Thyroid questions answered

Knight Ridder/Tribune Business News

01-02-12

Jan. 01–The terrible earthquake in Japan, and the resulting nuclear meltdowns, again have placed thyroid cancer in the news. There is a very close link between radiation exposure and thyroid cancer, and it is likely that Japan will see a sharp increase in aggressive thyroid cancers in the coming years, as was the case in Russia after the Chernobyl disaster in 1986.

Here in the United States, there was an increase in thyroid cancer following the nuclear testing in the 1950s in the Southwest. Though we have ceased such open-air testing, there are still numerous ways to be exposed to radiation, such as by receiving radiation therapy for cancer. And there is also a natural incidence of thyroid cancer unrelated to radiation exposure.

January is Thyroid Awareness Month, so it’s an apt time to discuss the thyroid, thyroid cancer and other thyroid conditions.

What is the thyroid?

The thyroid is a gland in the neck that regulates metabolism. Around New Year’s, it is common to hear talk of underactive thyroid and how it can cause weight gain and sluggishness. Underactive thyroids can be treated very successfully with medication. Hormone replacement therapy is typically associated with few complications.

While thyroids can be underactive, they also can be overactive, causing jitteriness, weight loss, bulging eyes and sweating, among other symptoms. Overactive thyroids can be treated with medication, doses of radioactive iodine or surgery.

While all surgeries carry risks, surgical removal of a portion of the thyroid is a very effective way of treating overactive thyroid. Some surgeons will choose to remove only enough of the thyroid to reduce the glandular activity to a normal level. However, this carries the risk that the thyroid will again become overactive. As such, I, and other surgeons in my field, prefer to remove all of the thyroid — total thyroidectomy — and then place the patient on hormone replacement therapy. This helps to ensure additional surgery is not necessary.

Thyroid cancer

Thyroid cancer is much more common in women than in men. Often it is discovered when the patient feels a lump in the neck that is subsequently diagnosed as cancer.

If there is a question about whether a lump is benign, patients with a history of radiation exposure typically will be advised to have it removed. In patients without a history of radiation exposure, a course of action can include fine-needle aspiration, or needle biopsy, of the lump in order to guide decision-making. Thyroid cancer typically is very slow growing, and that allows a latitude in treatment that is unavailable when dealing with fast-growing cancers.

There are aggressive forms of thyroid cancer unrelated to radiation exposure, but they are very rare and typically occur in older males. You may recall that former U.S. Supreme Court Chief Justice William Rehnquist was diagnosed with an aggressive form of thyroid cancer.

More common forms of thyroid cancer often can be treated very effectively with thyroid surgery and medication.

Early detection

Women should have their thyroids checked as part of their annual physical. Thyroid cancer can strike women of any age, from the teenage years through the golden years.

People with a history of radiation exposure also should be careful in monitoring their thyroids. And anyone who develops a lump in the neck that remains for more than a couple of weeks should visit a doctor.

At the University of Virginia Health System, we take a multidisciplinary approach to treating thyroid cancer and other thyroid issues. Our physicians have significant experience and expertise in thyroid cases, and we work collaboratively to determine the best course of treatment for each patient.

Dr. John B. Hanks is a surgeon who treats thyroid and adrenal issues at the University of Virginia Health System.

Visit uvahealth.com for more information about thyroid issues.

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(c)2012 The Daily Progress (Charlottesville, Va.)

Visit The Daily Progress (Charlottesville, Va.) at www2.dailyprogress.com

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Classy and extra nutritious

United Press International

12-23-11

Chefs prepare food that is black in color because the shade is chic and a bit dramatic, but the dishes are also a boost to health, a U.S. food expert says.

Phil Lempert, a food industry analyst, trend watcher and creator of the Web site supermarketguru.com, said the dark color is the result of naturally occurring flavonoid pigments called anthocyanins — which protect the plant against oxidation, pests and from damaging radiation from the sun.

In the body, anthocyanins act as antioxidants and anti-inflammatory agents, protecting against the development of chronic diseases, such as Alzheimer’s, diabetes, heart disease and certain cancers, as well as contributing to overall good health.

For example, black rice, which contains higher amounts of vitamin E in the bran, is great for the immune system and contains more anthocyanin antioxidants than blueberries, the Agricultural Center at Louisiana State University found.

One cup of black lentils contain 8 milligrams of iron, about half the daily recommendation for women, while

black beans are packed with bioflavonoids, powerful plant nutrients that may protect against cancer, Lempert said.

Blackberries, a great source of fiber, are a great choice as an ingredient or as dessert. They contain polyphenols that may help reduce cognitive decline, the Human Nutrition Research Center on Aging found.

To wash it down, choose black tea, which contains theaflavins, antioxidants Rutgers University suggested may improve recovery from muscle soreness after intense exercise, Lempert said.

Copyright United Press International 2011

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Mercury falling

Akron Beacon Journal, Ohio

12-27-11

Dec. 26–The Obama White House hardly delivered a surprise with its new limits on emissions of mercury and other toxic pollutants from the nation’s coal- and oil-burning power plants. The rules have been 20 years in the making. George W. Bush proposed a regulation covering mercury emissions, but he failed in the courts because the rule did not meet the minimum standards of the Clean Air Act. That result is worth keeping in mind, reflecting, as it does, the purpose of the law: To protect public health.

Mercury is a neurotoxin. It can harm the nervous systems of fetuses and young children, leading to lifelong development problems. Mercury emissions fall to the ground via rain and snow, accumulating in rivers and lakes, resulting in advisories about their use, even filtering into the food chain. Other toxic pollutants covered by the new rule, including dioxin, can lead to cancer, premature death, heart disease and asthma.

The U.S. Environmental Protection Agency calculates that the limits will reduce mercury emissions by 90 percent, preventing 11,000 premature deaths and 4,700 heart attacks per year. It will reduce annual childhood asthma cases by 130,000 and acute bronchitis in children by 6,300. All of that translates into fewer hospital visits (by 5,700 annually). It also means fewer days missed at school and work (a projected 540,000 a year).

The EPA puts the health benefits between $37 billion and $90 billion by 2016.

That range compares favorably to the estimated cost of implementing the limits, power companies facing a tab of $11 billion. The breakdown tracks past experience under the four-decade-old Clean Air Act, benefits outpacing costs.

The point isn’t to say implementation will be easy. Ohio ranks as the nation’s second leading emitter of mercury pollution. FirstEnergy and especially American Electric Power face making substantial investment.

One option for power companies is closing down aging plants. The Associated Press conducted a survey of plant operators and found that as many as 68 coal-fired plants, or 8 percent of the nation’s capacity, will be shut down in the years ahead. The average age of these plants is 51 years, indicating that they already are nearing retirement. Why not just wait? Because that has been the thinking for decades, power companies then finding ways to prolong the life of dirty plants.

Be skeptical, too, of dire warnings about portions of the country losing power. For starters, the rule contains enough flexibility. More, it states clearly, and logically, that if there is a threat to the power supply, the implementation regimen will be adjusted. Know that the North American Reliability Corp. has observed recently that it doesn’t think the lights will go out because of the new limits.

For decades, decisions to implement the Clean Air Act have come with some pain. The test has been whether the pollution control has brought benefits overall. Again, the experience has been that it has, and it will likely prove the same now that the country finally has moved to reduce mercury and other toxic emissions.

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(c)2011 the Akron Beacon Journal (Akron, Ohio)

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Listening to body signals aids weight loss

United Press International

12-12-11

Mastering mindful eating — awareness of eating — and stress-reduction techniques help prevent weight gain even without dieting, U.S. researchers say.

Jennifer Daubenmier and the Elissa Epel University of California, San Francisco, said the women involved in their study were not on calorie-counting diets.

Instead, 24 of the 47 chronically stressed, overweight and obese women were randomly assigned to mindfulness training and practice. The other 23 served as a control group. No diets were prescribed, but all participants attended one session about the basics of healthy eating and exercise.

The training included nine weekly sessions, each lasting 2.5 hours, during which the women learned stress reduction techniques and how to be more aware of their eating by recognizing bodily sensations, including: hunger, fullness and taste satisfaction.

At week six they attended an intensive 7-hour, silent meditation retreat, the researchers said.

The study participants were asked to set aside 30 minutes daily for meditation exercises and to practice mindful eating during meals.

The study, published online in the Journal of Obesity, found those who had greater improvements in listening to their bodies’ cues, or greater reductions in stress or cortisol — a stress hormone — experienced the greatest reductions in abdominal fat.

Copyright United Press International 2011

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Why women quit breast cancer drugs early

NewsRx.com

12-22-11

CHICAGO – Why do so many postmenopausal women who are treated for estrogen-sensitive breast cancer quit using drugs that help prevent the disease from recurring?

The first study to actually ask the women themselves – as well as the largest, most scientifically rigorous study to examine the question – reports 36 percent of women quit early because of the medications’ side effects, which are more severe and widespread than previously known. The Northwestern Medicine research also reveals a big gap between what women tell their doctors about side effects and what they actually experience (see also Breast Cancer).

“Clinicians consistently underestimate the side effects associated with treatment,” said lead investigator Lynne Wagner, an associate professor in medical social sciences at Northwestern University Feinberg School of Medicine and a clinical psychologist at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “They give patients a drug they hope will help them, so they have a motivation to underrate the negative effects. Patients don’t want to be complainers and don’t want their doctor to discontinue treatment. So no one knew how bad it really was for patients.”

The symptom most likely to cause women to stop using the drugs was joint pain. Other side effects women reported as compromising their quality of life were hot flashes, decreased libido, weight gain, feeling bloated, breast sensitivity, mood swings, irritability and nausea.

Wagner’s research will be presented Dec. 9 at the 34th Annual San Antonio Breast Cancer Symposium.

The drugs, aromatase inhibitors, stop the production of estrogen in postmenopausal women, whose breast cancer cells are stimulated by estrogen. About two-thirds of breast cancers are estrogen sensitive, and aromatase inhibitors reduce the recurrence of cancer in postmenopausal women.

The women at highest risk for quitting the medications before the recommended five years are those who still are experiencing residual side effects from recent chemotherapy or radiation therapy when they start the aromatase therapy, according to the study. Women who had surgery for breast cancer but not chemotherapy or radiation therapy, or who weren’t taking many other medications, were more likely to keep taking the aromatase medication.

“The more miserable they were before they started, the more likely they were to quit,” Wagner said. “By the time they get through chemotherapy or radiation, they have to face five more years of another medication that will make them feel lousy. They feel like they already lost enough time to cancer and have reached their threshold for feeling bad.”

“This is a wake-up call to physicians that says if your patient is feeling really beaten up by treatment, the risk of her quitting early is high,” Wagner said. “We need to be better at managing the symptoms of our patients to improve their quality of life.”

The new research exposes the disparity between clinicians’ reporting of side effects and women’s actual experiences. In a previous study, clinicians reported 5 percent of their patients experienced moderate to severe symptoms as a result of taking aromatase inhibitors. The new Northwestern study surveyed 686 women with a detailed questionnaire about their symptoms before treatment and at three, six, 12 and 24 months after starting treatment. The researchers found after three months of treatment that 33 to 35 percent of women had severe joint pain, 28 to 29 percent had hot flashes, 24 percent had decreased libido, 15 to 24 percent had fatigue, 16 to 17 percent had night sweats and 14 to 17 percent had anxiety. These numbers increased as women were on treatment longer.

Earlier studies also asked women to recall their symptoms after treatment ended, which is less accurate than reporting them at regular intervals while taking the drugs.

As a result of the side effects, 36 percent of women ended treatment before an average of 4.1 years. After two years, 10 percent had quit; the remainder quit between 25 months and the 4.1 years.

“These findings can help us identify women at risk for quitting the therapy, counsel them about the importance of staying on it and provide treatment for troubling side effects,” Wagner noted.

Weight gain can be addressed with nutritional counseling, while mood swings and irritability can be treated with cognitive behavioral therapy or mind-body techniques, Wagner said. Joint pain can be tempered with nonsteroidal anti-inflammatory drugs, or women may be switched to a different hormonal medication. Nausea can be reduced with medication.

For the study, patients who had postmenopausal breast cancer filled out a 46-question survey rating their quality of life and symptoms associated with breast cancer and endocrine treatment. The survey included an item asking how much they were bothered by side effects of treatment from zero (not bothered) to four (severely bothered). For each additional one-point increase on this item, the patient’s risk of quitting treatment early rose 29 percent. The patients were randomized to take one of two hormonal treatments (anastrozole or exemestane) daily for five years.

Keywords: Hormones, Oncology, Cytochromes, Orthopedics, Hemeproteins, Rheumatology, Endocrinology, Women’s Health, Oxidoreductases, Enzyme Inhibitors, Steroid Hydroxylases, Enzymes and Coenzymes, Mixed Function Oxygenases.

This article was prepared by Biotech Week editors from staff and other reports. Copyright 2011, Biotech Week via NewsRx.com.

To see more of the NewsRx.com, or to subscribe, go to http://www.newsrx.com .

2007 NewsRx.com. All Rights Reserved.Copyright 2011, Biotech Week via NewsRx.com

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Doctor: Heed post-menopausal bleeding

United Press International

12-06-11

Recognizing possible symptoms of gynecologic cancers can lead to diagnosis and timely treatment, a U.S. gynecologic oncologist says.

Dr. Debra Richardson of the University of Texas Southwestern Medical Center in Dallas said women who have gone through menopause, for instance, should not experience any menstrual bleeding.

“Any bleeding — even spotting — after menopause is not normal and should be checked out by a gynecologist,” Richardson said in a statement.

Some common causes of postmenopausal bleeding include:

– Polyps are usually non-cancerous, but these growths can develop in the uterus, on the cervix or inside the cervical canal.

– Endometrial atrophy: The tissue that lines the uterus can become very thin after menopause.

– Endometrial hyperplasia: Sometimes the lining of the uterus becomes thick, usually due to too much estrogen and too little progesterone. Some patients may have abnormal cells that can lead to endometrial cancer.

– Cancer: Bleeding after menopause can be a sign of endometrial or uterine cancer.

Copyright United Press International 2011

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Blood pressure meds extend long-term life expectancy

Agence France-Presse

12-21-11

People who took blood pressure medicine during a 1980s clinical trial showed longer life expectancy two decades later than people who took a placebo, a US study said on Tuesday.

The randomized trial included 4,736 patients aged 60 and over who had high blood pressure. Some were given a drug called chlorthalidone and others were given a sugar pill for a 4.5 year period beginning in 1985.

At the end of the Systolic Hypertension in the Elderly Program (SHEP) trial, all participants were advised to begin following the drug regimen.

Recently, researchers in New Jersey decided to go back over the data, in consultation with the National Death Index, to see if the therapy had any impact on long-term life expectancy.

Indeed, they found that those who had taken chlorthalidone lived several months longer than those who had taken the placebo, according to the findings published in the Journal of the American Medical Association.

Those who took the drug lived 158 days longer before dying of cardiovascular causes than people who had taken the placebo, and 105 days longer when it came to dying of any cause.

“The gain in life expectancy free from cardiovascular death corresponds with one day (0.89 days) gained per month of treatment,” said the study.

“For all-cause mortality, the gain in life expectancy from one month of antihypertensive drug treatment was estimated at a half day (0.59 days).”

The study, led by John Kostis of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, should send a “strong message” to patients and doctors about the benefits of anti-hypertensive therapy, it concluded.

Left uncontrolled, high blood pressure — defined as 140/90 mmHg (millimeters of mercury) or above most of the time — can lead to heart failure, stroke, and kidney disease.

About one in three US adults has hypertension, according to the Centers for Disease Control and Prevention.

The research was funded by the National Heart, Lung, and Blood Institute, the National Institute on Aging, and the Robert Wood Johnson Foundation.

ksh/jm

COPYRIGHT 2002 Agence France-Presse. All rights reserved.

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BPA: a threat to health that’s hard to avoid

Annie Siebert
Pittsburgh Post-Gazette

12-20-11

Dec. 19–As concerns grow over the use of bisphenol A, or BPA, in consumer products ranging from water bottles to food cans, it’s already being phased out of certain items.

But that doesn’t mean the average American can get through a day without exposure to BPA, a chemical that could cause a range of health issues, including reproductive problems, cancer, diabetes, cardiovascular disease, obesity and behavioral issues. The 2003-04 National Health and Nutrition Examination Survey conducted by the U.S. Centers for Disease Control and Prevention found detectable levels of BPA in 93 percent of 2,517 urine samples from people 6 years and older.

The chemical is contained in polycarbonate plastics, making them tough and lightweight compared to glass. These include some food and drink packaging, compact discs, impact-resistant safety equipment and medical devices. BPA is also used in epoxy resins to coat metal products such as food cans, bottle tops and water supply pipes. According to the National Institute of Environmental Health, some dental sealants and composites may also add to BPA exposure.

BPA is often found in thermal paper receipts, as color developer in the paper coating. People often tuck receipts into pockets, wallets or purses alongside paper money, contaminating currency with the chemical, according to a study published in the journal Environmental Science & Technology in September. Kurunthachalam Kannan, a researcher with the Wadsworth Center at the New York State Department of Health and an author of the study, noted that 52 samples of paper currency from 21 countries all were tainted with BPA.

The highest concentration of 82.7 micrograms per gram was found in Brazil.

Receipts are often tossed in with recyclable paper, too, Mr. Kannan noted in a July study published in the same environmental journal.

“BPA gets into the paper recycling process, which contaminates many of the paper products,” he said.

Mr. Kannan found that BPA was found in milligram-per-gram levels in thermal receipt paper but only in microgram-per-gram levels in recycled items such as toilet paper, paper towels, paper napkins and newspapers.

Brief history of BPA

According to the Bisphenol A Global Industry Group, the first reported synthesis of BPA, from phenol and acetone, was from Thomas Zincke of the University of Marburg, Germany, in 1905. Although he reported key physical properties of BPA (such as its molecular composition, melting point, solubility in common solvents), he did not propose any application or use for BPA.

In 1953, Hermann Schnell of Bayer in Germany and Dan Fox of General Electric in the United States independently developed manufacturing processes for a new plastic material, polycarbonate, using BPA as the starting material. Polycarbonate plastic was found to have a unique combination of useful properties — optical clarity, shatter-resistance and high heat-resistance — which later made polycarbonate part of everyday life in a variety of products, the industry group says on the website www.bisphenol-a.org.

Commercial production began in 1957 in the United States and in 1958 in Europe. About this same time, epoxy resins were developed with the versatility to meet a wide range of industrial and consumer needs.

Its widespread use in manufacturing was noted in a U.S. Environmental Protection Agency action plan on bisphenol A, dated March 2010. Production volume of the chemical in the United States was estimated at 2.4 billion pounds in 2007, with an estimated value of almost $2 billion.

“The levels are lower than in thermal receipt papers,” he said.

Although the levels of BPA are significantly less in recycled paper products, it’s still a concern, Mr. Kannan said.

“The general population comes into contact with the paper products that we analyzed,” he said. “Obviously there is a source of exposure that has not been studied before.”

A Harvard School of Public Health study looked at another potential source of daily exposure for Americans — canned food.

The study linked consuming canned soup to elevated BPA levels. Participants in one group were given one serving of canned vegetarian soup once a day for five days. The other group consumed one serving of vegetarian soup made from scratch for five days.

Participants were given only 12 ounces of soup, noted lead author Jenny Carwile, and some complained that it wasn’t even enough food for lunch. After just five days, researchers checked the concentration of BPA in the participants’ urine.

Urine samples from the participants that consumed the canned soup showed a 1,221 percent increase in BPA compared to those who consumed the fresh soup.

“It was very surprising because we gave them so little canned food,” Ms. Carwile said. “It was a very moderate amount of canned food.”

She noted that manufacturers are starting to phase BPA out of plastic baby bottles, water bottles and other items, but we’re a long way from being BPA free, and limiting the consumption of canned food is one way to reduce exposure.

“A lot of people try to be aware of their exposure to chemicals like BPA, and this is one more way that they can avoid this chemical if they want to,” she said.

“It’s not about canned soup in particular,” she said. “It’s about canned food.”

A long-term study published last month in the journal Pediatrics looked at exposure to BPA in the womb and how it can affect children’s behavior.

Studies in animals indicated that exposure to BPA could cause behavioral problems, noted Joe Braun, Harvard Public Health researcher and the study’s lead author.

The study followed a group of women from the second trimester of pregnancy up until the child’s eighth or ninth birthday. During their pregnancies, the women were surveyed twice for demographic information and concentrations of BPA in their blood and urine were measured. Then, every year, the children would meet with researchers once a year for behavioral tests and give blood and urine samples. The children’s behavior was measured using scales reported by the mothers. They reported issues like having trouble sitting still, having to be redirected often, or talking about being sad or depressed, Mr. Braun said, noting that it’s a “valuable, reliable scale” that provides a continuous measure of behavior.

The researchers found each 10-fold increase in the mother’s urinary BPA concentration during pregnancy was associated with about a 10-point increase on the scale measuring behavioral difficulties, but only in girls.

Boys, for reasons unknown to the researchers, showed less hyperactive behavior, Mr. Braun said.

Studies in animals have shown, though not consistently, that BPA may affect behaviors differently in males and females because BPA acts like a hormone, and hormones are important for brain development, Mr. Braun said.

The National Resources Defense Council filed a petition with the U.S. Food and Drug Administration in February 2008 requesting a ban on BPA in any packaging that would come in contact with food. When the agency did not respond, NRDC filed a suit asking the court to intervene and require the FDA to respond.

In a Dec. 7 settlement with the NRDC, the FDA committed to decide by March 31 whether BPA should be banned from use in food and drink packaging.

In the meantime, how can the average consumer avoid coming into contact with BPA?

Mr. Kannan says people who work as cashiers and come into contact with thermal receipt paper throughout the day should wear gloves.

“The perfect solution would be to stop using BPA in receipt papers,” he said. “In the absence of that, if you have to have BPA on this paper, I would suggest washing your hands.”

Ridding your home of plastics containing BPA might be easier than avoiding receipts. To determine if a plastic container contains BPA, look at the bottom of the container. A “7″ in the recycling symbol means it might contain BPA. If it says “PC” below the recycling symbol, it definitely contains BPA, Ms. Carwile said.

Mr. Braun and Ms. Carwile recommended taking reasonable steps to avoid canned goods.

“If women are concerned about BPA, they can certainly take steps to reduce exposure,” Mr. Braun said. But he noted that eliminating canned goods isn’t practical for a lot of people.

“I certainly wouldn’t want people to switch canned vegetables … for cheeseburgers,” he said.

Annie Siebert: asiebert@post-gazette.com or 412-263-1613.

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Soy offers hope in treatment-resistant prostate cancer

Friday, December 16, 2011. The results of a pilot study published in the November, 2011 issue of the Southern Medical Journal suggest a benefit for soy in men whose prostate cancer failed to respond to radiation or surgery.

The success of prostate cancer therapy is evaluated by measuring a protein known as serum prostate specific antigen (PSA). A rise in PSA following radiation or surgery for prostate cancer indicates treatment failure. An option for these patients is androgen deprivation therapy which reduces testosterone (a hormone that may increase the growth of prostate cancer); however, the treatment has significant side effects and is not effective for all who use it.

Monika Joshi, MD and her colleagues at Pennsylvania State University enrolled ten men with treatment-resistant prostate cancer that had not metastasized, and assigned them to three servings of soy per day for two years, during which PSA levels were monitored. After 24 months, half of the men showed a response to soy with temporary or permanently declining PSA levels or stable PSA levels. Of three subjects who were being treated with androgen deprivation therapy and continued to have rising PSA levels, one responded to soy, while four of the remaining seven showed favorable responses. The researchers remark that soy may reduce PSA via a reduction in the expression of the androgen receptor and other mechanisms.

“Our findings are fairly congruent with what has been described in the literature on the use of this modality in prostate cancer,” the authors write. “We also show that soy can provide benefit in castration-resistant prostate cancer. Our clinical experience suggests that soy supplementation using commercially available soy products can have durable beneficial effects on PSA levels and PSA kinetics in some men with prostate cancer.”

“The results from Pennsylvania State University appear consistent with a considerable amount of published research showing that soy may help to prevent prostate cancer and may be useful in its treatment,” noted oncologist Omer Kucuk, MD, who is Georgia Cancer Coalition’s distinguished cancer scholar and chief of genitourinary medical oncology at Emory University’s Winship Cancer Institute. “For men unresponsive to surgery and radiation for prostate cancer, it is critically important to find androgen deprivation therapy alternatives, such as soy as a dietary intervention. While this study is small, it’s important because it takes place in real-life conditions in a clinical setting.”

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Medications can cause serious issues for elderly

Annie Getsinger, Herald & Review, Decatur, Ill.
Knight Ridder/Tribune Business News

12-14-11

Dec. 14–DECATUR — Each year, adverse reactions to medications cause approximately 100,000 emergency hospital visits for American adults 65 and older. The figure comes from a Centers for Disease Control and Prevention study recently published in the New England Journal of Medicine.

The study found that a small group of diabetes medications and drugs to prevent blood clots were causing about two-thirds of the hospitalizations, according to a news release issued by the CDC. The information was collected between 2007 and 2009 by the centers’ National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project.

“These data suggest that focusing safety initiatives on a few medicines that commonly cause serious, measurable harms can improve care for many older Americans,” said Dr. Dan Budnitz, director of CDC’s Medication Safety Program. “Blood thinners and diabetes medicines often require blood testing and dosing changes, but these are critical medicines for older adults with certain medical conditions. Doctors and patients should continue to use these medications but remember to work together to safely manage them.”

Approximately 48 percent of the hospitalizations mentioned in the study occurred in those 80 and older, and two-thirds were caused by overdoses or in situations where patients might have taken the amount of medication as prescribed, but the drug caused more than the intended effect in the person’s body.

Some of the drugs mentioned in the report were warfarin, a medication used to prevent blood clots, insulin, a substance used to control blood sugar in those with diabetes, oral diabetes medications and antiplatelet drugs, which inhibit platelet function to prevent clotting. Together, these medication types accounted for more than 70 percent of the hospitalizations.

National medication safety monitoring and initiatives will continue to be important, the CDC reported. And patients should work together with their physicians and pharmacists to gain a better understanding of the

medications they are on and how to manage them.

“Policies and improvement programs to promote safe use of medications that most commonly cause serious, measurable harms can increase patient safety and reduce unnecessary hospitalizations and costs at the same time,” Dr. Patrick Conway, chief medical officer of the Centers for Medicare & Medicaid Services and director of CMS’ office of Clinical Standards and Quality, was quoted as saying. “We are working across the federal government to address common preventable adverse drug events through medication management, care transition programs and other initiatives.”

For more information about the centers’ efforts to protect older adults from adverse medication events, visit www.cdc.gov/medicationsafety on the Web.

The Macon County Health Department has a medication management program for people of all ages to help ensure that people are taking their medications as directed, maintaining proper communication with physicians and pharmacies and understand the drugs and their effects.

agetsinger@herald-review.com 421-6968

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(c)2011 the Herald & Review (Decatur, Ill.)

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