Breast cancer ‘can return 15 years after treatment ends’
Breast cancer can resurface after remaining dormant for 15 years following successful treatment, a study has found.
Women with large tumours and cancer that had spread to the lymph nodes had the highest 40% risk of it coming back.
Researchers writing in the New England Journal of Medicine said extending treatment with hormone therapy could reduce the risk of it recurring.
Scientists analysed the progress of 63,000 women for 20 years.
All had the most common form of breast cancer.
This is a type fuelled by the hormone oestrogen which can stimulate cancer cells to grow and divide.
Every patient received treatments such as tamoxifen or aromatase inhibitors which block the effects of oestrogen or shut off the hormone’s supply.
Although after five years of treatment their cancers had gone, over the next 15 years a steady number of women found that their cancer spread throughout their body – some up to 20 years after diagnosis.
Women who originally had large tumours and cancer that had spread to four or more lymph nodes were at highest risk of the cancer returning the next 15 years, the study said.
Women with small, low-grade cancers and no spread to the lymph nodes had a much lower 10% risk of cancer spread over that time.
‘Remarkable’
Lead researcher Dr Hongchao Pan, from University of Oxford, said: “It is remarkable that breast cancer can remain dormant for so long and then spread many years later, with this risk remaining the same year after year and still strongly related to the size of the original cancer and whether it had spread to the (lymph) nodes.”
Doctors have long known that five years of tamoxifen reduces the risk of recurrence by about a third in the five years after stopping treatment.
Recent research has suggested that extending hormone therapy to 10 years may be more effective at preventing breast cancer recurrence and death.
Aromatase inhibitors, which only work for post-menopausal women, are believed to be even more effective.
But there are side effects with hormone treatments which can affect patients’ quality of life and cause them to stop taking the pills.
These include menopausal symptoms, osteporosis, joint pain and carpal tunnel syndrome.
Prof Arnie Purushotham, senior clinical adviser at Cancer Research UK, which funded the study, said that since the research began, new drugs had been used to treat breast cancer and those worked in different ways to tamoxifen.
He said: “It’s vital that work continues to better predict which cancers might return.
“We also need to know what the difference for women might be in taking hormone therapies for 10 years instead of five, the side effects and how this affects patients’ quality of life.”
Sally Greenbook, from charity Breast Cancer Now, said it was essential that women discussed any changes in treatment with their doctor.
“We would urge all women who have had treatment for breast cancer not to be alarmed, but to ensure they are aware of the signs of recurrence and of metastatic breast cancer, and to speak to their GP or breast care team if they have any concerns.”
Source: http://www.bbc.com/news/health-41928647
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Writing own medical record may benefit patients: study
According to the study, published in the journal Annals of Internal Medicine, the practice may also benefit doctors by reducing time spent on documentation.
Letting people write their own medical records can help patients be more involved in the treatment, scientists say.
Researchers from the University of California, Los Angeles (UCLA) in the US found that patients could benefit if they are invited to co-produce medical notes, called “OurNotes,” with their doctors, rather than merely reading them.
According to the study, published in the journal Annals of Internal Medicine, the practice may also benefit doctors by reducing time spent on documentation.
“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” said John Mafi, from UCLA.
“Piloting OurNotes will start at four centres in 2018,” he said.
To prepare for the pilots, the researchers conducted in-depth telephone interviews with 29 health care experts.
Participants overall believed that OurNotes could promote patient engagement, improve patient-centred care and patient-provider collaboration, and possibly take some of the documentation burdens off busy providers.
The consensus was that the most promising approach for OurNotes is to contact patients before an upcoming visit and ask them to review previous notes, provide an interval history, and list what they hope to address at the visit.
Source: http://indianexpress.com/article/lifestyle/health/writing-own-medical-record-may-benefit-patients-study-4965778/
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Blood pressure starts dropping 14 years prior to death: Study
The researchers found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with. But long-term declines also occurred without the presence of any of these diagnoses.
Doctors have long known that in the average person, blood pressure rises from childhood to middle age, but a new study warns that in the elderly, blood pressure gradually begins to decrease about 14 years before death. The study that looked at the electronic medical records of 46,634 British citizens who had died at age 60 or older showed that blood pressure declines were present not only in those with hypertension but also in those who were not diagnosed with the condition.
The findings, published in the Journal of the American Medical Association Internal Medicine, however, do not suggest that hypertension should not be treated in late life or that those diagnosed with hypertension should stop their blood pressure medications. “Our work highlights the importance of conducting research evaluating older patients like those seen in physician practices everywhere,” said one of the study authors George Kuchel from the University of Connecticut in the US.
The researchers found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with.But long-term declines also occurred without the presence of any of these diagnoses.
The findings should make both doctors and researchers carefully consider what dropping blood pressure really means for older patients, Kuchel said. More research is needed to figure out why blood pressure declines in the elderly in this way.
“Observational studies such as ours need to be followed by rigorous clinical trials in order to guide clinical care guidelines,” Kuchel said.
Source: http://indianexpress.com/article/lifestyle/health/blood-pressure-starts-dropping-14-years-prior-to-death-4968978/
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Air pollution can damage a child’s brain forever: UNICEF
The link between air pollution and respiratory diseases is well-established, but the United Nations Children’s Fund, in a report on Tuesday, said there is a growing body of scientific research which shows that air pollution can permanently damage a child’s brain.
The findings come at a time when India, particularly in the north, is facing a serious crisis due to rising levels of pollution. Last month, Delhi schools had to be shut temporarily to reduce children’s exposure to pollutants that had enveloped the capital.
The Unicef report also said that South Asia had the largest proportion of babies living in areas where air pollution is at least six times higher than international limits (10 micrograms per cubic metre).
The Unicef report, titled “Danger in the air”, explains that brain damage can happen through several mechanisms. First, it stated, particulate matters can cause neuro-inflammation by damaging the blood-brain barrier – a thin, delicate membrane that protects the brain from toxic substances.
Second, exposure to specific air pollutant particles, such as magnetite, can lead to oxidative stress which is often the cause of neurodegenerative diseases. Quoting multiple studies, the UN body said polycyclic aromatic hydrocarbons commonly found in areas of high automobile traffic contribute to a loss of or damage to white matter in the brain. White matter is important for continued learning and development. “Pollutants can permanently damage their developing brains,” Unicef executive director Anthony Lake said.
The latest analysis of multiple researches states that pollutants can cross the placenta and affect the developing brain of a foetus. “A young child’s brain is especially vulnerable because it can be damaged by a smaller dose of toxic chemicals. Children are also highly vulnerable to air pollution because their physical defences and immunities are not fully developed’, Unicef said.
It advised parents to reduce children’s exposure to pollutants by making it feasible for them to travel during times of the day when air pollution is lower.
Source: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/air-pollution-can-damage-childs-brain-forever-says-unicef/articleshow/61943444.cms
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Common painkillers may double obesity risk: study
Researchers from the Newcastle University in the UK have warned that regular use of commonly prescribed painkillers may double the risk of developing obesity and also cause sleep deprivation. Over the past 10 years, there has been a large increase in the prescription of medications such as opioids and some antidepressants for chronic pain management.
Scientists assessed the cardio-metabolic health — the inter-relationship between metabolic and cardiovascular disease — in more than 133,000 participants from the UK Biobank. Body Mass Index (BMI), waist circumference and blood pressure were studied.
The findings, published in the journal PLOS ONE, shows that medications commonly used to treat pain, like gabapentinoids, gabapentin, pregabilin and opiates, doubled the risk of obesity and were associated with poor sleep.
The study shows that people on opiates and cardio- metabolic drugs reported 95 per cent rates of obesity, 82 per cent ‘very high’ waist circumference and 63 per cent hypertension, as opposed to those on cardio-metabolic drugs only. The results suggest that chronic pain medications should be prescribed for shorter periods of time to limit serious health complications.
In 2016, 24 million opiates prescriptions were issued in the UK, exactly double the amount of 2006. Two years ago, 11,000 patients were admitted to hospital due to an opiate overdose. Opioids are recognised as being among the most dangerous prescription painkillers because they are addictive which can lead to them being abused. Patients can require continuous use of the drugs to feel normal and avoid symptoms of withdrawal.
Source: http://www.thehindu.com/sci-tech/health/common-painkillers-may-double-obesity-risk-study/article21290389.ece
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Scientists just developed a gel to treat eye injuries
Scientists have developed an on-the-spot, temperature-sensitive gel that could seal eye injuries on the battlefield.
The reversible, temporary seal developed by researchers at University of Southern California (USC) in the US changes from a fluid to a super-strong semi-solid when applied to the eye.
When the patient is ready for surgery to permanently close the injury, doctors can remove the seal by adding cool water.
The material the group worked with for retinal implants is a hydrogel called PNIPAM, poly(N-isopropylacrylamide), which has a unique attribute that makes it a natural fit for this application.
When cooled, the hydrogel becomes a liquid for easy application, and when heated, it becomes a viscous semi-solid with strong adhesion, researchers said.
“Since the initial hydrogel’s transition temperature was very close to the temperature of the human eye, we had to modify its properties to ensure that it would form a solid seal as soon as the gel was applied to the eye by a soldier or medic,” said Niki Bayat, lead author of the study published in the journal Science Translational Medicine.
“Providing a perfect, yet reversible seal, the smart hydrogel shows promise for the next generation of tissue adhesives,” Bayat said.
When an ophthalmologist is ready to repair the eye, the hydrogel can be extracted by applying cool water and converting it back to a less adhesive state.
The research team also developed a special syringe for the hydrogel that would be easy to use on the front lines and capable of quickly cooling the hydrogel before application.
The syringe has a cooling chamber filled with calcium ammonium nitrate crystals – the type used in instant ice cold packs.
By adding water to the chamber, the crystals activate and cool the hydrogel to operating temperatures within 30 seconds.
The customised seal and delivery device will also reduce the amount of time it takes to close penetrating eye injuries overall.
“We were able to optimise the delivery device so that it not only rapidly cools the hydrogel but also holds it at that temperature, giving users a 10-minute window to fill penetrations in the eye,” said John Whalen, assistant professor at USC.
Source: http://zeenews.india.com/health/scientists-just-developed-a-gel-to-treat-eye-injuries-2064219
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