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Drug recommended to prevent prostate cancer in some older men

admin — Mon, 23 Feb 2009 04:07:14 +0000

The panel stopped short of recommending that all men take the drug because clinical trials have not yet shown that it reduces deaths.
Prostate cancer is the second-leading cause of cancer deaths among men, behind lung cancer, with 186,000 new cases diagnosed and 28,660 deaths each year.
Finasteride is used in low doses under the brand name Propecia as an anti-balding drug and in higher doses under the name Proscar for shrinking enlarged prostate glands. The dose recommended for cancer prevention is the same dosage used in Proscar.
The drug interferes with the production of male hormones, starving the tumors of fuel they need to grow.
A major clinical trial reported in 2003 showed that finasteride reduced the risk of prostate cancer by about 25% in men who took it, preventing about 15 cases in every 1,000 men. That means 71 men would have to take the drug for seven years to prevent one case, Kramer said.
Another drug in the same family, called dutasteride or Avodart, is thought to be even more potent and is undergoing clinical trials for prevention. It is also recommended in the guideline.
The medical groups did not issue new recommendations after the completion of the 2003 trial because it appeared that finasteride might have been promoting the growth of more aggressive tumors at the expense of those that are more benign.
“Now we know this is not the case,” Jacoub said. Subsequent studies have shown that shrinkage of the prostate caused by finasteride simply made the aggressive tumors more easily discovered.
The drug does have side effects in some men, however, including reduced potency and loss of sexual desire. Those effects can go away after a couple of months. On the other hand, the drug can result in reduced incontinence and fewer urinary problems.
Cost can also be a problem. The pills cost $2 to $3 a day, or about $1,000 per year, and most insurers do not cover them for cancer prevention.
Speaking at the news conference, panel member Dr. Howard Sandler of Cedars-Sinai Medical Center said, “If I tried the medication for a month or two and I got some side effects, then for me personally the benefit wouldn’t be worth the risk.” But if there were no side effects, he added, “I might sleep better at night.”

Drug recommended to prevent prostate cancer in some older men

admin — Tue, 06 Jan 2009 14:06:10 +0000

Caring for Older Horses: The Elmer Bandit Diet

admin — Sat, 22 Nov 2008 02:07:51 +0000

After Elmer Bandit, a 37-year-old Half-Arabian, broke the record for lifetime competitive trail mileage last month, we were flooded with questions about Elmer’s care and, specifically, what fuels the fire that keeps him going. As it turns out, feeding Elmer requires careful consideration and a serious time commitment.
“Getting enough calories to Elmer challenges me,” said his owner andrider, Mary Anna Wood of Independence, Mo.
Wood feeds Elmer 16,000 calories per day, divided into two meals. This estimated requirement was based on his body weight and his workload. She continually reevaluates his condition to see if changes are in order.
Each of Elmer’s two daily meals usually consist of two gallons of water, four pounds of beet pulp shreds with molasses, four pounds of some type of equine pellet (Wood uses Equine Senior or Strategy), and the supplements ReStore or Revolution (by Biovance Technologies, Inc., of Omaha, Neb.). She mixes all of these ingredients together into an elaborate caloric soup before giving it to Elmer.
“I think Elmer likes the taste of anise, found in some pellets, but he has not exactly told me that,” noted Wood.
Wood will add 1 to 1.5 pounds of alfalfa to Elmer’s meals, depending on the weather, the horse’s current workload, and his behavior.
She noted that Elmer is particularly fond of apples for dessert and snacks.
Elmer receives dental care at least once per year, but due to age-related dental conditions, he cannot grind food. Soaking all his food helps, but Elmer still requires between 50 and 90 minutes to eat.
Wood moves Elmer into a panel enclosure, separate from his pasture friends, for meals. Each morning, Wood gets up early, allowing two hours to feed Elmer, monitor his attitude and appetite, and make menu adjustments. She employs help to feed Elmer in the evenings.
Wood believes keeping Elmer on pasture has contributed to his longevity, and she compares life in a stall, at least for Elmer, to “solitary confinement.”
“Whether this diet and schedule would work for other senior athletes or not is unknown,” noted Wood. Elmer has gained weight over the past few years, which Wood said she feels is due to continual tweaking of his diet and feeding arrangements.
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Vitamins Do Older Women Little Good

admin — Mon, 03 Nov 2008 22:06:15 +0000

MONDAY, Feb. 9 (HealthDay News) — In yet another blow to the dietary supplement industry, researchers find no evidence that multivitamin use helps older women ward off heart disease and cancer, the top two killers of women, respectively.
“Women can be encouraged by the fact that these vitamins seem to do no harm, but they also seem to confer no benefit,” said study co-author Sylvia Wassertheil-Smoller, a professor of epidemiology and population health at Albert Einstein College of Medicine in New York City. “The kind of vitamins you get from diet is quite different, because foods are very complex and have a lot of chemicals we don’t know about that interact with each other. [Eating a varied diet] is not the same as distilling it into a pill. The message is to eat a well-balanced diet, exercise and maintain weight.”
Other recent studies have suggested that supplement forms of vitamins B, C, D and E, along with folic acid and beta carotene, don’t seem to have cancer-fighting abilities, especially in women.
And just last week, other researchers reported that many healthy U.S. children and teenagers may be popping vitamins and mineral supplements they don’t need, even while children who may actually need the supplements aren’t getting them.
However, all these findings, including the latest one, come with a caveat from another expert.
“There are a lot of variables associated with this study, and unless there is an actual randomized, controlled trial, we can’t say anything,” said Rajat Sethi, an assistant professor of pharmaceutical sciences at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy in Kingsville. “There have been a mixture of studies where vitamins indeed have indirectly shown benefit.”
And Andrew Shao, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, stated, “Multivitamins, like all other dietary supplements, are meant to be used as part of an overall healthy lifestyle; they are not intended to be magic bullets that will assure the prevention of chronic diseases, like cancer… From a practical standpoint, this study does not change the fact that the majority of consumers could benefit from taking an affordable multivitamin, particularly as the majority of Americans fail to consume the recommended amounts of a variety of essential nutrients established by the Institute of Medicine.”
According to background information in the study, which was published in the Feb. 9 issue of
, half of Americans regularly use dietary supplements, to the tune of $20 billion a year.
Many people believe multivitamins will prevent chronic conditions such as cancer and heart disease. Yet “convincing scientific data . . . are lacking,” the researchers stated.
Two exceptions are folic acid use in women of childbearing age to prevent neural tube defects in babies, and avoiding beta carotene supplements if you’re a smoker.
These researchers looked at 161,808 postmenopausal women participating in the government-sponsored Women’s Health Initiative who were followed for about eight years. Some 41.5 percent of participants reported using multivitamins.
There appeared to be no association between multivitamin use and risk of breast, colorectal, endometrial, lung or ovarian cancers; cardiovascular disease; or overall death.
“There was some hint that stress vitamins, which are mostly high doses of B vitamins, may have been protective for some forms of cardiovascular disease,” Wassertheil-Smoller said.
And the study does come with other caveats, Wassertheil-Smoller said.
“Most of the women in the study probably did eat a fairly decent diet, meaning we don’t yet necessarily know how vitamins affect women eating poorly,” she said. “The other thing is we didn’t measure other things about diet such as sense of energy and well-being.”
has more on different vitamins.

Peppermint oil, older drugs help treat IBS: review

admin — Fri, 12 Sep 2008 15:51:08 +0000

Older treatments for irritable bowel syndrome like peppermint oil safely help ease symptoms and should be used, a review suggests.
IBS is characterized by abdominal pain and discomfort accompanied by changes in bowel function, diarrhea, constipation or a combination of both, typically over months or years.
It is estimated to affect 13 to 20 per cent of Canadians, according to the Canadian Society of Intestinal Research.
In Canada and most western nations, IBS occurs more often in women. It can occur at any age, but often begins in adolescence or early adulthood.
The cause is unknown. According to the U.S. National Institutes of Health’s website, risk factors may include:
A low-fibre diet.
Emotional stress.
Use of laxatives.
Having infectious diarrhea or other temporary bowel inflammation.
Some newer and more expensive drugs have been pulled from the market over safety concerns or fallen out of favour over lack of efficacy, the researchers said.
In Friday’s issue of the British Medical Journal, Dr. Alexander Ford of the gastroenterology division at McMaster University in Hamilton and his colleagues concluded fibre, antispasmodics and peppermint oil were all effective therapies for IBS, based on their review of studies comparing the therapies with placebo or no treatment in more than 2, 500 adult patients with the disorder.
“This systematic review and meta-analysis has shown that fibre, antispasmodics and peppermint oil are all more effective than placebo in the treatment of irritable bowel syndrome. The number needed to treat to prevent one patient having persistent symptoms was 11 for fibre, five for antispasmodics and 2.5 for peppermint oil,” the study’s authors wrote.
None of the treatments had serious adverse effects.
National guidelines on the management of the condition should be updated to include the latest findings, the team said.
The beneficial effect of fibre seemed to be limited to ispaghula husk, a soluble form of fibre, rather than insoluble forms such as wheat bran, the researchers said.
When fibre supplements are required, British guidelines recommend soluble fibres such as ispaghula, the study’s authors noted.
Hyoscine, which is extracted from the corkwood tree, was the most successful antispasmodic drug looked at and should be the first choice for doctors to prescribe, the team suggested.
Peppermint oil seemed to be the most promising based on the number needed to treat, but the figure was based on four trials involving fewer than 400 patients in total, Roger Jones, a professor in the department of general practice and primary care at King’s College London, said in a journal commentary.
“It may be a little premature to follow the authors’ recommendation that national guidelines should be updated to include therapeutic guidance on these agents, but the results should reawaken an interest in the pharmacotherapy of irritable bowel syndrome and stimulate further research.”
The study did not identify which types of patients would benefit from each treatment. Since the treatments are safe and cheap, patients could test what works best for them, Jones said.

Glaxo Buys UCB's Older Drugs In Emerging Mkts

admin — Sat, 23 Aug 2008 07:59:04 +0000

(Adds details, management and analyst comment.)
LONDON (Dow Jones)–GlaxoSmithKline PLC (GSK) said Friday it has signed a deal with UCB S.A. (UCB.BT) to purchase the Belgian drugmaker’s older drugs in emerging countries, as part of its move to grow its business outside established markets in North America and Europe.
The world’s second-largest pharmaceutical company is paying EUR515 million …

Rethinking Prostate Cancer in Older Men

admin — Sat, 09 Aug 2008 05:13:20 +0000

FRIDAY, Oct. 17 (HealthDay News) — With increasing life expectancies, improved surgical tools, and better information on patient results, many older men diagnosed with early prostate cancer are taking a pass on the traditional advice to hold off on treatment for a period of time.
So-called “watchful waiting” — or closely monitoring the cancer’s progression — is still a viable option. But many experts now believe that aggressive treatment — even for older men — may be the better way to go.
“We’re pushing the limits on the upper end,” said Dr. Edouard J. Trabulsi, assistant professor in the department of urology at Jefferson Medical College and co-director of the Jefferson Prostate Diagnostic Center in Philadelphia.
helped shake up the conventional wisdom. The study, which involved some 44,000 men, found that the death risk for those who received prostate cancer treatment was nearly one-third lower than for men who received no treatment. And that was true across all age categories, including the oldest men in the study, aged 75 to 80.
“We often think of prostate cancer as an indolent disease, and it is for many men, which is why observation is a very reasonable treatment option for patients with low and intermediate risk disease,” said the study’s lead author, Dr. Yu-Ning Wong, a medical oncologist at the Fox Chase Cancer Center in Philadelphia.
“However, the life expectancy for a 70-year-old man is about 13 years, and patients who are otherwise healthy should recognize that if they live long enough, they may be at risk of developing complications from prostate cancer,” she added.
Prostate cancer is the second most common type of cancer in American men, after skin cancer. In 2008, about 186,320 new cases of the disease will be diagnosed, and about 28,660 men will die from it, according to the American Cancer Society.
Because prostate cancer is generally a slow-growing cancer, some men may never need treatment. And for many older men without symptoms, watchful waiting has been recommended, because it was believed they would die from other causes before their cancer advanced.
But as men’s life expectancy creeps higher and new robotic techniques improve the precision of surgery, the decision is becoming more complicated.
“Patients should understand the risks and benefits of all their treatment options — radiation, surgery and observation,” Wong noted. “If they choose observation, they should be committed to careful follow-up with their physicians.”
Watchful waiting does not mean watching someone die. Many oncologists today prefer the term “active surveillance,” Trabulsi said, because it more accurately describes the diligent approach to monitoring these patients, including the use of PSA blood tests, digital rectal exams and biopsies of the prostate to detect changes in the cancer.
Still, determining the best course of treatment is difficult, because there isn’t good data to help guide patients and their families on the effectiveness and harms of treatments for clinically localized prostate cancer, according to a recent literature review prepared for the federal Agency for Healthcare Research and Quality.
But oncologists hope to have better information on the benefits and risks of active surveillance, also known as “expectant management,” compared with treatment, by late next year. The National Cancer Institute and the Department of Veterans Affairs are co-sponsoring a study, called the Prostate Cancer Intervention Versus Observation Trial, to compare radical prostatectomy — which is removal of the gland — and expectant management on patient survival and overall quality of life.
For now, Wong advises: “They [patients] should place the potential benefit of treatment found in our study in the context of the potential side effects of treating the patient’s other medical problems.”
For more on treatments for prostate cancer, visit the
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New Tutorial Discusses Health Care, Long-Term Care For Older Women …

admin — Fri, 08 Aug 2008 12:19:29 +0000

New Tutorial Discusses Health Care, Long-Term Care For Older Women; GAO Report Examines Health Centers In Medically Underserved Areas
,”
: The slide tutorial — narrated by Alina Salganicoff, vice president and director of women’s health policy at the
— provides an overview of health coverage and cost challenges for women older than age 65. Salganicoff discusses the roles of Medicare and Medicaid as a source of coverage for older women, as well as health and socioeconomic factors that predispose older women to comprise the majority of the long-term care population. She also addresses long-term care financing and older women’s out-of-pocket health spending (Kaiser Family Foundation release, 9/11).
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data and examines to what extent medically underserved areas lacked health center sites in 2006 and 2007, as well as HRSA’s oversight of technical assistance for grant applicants. The report finds wide geographic variation in the percentage of medically underserved areas that did not have a health center in both years. Half of all grants for new health center sites in 2007 were awarded in the Southern region of the U.S. (“Health Resources and Services Administration: Many Underserved Areas Lack a Health Center Site, and the Health Center Program Needs More Oversight,” GAO, 8/8).
. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at
. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
For any corrections of factual information, or to contact the editors please use our
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Medical coverage for older children

admin — Fri, 08 Aug 2008 02:13:30 +0000

A new state law extends health-care coverage to more young adults. But it also could cost municipalities and businesses, already stretched thin, a lot more money.
“The state wants to make sure these kids all have insurance. But it’s going to be an expense to the employers,” said Linda Meyer, Kendall County’s human resources associate.
What kind of cost does the county anticipate?
“We haven’t even gotten into that,” Meyer said.
In August, Gov. Rod Blagojevich used his amendatory veto power to “improve” House Bill 5285 and allow parents to keep dependents on their health-care policies until their 26th birthday, or 30th birthday for veteran dependents, according to the governor’s office.
The law will become effective after June 1, 2009, whenever health-care policies are renewed.
The goal is to cover the more than 300,000 19- to 25-year-olds estimated to be uninsured in Illinois, said Susan Hofer, spokesman for the Illinois Department of Financial and Professional Regulation.
This comes at a time, Hofer said, when “more and more companies” are dropping group insurance plans.
“Especially for the kinds of jobs young people usually take,” she said.
Under this new legislation, covered dependents must be unmarried, but they do not have to be students, nor do they have to live with their parents.
For businesses insured by Blue Cross and Blue Shield Illinois, unmarried dependents are currently covered up to age 19, or 25 if they are full-time students, according to Mary Ann Schultz, senior manager of media relations for the insurance giant.
Schultz noted that this new legislation will not affect the self-insured groups, which pay health-care providers directly for employee’s medical claims.
She said Blue Cross and Blue Shield has established a task force to assess the new law’s impact. But Schultz estimated that premiums will increase by about 1 percent for an average group for the typical dependent benefit change.
“They’ll definitely have to pass that (cost) on to us then,” Kendall County’s Meyer said, when she learned of the estimated premium increase.
Republican House Minority Leader Tom Cross of Oswego voted against the legislation for just this reason, said his spokesman, David Dring.
“We don’t want to further burden municipalities and other groups providing jobs for citizens,” Dring said.
Republican State Sen. Chris Lauzen of Aurora, who also voted against the bill, raised concern about its effect on small businesses.
“The burden falls on small businesses,” Lauzen said. “Small business owners say, ‘I just can’t afford it,’ so they discontinue providing health insurance.”
Fox Valley businesses contacted for this story did not immediately return phone calls seeking comment.
The city of Aurora’s human resources department is uncertain exactly how the city will be affected by the dependent coverage changes.
But Alex Alexandrou, who heads the department, said he is sure this new law will cost the city more to administer.
“All we know now is, we’re awaiting further guidelines,” he said. “Stay tuned.”
Hofer stressed that the new law is optional.
“If a child graduates on their 21st birthday and gets a job with insurance, you don’t need to buy extra insurance,” Hofer said.
Still, Schultz said the new legislation is broad in how it defines a dependent.
This means, she reasoned, that a small employer could be required to cover a 24-year-old dependent who may be able to obtain coverage elsewhere, either through their employer or an individual policy.
“It’s affecting everybody,” Meyer said. “The economy is slowing down … and we’re turning around and having to increase the cost of insurance.”
Staff writer Andre Salles contributed to this report.

Fractures in Older Adults Up Death Risk

admin — Sun, 27 Jul 2008 01:17:14 +0000

TUESDAY, Feb. 3 (HealthDay News) — Any bone fracture that occurs in people over age 60 needs to be taken seriously, a new study concludes.
That’s because the Australian researchers found the risk of dying goes up for at least five years following any low-trauma fracture, and for at least 10 years after a hip fracture.
“All low-trauma fractures are associated with premature mortality, not just hip fractures,” said study senior author Dr. Jacqueline Center, an associate professor and senior research officer at the Garvan Institute of Medical Research, in Sydney.
“Thus, all low-trauma fractures in the elderly need to be regarded as important events,” she noted, adding, “Anti-osteoporosis treatment — assuming a low bone density — should be instituted following any low-trauma fracture to at least decrease the risk of a subsequent fracture, although we have yet to see whether it will decrease mortality.”
Results of the study were published in the Feb. 4 issue of the
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Each year, more than one-third of Americans aged 65 and older will experience a fall, and nearly 16,000 of those people will die as a result of those falls, according to the U.S. Centers for Disease Control and Prevention.
Statistics for the new research came from a large study of 32,000 people living in Dubbo, Australia. Slightly more than 4,000 of the people were over age 60 at the start of the study, and were community-dwelling, which means they weren’t in a hospital or residential care facility.
Between 1989 and 2007, 952 women and 343 men experienced low-trauma fractures. Some time after their fracture, 461 of the women and 197 of the men died.
The researchers found the risk of death increased more than twofold for women and more than threefold for men following a hip fracture. The risk of death after other major fractures increased by 65 percent for women and 70 percent for men. Even after minor fractures, such as a wrist fracture, the mortality risk increased by 42 percent in women and 33 percent in men, although this increase was only statistically significant for those over 75.
The increased risk of death persisted for five years for all fractures and up to 10 years after a hip fracture, the study found.
Increased age and a second fracture also increased the risk of death, as did lesser strength in the quadriceps — the large thigh muscle.
Dr. David Markel, chief of orthopedics at Providence Hospital in Southfield, Mich., said he believes most fractures indicate other underlying problems.
“As people age, having a fall or other things that lead to fracture should be looked at as a cue that there are other health issues. It’s important to not minimize osteoporotic fractures overall, and we should use these events as an indicator for health intervention and prevention,” he said.
This study also confirms what a lot of other research says, Markel noted: “Continued physical activity and a healthy lifestyle is good for you as you age.”
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