Tuesday, September 07, 2010
Stats on: Ovarian Cancer and Us blog
Stats on: Ovarian Cancer and Us blog
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Canadian Doctors for Medicare | False Alarm on Health Care
"....the tiresome insistence on using faulty logic to justify alarmist views on health care.
Three pieces of real data ought to put this debate to rest.
First, increases in the cost of health care are not a result of our public system. They are common to systems around the world, all facing new and expensive technologies and ever-increasing demand.
Second, Canada's medicare system is actually quite reasonably priced. It is the increasing cost of drugs, which are mostly privately funded, that is increasing health-care costs.
Third, user fees and privatization would increase health-care costs overall by downloading them from governments onto citizens. Furthermore, experience with user fees demonstrates that they cause people to delay necessary care, which leads to more profound and expensive illnesses when care is eventually sought....."cont'd
NCI Cancer Bulletin: Chemotherapy Affects Brain Structure of Breast Cancer Patients - Chemobrain
Note: small study/also reference blog abstract posting
Chemotherapy Affects Brain Structure of Breast Cancer Patients
A new study has provided some of the strongest direct evidence to date that chemotherapy has physical effects on areas of the brain that, when altered, could be result in the array of cognitive symptoms that is often called “chemobrain.” The study was published online August 6 in Breast Cancer Research and Treatment.
In a small study of women with breast cancer, researchers from the Indiana University School of Medicine used MRI scans to show that chemotherapy was associated with a decrease in the density of brain gray matter. The affected areas include those involved in memory and in the ability to process information. Although several other studies have shown similar changes in these areas of the brain, this was the first study to follow women prospectively and to compare scans before and after chemotherapy.
“The alterations in gray matter density observed in the [chemotherapy] group are… consistent with the pattern of cognitive complaints and impairment found in neurocognitive studies,” wrote Dr. Andrew J. Saykin and colleagues.
The study included 17 women with breast cancer who underwent chemotherapy after surgery, 12 women with breast cancer who did not receive chemotherapy after surgery, and a control group of 18 healthy women. The initial MRI scans, performed shortly after surgery in the participants with cancer, showed no notable differences in gray matter density among the three groups. One month after completion of chemotherapy, however, MRI scans revealed notable decreases in gray matter density in women with breast cancer, as well as changes in gray matter density in women who received surgery only, although the changes for these women were not as great. No changes were seen in women in the control group. After 1 year, women treated with chemotherapy had recovered gray matter losses in some regions, but other deficits persisted.
Exactly how chemotherapy may be causing these changes is unclear, said study co-author Dr. Brenna McDonald. “However, the finding that the changes appear to resolve naturally to some degree in the first year after chemotherapy is completed is a very positive one,” she wrote in an e-mail message. Because of the limited follow-up in the study, she continued, it’s unclear how much further recovery may occur naturally. A number of studies have shown that such cognitive effects can persist for many years, she added. Additional studies are investigating whether other therapies, such as tamoxifen, may have similar effects on brain structure.
For more information on this topic, see: “Delving Into Possible Mechanisms for Chemobrain.”
Gray matter reduction associated with systemic chemotherapy for breast cancer: a prospective MRI study - abstract
"...Findings were not attributable to recency of cancer surgery, disease stage, psychiatric symptoms, psychotropic medication use, or hormonal treatment status. This study is the first to use a prospective, longitudinal approach to document decreased brain gray matter density shortly after breast cancer chemotherapy and its course of recovery over time. These gray matter alterations appear primarily related to the effects of chemotherapy, rather than solely reflecting host factors, the cancer disease process, or effects of other cancer treatments."
NIH expands network focused on how genes affect drug responses, September 7, News Release - National Institutes of Health (NIH)
"...Spearheaded by the NIH's National Institute of General Medical Sciences (NIGMS) and launched in 2000, the PGRN has already identified gene variants linked to responses to medicines for different cancers, heart disease, asthma, nicotine addiction and other conditions...."cont'd
UK, China Research Teams Partner on $31M Epigenetics Study | GenomeWeb Daily News | GenomeWeb
"The study will harness King's College London's Twin Research and Genetic Epidemiology department and will involve 5,000 twins. The project initially will focus on obesity, diabetes, allergies, heart disease, osteoporosis, and longevity.
"Finding the crucial differences between twins will lead us to the key genes that are being turned on and off, and so to the cause of disease, with great potential to find key targets for drug treatments," Tim Spector, director of TwinsUK and leader of the Epitwin project, said in a statement."
Palliative Care — A Shifting Paradigm — NEJM
"....Despite the increasing availability of palliative care services in U.S. hospitals and the body of evidence showing the great distress to patients caused by symptoms of the illness,3 the burdens on family caregivers,4 and the overuse of costly, ineffective therapies during advanced chronic illness,5 the use of palliative care services by physicians for their patients remains low. Physicians tend to perceive palliative care as the alternative to life-prolonging or curative care — what we do when there is nothing more that we can do — rather than as a simultaneously delivered adjunct to disease-focused treatment.6...."
free full access: The anxious wait: assessing the impact of patient accessible EHRs for breast cancer patients
Conclusions
Participants generally found the portal easy to use; however, the perceived value of improved participation was not detected in the self-efficacy scores. Having access to personal health information did not increase anxiety levels. While these results suggest that the use of this PHR (personal health records) may be of benefit for informing patients, further research is required to investigate the impact on the experiences of patients, their participation in their care, their relationships with the health care team, and their health outcomes.
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