COLORECTAL CANCER

Adding a drug to chemotherapy may lengthen life expectancy.

* THE QUESTION Drugs that starve tumors of the blood supply they need to grow and spread are being tested against several types of cancer. Would adding such a drug to the chemotherapy treatment generally given people with advanced colorectal cancer improve their survival chances?

* THIS STUDY randomly assigned 813 adults with metastatic colorectal cancer to receive the normal chemotherapy regimen (irinotecan, fluorouracil and leucovorin), plus either bevacizumab (Avastin) or a placebo. Chemotherapy was administered weekly for four weeks, with the cycle repeated six weeks later; Avastin or the placebo was given every two weeks. The average survival of those in the Avastin group was 20 months; it was 16 months for those who got the placebo.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with colorectal cancer, which occurs mostly in those over age 50.

* CAVEATS Side effects, mainly hypertension and diarrhea, were greater among those receiving Avastin than those in the placebo group. The study was funded by Genentech, which makes and markets Avastin. The company also collaborated on the study design and the data collection and analysis; 13 of the 15 authors of the study received consulting or lecture fees from or were employees of Genentech.

* BOTTOM LINE People with advanced colorectal cancer may want to ask their doctor about Avastin.

* FIND THIS STUDY June 3 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.

* LEARN MORE ABOUT colorectal cancer at www.cancer.gov and www.mayoclinic.com.

osteoporosis

Epilepsy drugs may have a side effect that alters bone density.

* THE QUESTION Not only people with epilepsy but increasing numbers of people with compulsive behaviors such as overeating and smoking are being given drugs originally designed to combat seizures. Do women who take these drugs risk losing bone density?

* THIS STUDY measured the bone density of 9,704 white women 65 years of age and older. Some women were taking anti-epilepsy drugs -- primarily phenytoin (Dilantin) but also carbamazepine, phenobarbital or primidone -- but most were not. Density was measured at the heel and hip, which have different types of bones, with about six years between heel measurements and five years between hip measurements. Bone scans showed that women taking anti-epilepsy drugs lost bone density at nearly twice the rate of those not taking the drugs. Those who took the drugs regularly lost more density than those who took them sporadically.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Older women who take anti-epilepsy drugs. Both osteoporosis and epilepsy become more common as people age.

* CAVEATS The findings may not apply to other racial groups. It is not clear whether the different anti-epilepsy drugs produce differing results.

* BOTTOM LINE Women taking anti-epilepsy drugs may want to ask their doctor about monitoring their bone density.

* FIND THIS STUDY June 1 issue of Neurology; abstract available online at www.neurology.org.

* LEARN MORE ABOUT bone density and osteoporosis at www.osteo.org. Learn more about epilepsy medications at www.epilepsyfoundation.org.

LEG ULCERS

Recurrence of sores may be stemmed with vein surgery.

* THE QUESTION Compression, first with bandages and then with elastic support stockings, has been standard treatment for leg ulcers caused by vein problems. However, the ulcers frequently return. Might surgery lessen the chance of recurrence?

* THIS STUDY randomly assigned 500 people with venous ulcers between the knee and ankle to either standard compression treatment alone or compression supplemented with surgery to remove part of the problem vein. All participants were encouraged to exercise and elevate the affected leg as much as possible. After 24 weeks, ulcers had healed in 65 percent of both groups. However, after a year, ulcers had recurred in 12 percent of those who had had surgery, compared with 28 percent of those who had been treated only with compression.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with chronic venous leg ulcers.

* CAVEATS Results may vary, depending on the degree of vein damage. In the study, about 16 percent of those in the surgery group refused the procedure.

* BOTTOM LINE People with recurring leg ulcers may want to ask their doctors whether they might benefit from surgery.

* FIND THIS STUDY June 5 issue of the Lancet; abstract available online at www.thelancet.com.

* LEARN MORE ABOUT leg ulcers at www.clevelandclinic.org/vascular/medicine/ulcer.htm.

-- Linda Searing