dogs for necropsy is always problematic," he said. In fact, it's often "harder in many instances to get lung pathology samples from dogs than it is from humans," Corcoran said.

"However, one of our plans is to try and build up a group of concerned owners who will volunteer to donate their dog when that day arrives. We've been having some discussions on that already with our colleagues in America," Corcoran said. "Hopefully, the more publicity that we get with this condition, the more we may get owners coming forward and volunteering their dogs for research."

Corcoran and the other experts said that a cure for IPF is definitely not around the corner -- the disease has been as tenacious in keeping its secrets as, well, a terrier.

But Westies may be just the foe in the fight against IPF requires. Corcoran pointed out that the dogs' tight breeding means genetic research could yield important clues. And their shorter lifespan -- a seventh of that of humans -- means scientists can watch the disease in "fast-forward," which might also speed research.

Westies are also free of certain confounding factors, such as smoking, that often muddle human research. "The dogs might turn out to have a very pure form of the disease that allows you to investigate the disease itself and not worry about other factors," Corcoran noted.

Given all of this, "why wouldn't you look at a Westie and research how the disease progresses?" said patient-advocate Shreve.

"We think it's a very creative approach to trying to help out humans," he said, "and our patients don't really have the patience to hang around waiting for a miracle.

More information
To learn much more about IPF, visit the Coalition for Pulmonary Fibrosis.

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Cancer Killed Almost 8 Million Worldwide in 2007

(HealthDay News) -- Cancer continues to cut a deadly swath across the globe, with the American Cancer Society reporting 12 million new cases of malignancy diagnosed worldwide in 2007, with 7.6 million people dying from the disease.

The report, Global Cancer Facts & Figures, finds that 5.4 million of those cancers and 2.9 million deaths are in more affluent, developed nations, while 6.7 million new cancer cases and 4.7 million deaths hit people in developing countries.

"The point of the report is to promote cancer control worldwide, and increase awareness worldwide," said report co-author Dr. Ahmedin Jemal, director of the society's Cancer Occurrence Office.

The number of cancers and cancer deaths around the world is on the rise, Jemal said, mostly due to an aging population. "There is increasing life expectancy, and cancer occurs more frequently in older age groups," he noted.

Lifestyle may be another reason for the rise in malignancies in developing countries, Jemal said, as people adopt Western behaviors such as smoking, high-fat diets and less physical activity.

The best way to stem the increasing number of cancer cases and deaths is prevention, especially in poorer countries, the expert said. In many developing nations, the health-care infrastructure simply isn't there to offer cancer screening and treatment for most people, Jemal added.

In developed countries, the most common cancers among men are prostate, lung and colorectal cancer. Among women, the most common cancers are breast, colorectal and lung cancer, according to the report.

However, in developing countries the three most common cancers among men are lung, stomach and liver, and among women, breast, cervix uteri and stomach.

Worldwide, some 15 percent of all cancers are thought to be related to infections, including hepatitis (liver cancer) and human papilloma virus (cervical cancer). But the incidence of infection-related cancers remains three times higher in developing countries compared with developed countries (26 percent vs. 8 percent), according to the report.

In addition, cancer survival rates in many developing countries are far below those in developed countries. This is mostly due to the lack of early detection and treatment services. For example, in North America five-year childhood cancer survival rates are about 75 percent compared with three-year survival rates of 48 percent to 62 percent in Central America, the report notes. The report estimates that 60 percent of the world's children who develop cancer have little or no access to treatment.

The report also includes a section on the toll tobacco use takes around the world. In 2000, some 5 million people worldwide died from tobacco use. Of these, about 30 percent (1.42 million) died from cancer -- 850,000 from lung cancer alone.

Jemal believes smoking is a key culprit.

"Smoking prevalence is decreasing in developed countries. So, as tobacco companies are losing market in developed countries they are trying to expand their market in developing countries," he said.

In China alone, more than 350 million people smoke. "That's more than the entire population of the United States," Jemal said. "If these current patterns continue, there will be 2 billion smokers worldwide by the year 2030, half of whom will die of smoking-related diseases if they do not quit," he added.

In the 20th century, tobacco use caused about 100 million deaths around the world. In this century, that figure is expected to rise to over 1 billion people. Most of these will occur in developing countries.

One expert agreed that many cancer deaths can be avoided through lifestyle changes.
"What is most provocative here is not the total global burden of suffering and death cancer causes, dramatic though that may be, but the variations in cancer occurrence around the world, and the insights provided about how much of the cancer burden need not occur at all," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.

In developing countries, cancer of the uterine cervix is a leading cause of death in women, Katz noted.

"Yet this infection-related cancer is now preventable by vaccine, and long treatable when detected early using the Pap smear. As a result, death from cervical cancer in developed countries is dramatically lower. Its toll in the developing world is testimony to missed opportunities to apply our resources effectively, and equitably," he said.

Cancer of the liver, often related to hepatitis infection, is a leading cause of death in developing countries, but not so in developed countries. "Again, an infection preventable with vaccine is causing death because of inequities in the distribution and use of existing resources," Katz said.

Prostate and colon cancers are more common in wealthier countries, where they are likely related to poor diet and obesity, Katz said. "Unnecessary suffering and death are occurring in affluent countries due to dietary excesses," he said.

Katz also noted that tobacco-related cancer is largely preventable. "The toll of tobacco-related disease, including lung cancer, is an appalling example of a global willingness to tolerate preventable suffering and death for the sake of profit," he said.

These data show both developed and developing countries how to move toward the lower rates of specific cancers, Katz said.

"It will be a tragic failure for public health if instead of applying these lessons developed countries continue to export tobacco and dietary transgressions so that the developing world adds to its current cancer burden ours as well," he said.

More information
For more information on cancer, visit the American Cancer Society.

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Research Shows What Works to Cut Smoking Rates

(HealthDay News) -- Graphic warning labels on packages, bans on cigarette advertising, legislating smoke-free areas, boosting cigarette prices, and preventing smuggling and counterfeiting of tobacco products are among the most effective ways to discourage smoking, according to researchers involved in a study on international tobacco control policies.

Mandating tar and nicotine levels in cigarettes hasn't been as effective as these other approaches, said the researchers, who've been investigating progress on controlling tobacco use under the Framework Convention on Tobacco Control (FCTC). The 151 countries that have ratified the World Health Organization-introduced treaty are required to implement its policies within a few years.

"For the first time ever, we are beginning to scientifically assess which governmental tobacco control policies are working and which ones are not," K. Michael Cummings, chair of the department of health behavior at Roswell Park Cancer Institute in Buffalo, N.Y.

"In the same way that evidence-based medicine has been built from rigorous evaluation of treatment options, our goal is to contribute to the development of a sound science base for tobacco-control policies," Cummings said.

He launched the study in four countries in 2002 and has expanded it into 15 countries with the help of 60 investigators from 17 research institutes.

The International Tobacco Control Policy Evaluation study compares tobacco use behaviors in nations that have implemented tobacco control policies to countries -- including the United States -- that have not implemented such measures. There are between 1,000 to 2,000 participants in each country included in the study.

A number of policies are effective, including graphic warning labels on cigarette packages.
"Our research on package warnings has revealed that these warnings, especially if they are large and graphic, are more effective than anyone realized, especially in poorer countries that can't afford expensive counter-marketing campaigns," Cummings said.

But the European Union's move to set maximum tar and nicotine emission standards for cigarettes has failed. The goal was to reduce the toxicity of cigarettes. However, the testing method used by the EU was flawed, and cigarette makers increased filter ventilation to pass the test, without having to reduce the toxicity of cigarettes.

"The well intentioned, but flawed EU policy has given smokers the false illusion that their cigarettes deliver less tar and nicotine, which they don't," Cummings said.

The research was to be presented Thursday at an American Association for Cancer Research meeting in Philadelphia.

More information
The U.S. Centers for Disease Control and Prevention has more about global tobacco control.

Cancer Patients Gain From Reporting Symptoms Online

(HealthDay News) -- Having cancer patients report to doctors on their symptoms and side effects online may improve their care, a new study finds.

Even the sickest cancer patients are willing and capable of reporting their symptoms online, says a team from Memorial Sloan-Kettering Cancer Center in New York City.

"Cancer care has become increasingly complex, causing office visits to become more compressed. This makes it challenging for the clinician to comprehensively assess each patient's symptoms in that brief window of time," study author Dr. Ethan Basch, a medical oncologist, said in a prepared statement.

"Because cancer therapies can be highly toxic, early detection of symptoms and timely treatment is vital. What is exciting to us about online self-reporting is that patients can alert clinicians to crucial symptoms in real time," Basch said.

The study included 107 lung cancer patients receiving outpatient chemotherapy who had access to a secure Internet patient reporting system developed by Basch and his colleagues. The patients were able to access the Symptom Tracking and Reporting (STAR) site using computers in waiting room kiosks and at home to report cancer symptoms and chemotherapy-related side effects.

The patients were followed for up to 16 months and 40 visits. All of the patients used the waiting room kiosks at some or all of their office visits, and an average of 78 percent logged onto the system at any given office visit. Patients were more likely to use STAR if they had prior computer experience.

The study found that 98 percent of patients found STAR easy to use, 90 percent said it was useful, and 77 percent believed it improved the quality of their discussions with clinicians.
The study appears in the Dec. 1 issue of the Journal of Clinical Oncology.

More information
The U.S. National Cancer Institute has more about coping with cancer.

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Prostate Cancer Treatments Often Compound Existing Health Problems

(HealthDay News) -- More than a third of prostate cancer patients may receive treatments that are inappropriate because of problems they are already having with urinary, bowel or sexual function, a new study suggests.

These mismatches might occur, because patients don't give enough information to their doctor or because their doctor favors a particular type of treatment, according to the report in the Nov. 26 online edition of Cancer.

"We found an awful lot of patients whose treatment seemed to be contraindicated by urinary, bowel or sexual problems they had before they got treated," said lead researcher Dr. James Talcott, from the Center for Outcomes Research at Massachusetts General Hospital Cancer Center in Boston. "That's pretty good evidence that information wasn't transmitted or didn't factor in with the treatment decision."

Unlike other cancers, there are several treatment options for prostate cancer. The treatment that is best for an individual patient is based on several factors, including stage at which the cancer is diagnosed, age of the patient, and existing problems with urinary, bowel or sexual function that the patient has.

Treatments include external radiation therapy; brachytherapy, in which tiny radioactive particles are implanted into the prostate gland, and the surgical removal of the prostate gland.
Although these treatments are effective, each has a different set of side effects. External radiation can lead to bowel dysfunction, brachytherapy can cause urinary problems, and surgery can damage nerves involved in sexual function.

Treating patients who already have problems in these areas with a procedure that could exacerbate their problem is usually not recommended.

For example, treatment designed to preserve normal functions, such as nerve-sparing, prostate-removal surgery, is not appropriate for patients who have already lost sexual function, Talcott said.

To find the extent of treatment mismatches, Talcott's team collected data on 438 prostate cancer patients. Patients were asked to complete questionnaires that included questions about urinary incontinence and other urinary problems, and bowel and sexual dysfunction.

The researchers found that 89 percent of the patients had some level of urinary, bowel or sexual problem before starting treatment. Among these patients, 34 percent of those with one serious symptom had a mismatched treatment, as did 37 percent who had a less serious symptom. Moreover, 40 percent of those who had several symptoms also received contraindicated therapy.

In addition, among patients with significant dysfunction in all three areas for whom no treatment would be recommended, only 5 percent chose watchful waiting. In this strategy, patients are not treated but are followed closely.

These mismatches appear to occur because doctors and patients don't communicate well. Patients are often reluctant to talk about urinary, bowel and sexual problems, Talcott said. "And, sometimes patients override their doctor's recommendation," he added.

Talcott also thinks that physicians can be wedded to a particular treatment at the exclusion of others. "Surgeons believe in surgery, and radiation oncologists believe in radiation," he said. "That may be part of the problem."

To counterbalance physician bias, patients should get another opinion, Talcott said. "Patients should always get a second consult," he said. "It's a good idea to talk with a surgeon, a radiation oncologist and possible a medical oncologist."

One expert thinks that patients need to make an informed decision about which treatment is best.

"The kind of doctor that you see often predetermines the treatment you receive," said Dr. Durado Brooks, director of prostate and colorectal cancer at the American Cancer Society. "Urologists are much more likely to have a surgical solution, and those who see a radiation oncologist are more likely to have radiation."

Patients need to be well-informed about their condition and the possible treatments and their side effects, Brooks said. "Patients need to arm themselves with as much information as possible about what their treatment options are, and what some of the contraindications of particular treatments are," he said.

Men also need to know what all the treatment options are, Brooks said. "Men need to be aware that, in some cases, depending on their overall medical condition and the stage of their cancer, that it is, at times, appropriate not to have any active treatment," he said. "Watchful waiting is a legitimate option in a significant proportion of men."

"In addition, doctors need to work with their patient to choose the best treatment option, Brooks said.

"If one takes the time to have a discussion, educate the patient and not rush them into a decision, then you may be able to allow them to get past their emotional response and make a more educated, logic-based response," Brooks said.

Brooks noted that because there are so many treatment options in prostate cancer, patients may insist on a particular treatment even though it's not the best choice for them.

"Where treatments are contraindicated in other places in medicine, doctors don't provide a treatment for a patient just because that's what they say they want," Brooks said. "You explain that that treatment is simply the wrong treatment for you, and therefore, we are not going to take that approach."

More information
For more on prostate cancer, visit the American Cancer Society.

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Cell Insights May Predict Breast Cancer's Spread

(HealthDay News) -- U.S. researchers believe they're on the way to solving a major question about breast cancer: Which women have a type of lesion in their breast duct that will progress to invasive disease?

"It's an exciting step forward -- people have been trying to get traction on this big clinical problem for about 40 years, and this is a big crack in the door," said lead researcher Thea Tlsty, a professor of pathology at the University of California, San Francisco.

Ductal carcinoma in situ (DCIS), as this type of lesion is officially known, is diagnosed in about 47,000 American women every year, according to the U.S. National Cancer Institute. To prevent its recurrence as invasive breast cancer, DCIS generally is treated by lumpectomy alone (approximately 25 percent of cases) or lumpectomy with adjunctive treatments such as radiation, chemotherapy, and/or hormones (approximately 40 percent).

In about 25 percent of cases, complete mastectomies are performed. Less than an estimated 5 percent of women choose "watchful waiting" in lieu of a surgical intervention, Tlsty said.

But doctors are still confronted with a guessing game when it comes to predicting those patients at highest risk for recurrence, Tlsty said. "Only about 12 to 15 percent of women diagnosed with DCIS are going to have a future invasive cancer, and all the others won't. Up until now, the problem was that we couldn't distinguish the 12 to 15 percent from those who were not [at risk]," explained Tlsty.

Consequently, some women unknowingly are overtreated by having a mastectomy, and others are undertreated if they chose a course of watchful waiting rather than surgical intervention, Tlsty added.

In their pilot study, published in the November issue of Cancer Cell, the UCSF team looked at how a collection of biomarkers, including molecules called p16 and ki67, interact to predict invasive tumors, she explained.

Because this initial study was done on tissue samples from 70 women, a larger retrospective study is under way at UCSF to validate the initial results, Tlsty said.

Further research, including a large prospective trial, is also needed before the findings can be ready for clinical use, she added. If that work upholds the results of the pilot study, the biomarkers could be ready for clinical use within four to five years, Tlsty said.

Dr. Joseph Geradts, a professor of pathology at Duke University in Durham, N.C., said that finding biomarkers that predict the conversion of DCIS into invasive cancer is "the holy grail of breast cancer research." He said there have been a number of previous studies that have been published, but, so far, they've been "mostly a fruitless effort."

According to Geradts, the UCSF study "is valuable," because "the authors propose two new biomarkers that in the past have not been looked at." The UCSF team's findings "are intriguing preliminary data" that "merit confirmation and subsequent studies," he added.

Geradts said his own lab currently is researching whether changes in DNA may identify a tumor's capacity to metastasize or become invasive. Other researchers are looking at other DCIS biomarkers, he said.

"DCIS itself is a non-life threatening condition" with rare exceptions, noted Dr. Eric Winer, director of breast oncology at the Dana-Farber Cancer Institute in Boston, and women are usually treated to help prevent invasive cancer. If the findings of the initial UCSF study are confirmed, then with "careful investigation, we may get to the point where we don't have to treat all women with DCIS, and we may be able to tailor it so some women get less, and some women get more" depending upon their risk for invasive breast cancer, Winer said.

"It's a very complex and interesting study" added Dr. Richard Bleicher, a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "We need to be cautiously optimistic."

Bleicher added that while the findings have "significant potential," women at this point shouldn't "pin all your hopes on it," because the p16 assay is not something they can ask their doctors for at this point in time.

More information
For more on breast cancer, visit the U.S. National Cancer Institute.
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