Tuesday, April 18, 2006

breast cancer
With chemotherapy, the type of tumor seems to affect results.

· THE QUESTION Not all breast tumors are alike. Some need the hormone estrogen to grow (estrogen-sensitive tumors) and some (estrogen-insensitive) do not. Might this difference explain why chemotherapy works better against breast cancer in some women than in others?

· THIS STUDY analyzed medical data on 6,644 women with breast cancer that had spread to the lymph nodes. The women had participated in one of three studies in which they had been randomly assigned to various types of chemotherapy treatment. Re-examination and comparison of the data showed that women with estrogen-insensitive tumors fared better overall with chemotherapy than did those with estrogen-sensitive tumors, with fewer recurrences and better survival rates. In the insensitive group, 23 percent more women were disease-free after five years if they had chemotherapy than if they did not; in the sensitive group, the difference was 7 percent.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Women with node-positive breast cancer, meaning it has spread to the lymph nodes. An estimated one in every eight women develops breast cancer at some point in her life.

· CAVEATS It remains unknown whether the degree to which a tumor is estrogen-sensitive or -insensitive may further alter the effectiveness of chemotherapy. The authors indicated that some tumors may have been mislabeled because determination of estrogen status is not always exact.

· FIND THIS STUDY April 12 issue of the Journal of the American Medical Association; abstract available online at http://www.jama.com/ .

· LEARN MORE ABOUT breast cancer at http://www.cancer.org/ and http://www.cancer.gov/ .

· THE QUESTION As people age, high blood pressure becomes increasingly common. Might having hypertension starting in middle age influence whether people develop dementia later in life?

· THIS STUDY analyzed medical data on 1,294 men participating in a long-term study on aging. About two-thirds of the men had had hypertension since they were middle-aged; none had dementia at about age 77. Six years later, 108 men were diagnosed with signs of dementia, mostly Alzheimer's. The longer the men had taken medication to lower their blood pressure, the less likely they were to have developed dementia. When compared with those who had not taken drugs to control their hypertension, treatment of less than five years corresponded to a 6 percent lower risk of dementia; five to 12 years' treatment brought a 48 percent lower risk; and treatment that had lasted more than 12 years reduced the risk by 60 percent. Among those without dementia, all men showed some cognitive decline, but the decline was greater for those with normal blood pressure or hypertension that had been treated for at least five years than it was for men with untreated high blood pressure.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Men with hypertension. About one in three American adults has high blood pressure. Among men, it usually develops between ages 35 and 55.

· CAVEATS Men in the study may have had undetected characteristics that reduced their risk for dementia. The study did not differentiate between types of blood pressure medication taken by participants.

· FIND THIS STUDY April 6 online issue of Stroke; abstract available at http://www.strokeaha.org/ (click "Stroke ASAP").

· LEARN MORE ABOUT dementia at http://www.ninds.nih.gov/disorders ; learn about high blood pressure at http://www.nhlbi.nih.gov/health .

· THE QUESTION Many people can keep epilepsy in check by taking medication, but others have seizures that drugs can't control. Might surgery to remove the area of the brain causing the seizures help people with intractable epilepsy?

· THIS STUDY involved 399 people who had epilepsy surgery after having had seizures for an average of 20 years. Six months after surgery, 81 percent of the participants were seizure-free or nearly so; after 10 years, 72 percent rarely if ever had seizures. People aged 18 to 40 had better results than other people. Those whose surgery involved the temporal lobe fared better than those who had surgery on other regions of the brain.

· WHO MAY BE AFFECTED BY THESE FINDINGS? People with epilepsy, which affects about 3 million Americans. The authors report that as many as 40 percent of epileptics have seizures that cannot be controlled solely by medication.

· CAVEATS Not all people with epilepsy are good candidates for surgery. Results may vary depending on the expertise of the surgeon.

· FIND THIS STUDY April issue of the Journal of Neurosurgery; article available online at http://www.thejns-net.org/ .

· LEARN MORE ABOUT epilepsy at http://www.ninds.nih.gov/disorders and http://www.mayoclinic.com/ .

--Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.

· THE QUESTION Many people can keep epilepsy in check by taking medication, but others have seizures that drugs can't control. Might surgery to remove the area of the brain causing the seizures help people with intractable epilepsy?

· THIS STUDY involved 399 people who had epilepsy surgery after having had seizures for an average of 20 years. Six months after surgery, 81 percent of the participants were seizure-free or nearly so; after 10 years, 72 percent rarely if ever had seizures. People aged 18 to 40 had better results than other people. Those whose surgery involved the temporal lobe fared better than those who had surgery on other regions of the brain.

· WHO MAY BE AFFECTED BY THESE FINDINGS? People with epilepsy, which affects about 3 million Americans. The authors report that as many as 40 percent of epileptics have seizures that cannot be controlled solely by medication.

· CAVEATS Not all people with epilepsy are good candidates for surgery. Results may vary depending on the expertise of the surgeon.

· FIND THIS STUDY April issue of the Journal of Neurosurgery; article available online at http://www.thejns-net.org/ .

· LEARN MORE ABOUT epilepsy at http://www.ninds.nih.gov/disorders and http://www.mayoclinic.com/ .

--Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.