Quick Study

Tuesday, September 2, 2008

BREAST CANCER

Osteoporosis drug may counter negative effects of chemotherapy.

THE QUESTION Chemotherapy can contribute to bone loss; might a drug used to combat osteoporosis help maintain bone mass in women undergoing this treatment for breast cancer?

THIS STUDY randomly assigned 101 pre-menopausal women with early-stage breast cancer to receive injections of the osteoporosis drug zoledronic acid (Zometa) or a placebo every three months. Injections were started after surgery but before chemotherapy began, and all women took calcium and Vitamin D supplements. Bone mineral density (BMD) measurements showed that women given the placebo had lost bone mass by 4 percent at the spine and 3 percent at the hip after a year, whereas BMD had stayed stable in those given the drug. No serious side effects were recorded in either group, but women taking Zometa reported more eye discomfort than the others.

WHO MAY BE AFFECTED? Pre-menopausal women planning to have chemotherapy for breast cancer. The treatment can induce early menopause, and the resulting estrogen deficiency has been linked to bone loss that can lead to fractures. In the United States, about 55,000 women younger than 55 are diagnosed with breast cancer each year.

CAVEATS The study was not long enough to determine whether women injected with the drug ultimately developed osteoporosis or had fewer broken bones.

FIND THIS STUDY Aug. 18 online issue of the Journal of Clinical Oncology.

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

CORONARY ARTERY DISEASE

B vitamins don't seem to keep heart problems at bay.

THE QUESTION Homocysteine, an amino acid present in the blood, has been linked to an increased risk for heart disease. Might taking B vitamins, which can lower homocysteine levels, help people with coronary artery disease reduce the likelihood of heart attack or stroke?

THIS STUDY randomly assigned 3,096 adults (average age, 62) with narrowed or blocked coronary arteries or heart valves to one of four groups taking daily supplements: folic acid (Vitamin B9), B6and B12; folic acid and B12; B6alone; or a placebo. Homocysteine levels fell an average of 30 percent within a year among those taking folic acid and B12. After three years, 422 participants had had a serious heart problem, such as a heart attack or stroke, but the rate was roughly the same (about 14 percent) for each treatment group.

WHO MAY BE AFFECTED? People with coronary artery disease, the most common type of heart disease. It occurs when plaque builds up on the inner walls of the arteries that supply blood to the heart, causing them to become hardened and narrowed.

CAVEATS The authors suggested that homocysteine levels might indicate cardiovascular risk rather than cause it. The study was stopped about a year early because a large number of participants quit after learning that another study involving B12suggested a possible link between the vitamin and an increased risk for cancer. The authors wrote that preliminary results from this study "did not give any reason for concern." Supplements used in the study were provided by Alpharma, one of 10 sponsors of the research.

FIND THIS STUDY Aug. 20 issue of the Journal of the American Medical Association.

LEARN MORE ABOUT coronary artery disease at http://www.nhlbi.nih.gov/health. Learn about B vitamins at http://www.ods.od.nih.gov.

COGNITIVE DECLINE

Thinking abilities drop off, even without dementia.

THE QUESTION How long before death do mental skills begin to decline?

THIS STUDY involved 288 people who did not have dementia and who were followed from age 70 until they died (at the average age of 84). Periodically, they were given standardized tests to assess verbal ability (understanding ideas expressed in words), spatial ability (recognizing the spatial relationships among objects) and perceptual speed (ability to compare figures quickly). On average, verbal skills started an accelerated decline about seven years before death, spatial skills about eight years and perceptual speed about 15 years before death.

WHO MAY BE AFFECTED? Older people who do not have dementia.

CAVEATS The study did not identify underlying medical conditions (such as heart disease) or lifestyle factors (such as activity level) that might cause what the authors called "terminal decline" that was not due to age alone.

FIND THIS STUDY Aug. 27 online issue of Neurology.

LEARN MORE ABOUT cognitive aspects of aging at http://www.nihseniorhealth.gov and http://www.mayoclinic.com (search for "senior health center").

-- 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.