Quotes of the Month
I don't know about your area of the country but we have had a delightfully moderate and unusually wet summer. A cool fall seems to be in the forecast and the combined moderate seasons are most unusual for North Texas - I'll take it any time. This Webletter will cover some advances in cancer therapy as reported at the recent meeting of the American Society of Clinical Oncology (ASCO) which was held in New Orleans, LA.
Stig Holmberg M.D. of Gothenberg, Sweden, principal investigator for the International Breast Cancer Study Group Trial 93, gave the first preliminary study report. He said older breast cancer patients who are clinically node negative (no palpable nodes in the axilla) can avoid axillary dissection and still have the same survival outcome as those women who underwent the surgical procedure. This information was outlined in the Aug 2004 issue of Oncology News International.
ED: By avoiding an axillary dissection, patients are spared the uncomfortable side effects of the procedure such as pain, numbness, swelling, and restricted motion. Oncologists had wondered if skipping a surgical dissection of the axilla, which risks leaving microscopic cancer cells behind, impacted the patient's survival chances. If these results hold up until the completion of the study it will be a major advance in breast cancer surgical therapy. I might add that all of the patients were placed on Tamoxifen so it's not like there was no treatment at all.
Teen age girls copy their favorite movie stars when it comes to smoking. The results of a three year study were reported in the American Journal of Public Health. Researchers interviewed 3000 teenage (12-15 yrs) girls and determined that if their favorite movie stars smoked on screen the teens were 80% more likely to smoke after 3 years than those whose favorite stars did not smoke on screen.
ED: Lifestyle emulation plus peer pressure-powerful stimulants.
A recent report from the Agency for Healthcare Research and Quality indicated that exercise programs can improve functional capacity and cardiopulmonary fitness, reduce symptoms of fatigue, and improve quality of life during and after cancer treatment. Exercise can also reduce cancer patients' symptoms of anxiety and depression during treatment.
ED: This is a good reason for oncologists to treat anemia in cancer patients so they can participate in exercise programs.
Also another exercise related study revealed that exercise, in addition to weight control, reduced cancer risks in women. Dr. James R. Cerhan, associate professor of epidemiology at the Mayo Clinic College of Medicine, studied 29,838 women in the Iowa Women's Health Study and found that data supported making the following guidelines to lower cancer risk in post-menopausal women:
A study from Brigham and Women's Hospital in Boston shoots down the perception that women with the same smoking history as men were more likely to develop lung cancer. The group from Brigham studied 60,296 women from the Nurses Health Study and 25,397 men from the Health Professionals Follow-up Study and concluded there was no difference in overall lung cancer susceptibility.
ED: Because of the perception stated above, researchers have tried to find a biological reason for the difference. This study suggests there is really no difference.
ONI interviewed John M. Jessup, M.D., professor of oncology at Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC. He has studied the data base of 150,000 patients with colon cancer treated between 1985 and 200 and determined that adjuvant chemotherapy has improved survival in stage III colon cancer but he thought more women and older patients should also receive as much treatment as male patients and younger patients. This would perhaps improve the underserved group's survival rate.
ED: Adjuvant chemotherapy is being used more in advanced colon cancer but I agree with Dr. Jessup. It is not offered to the elderly especially women as much as it should if co-morbid medical conditions do not prohibit its use.
QUOTES FOR THE QUARTER
Doctors are always working to preserve our health and cooks to destroy it, but the latter are the more often successful.
Take care until next time,
Richard J. Turner, III, M.D., F.A.C.S.
To ask questions or submit comments, please fill out and submit the contact form.
Summer Trip to Russia
Miscellaneous Medical One Liners
Trip to Ireland
Texas Surgical Society Meeting Notes
The Malpractice Crisis
Treatment and Prevention of Malignant Disease
West Nile/Cancers/Discontent with American Healthcare/Prescriptions
History of Preventive Medicine
Smoking Risks/Depression/The Western Diet
Food Consumption/Cancer and Treatment Relationships
Notes from the Spring Texas Surgical Society Meeting