Schizophrenia usually affects more men than women, and women usually develop symptoms around five years later than men. Thus far, the treatment for both men and women has been the same.
During her psychiatric training, Jayashri Kulkami, MBBS, PhD, spoke with many schizophrenic women who kept telling her "It's my hormones, Doc." They also told her "No one takes any notice when I say it's to do with my hormones." Dr. Kulkami took notice and she and her colleagues have now completed a series of small studies which shows that estrogen can have a noticeable effect in reducing symptoms such as delusions, hallucinations, and disordered thinking. The findings were from a four-week study of 102 women of childbearing age with diagnosed schizophrenia. Kulkami and her colleagues at Monash University in Melbourne, Australia used a patch containing estradiol, the most common form of estrogen, for half of the women. They continued to take the normal medications prescribed for their illness. The other half also had a patch, but it contained no active medication.
During the 28 days of the study, the symptoms and feelings of the study subjects were recorded on a weekly basis, and those on estrogen reported less negative changes in their condition.
More than a century ago it was recognized that there was a link between estrogen and mental illness, but it was only recently considered as a possible treatment. The exact affect of hormones on schizophrenia isn't understood, but the researchers said that it might have a swift effect on blood flow in the brain, or the way sugar is used as fuel for the brain. There is also the possibility that the way brain cells communicate with each other was affected. They said that there was a possibility that the hormone might have uses in other mental illnesses in women.
Estrogen has effects throughout the body, including promotion of hormone sensitive breast and cervical cancers. This means that continuing research using estrogen must be done with some caution. Kulkami's team is exploring the use of drugs called selective estrogen receptor modulators or SERMs. They want to see if these drugs exert the same antipsychotic effect as estrogen without the side effects.
The researchers did a brief study treating schizophrenic men with estrogen, and the therapy also seemed to reduce their acute symptoms. Though men do have some natural estrogen introducing too much would bring out effeminate characteristics. The researchers plan a larger study using SERMs in men. SERM trials on women are also planned. At present, Kulkami is focusing on a three-site study of estrogen patches in women of childbearing age with schizophrenia. This study is designed to ensure that the findings of the previous study were not a fluke.
Kulkami said she treats women with estrogen therapy but insures their continued health with Pap smears, breast exams, and blood pressure checks.
Other professionals warn that estrogen therapy appears useful, but much more work is needed before it can be considered safe and effective.
Showing posts with label Family health. Show all posts
Showing posts with label Family health. Show all posts
Wednesday, November 5, 2008
Psychiatrists Are Choosing Medications Over Traditional Psychotherapy
Many U.S. psychiatrists in today's environment are opting to break out the prescription pad and write prescriptions rather than inviting a patient to their couch for talk therapy. Some patients may like the new idea of prescribing medication rather than the more traditional therapy from their psychiatrists, especially for a quick fix, but is it just a band-aid or an actual resolution to the problem?
Lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health in Baltimore, which performed the most recent study based on the new trends of psychotherapy, explained that in today's environment insurance companies are reimbursing psychiatrists at a lower rate for a 45-minute psychotherapy, than they are for three 15-minute medication visits, possibly causing the swing in the form of treatment.
Psychiatrists are in a business, and as any business they also strive to make a profit. While their primary job is to help treat patients, they must also consider the profit-and-loss factor. Because patients are responsible for whatever part of their visit insurance doesn't cover, they may opt for the therapy that best meets their budget rather than their psychological needs. The authors of the study wrote that, "Psychiatrists who provided psychotherapy to all of their patients relied more extensively on self-pay patients, had fewer managed-care visits, and prescribed medications in fewer of their visits compared with psychiatrists who provided psychotherapy less often."
The findings of the new study, based on an annual survey performed during U.S. doctor visits, were published in a recent edition of Archives of General Psychiatry. The researchers based their analysis on 14,000 psychiatrist visits during a 10-year period and excluded psychologists visits or visits to other mental health counselors who may use talk therapy for treatment. Over 1996-1997 the study resulted in an average of 44 percent of patients that visited psychiatrists and received psychotherapy, but by 2004-2005 that number had dropped to only 29 percent.
Psychotherapy is used by trained psychotherapists as relational intervention. Psychotherapists work with a range of techniques to aid patients or clients in several areas, such as relationship building, open communication, attitude and behavior adjustments, and family struggles or group relationships, in hopes of improving the mental state of patients. Psychotherapy also known as verbal therapy, is used in hopes of aiding patients to evaluate their behaviors and thoughts and help to ease symptoms. Though there are other practitioners that may use psychotherapy to help patients, only psychotherapists may administer other medical treatments, such as psychosurgery, electroshock, and prescribe medications.
Some situations, such as those with childhood trauma or chronic depression sufferers, may benefit more from treatment through psychotherapy, than through medications. A child who is in the middle of their parents divorce may need to talk to someone outside of the family that can help them deal with their hurt, fears, and emotions. Hopefully, psychotherapists will continue to evaluate the overall situation, not be swayed by the insurance company's reimbursement percentage, and continue offering psychotherapy to those that would better benefit from the talk therapy rather than medications. Even though, based on this most recent study produced by Johns Hopkins Bloomberg School of Public Health, it seems couches used for talk therapy are being left vacant more often than in the past.
Lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health in Baltimore, which performed the most recent study based on the new trends of psychotherapy, explained that in today's environment insurance companies are reimbursing psychiatrists at a lower rate for a 45-minute psychotherapy, than they are for three 15-minute medication visits, possibly causing the swing in the form of treatment.
Psychiatrists are in a business, and as any business they also strive to make a profit. While their primary job is to help treat patients, they must also consider the profit-and-loss factor. Because patients are responsible for whatever part of their visit insurance doesn't cover, they may opt for the therapy that best meets their budget rather than their psychological needs. The authors of the study wrote that, "Psychiatrists who provided psychotherapy to all of their patients relied more extensively on self-pay patients, had fewer managed-care visits, and prescribed medications in fewer of their visits compared with psychiatrists who provided psychotherapy less often."
The findings of the new study, based on an annual survey performed during U.S. doctor visits, were published in a recent edition of Archives of General Psychiatry. The researchers based their analysis on 14,000 psychiatrist visits during a 10-year period and excluded psychologists visits or visits to other mental health counselors who may use talk therapy for treatment. Over 1996-1997 the study resulted in an average of 44 percent of patients that visited psychiatrists and received psychotherapy, but by 2004-2005 that number had dropped to only 29 percent.
Psychotherapy is used by trained psychotherapists as relational intervention. Psychotherapists work with a range of techniques to aid patients or clients in several areas, such as relationship building, open communication, attitude and behavior adjustments, and family struggles or group relationships, in hopes of improving the mental state of patients. Psychotherapy also known as verbal therapy, is used in hopes of aiding patients to evaluate their behaviors and thoughts and help to ease symptoms. Though there are other practitioners that may use psychotherapy to help patients, only psychotherapists may administer other medical treatments, such as psychosurgery, electroshock, and prescribe medications.
Some situations, such as those with childhood trauma or chronic depression sufferers, may benefit more from treatment through psychotherapy, than through medications. A child who is in the middle of their parents divorce may need to talk to someone outside of the family that can help them deal with their hurt, fears, and emotions. Hopefully, psychotherapists will continue to evaluate the overall situation, not be swayed by the insurance company's reimbursement percentage, and continue offering psychotherapy to those that would better benefit from the talk therapy rather than medications. Even though, based on this most recent study produced by Johns Hopkins Bloomberg School of Public Health, it seems couches used for talk therapy are being left vacant more often than in the past.
Depression Meds May Be Prescription for Bad Driving
Depression is a serious medical illness that affects more than 20 million Americans. Antidepressants are often prescribed to help relieve the symptoms of depression, such as mood changes, insomnia or excessive sleepiness, and feelings of worthlessness that can interfere with everyday life. But while these drugs bring about positive changes for many users, they may also negatively affect the person's cognitive abilities-and consequently their performance behind the wheel.
That is the consensus of a new study dubbed "The Effects of Antidepressants on Cognitive and Driving Performance." In a simulation, Holly J. Dannewitz, Ph.D., and Thomas Petros, Ph.D., psychologists at the University of North Dakota, measured the driving skills of 60 people; 29 who were not medicated (other than contraceptives in some cases) and 31 who were taking at least one type of antidepressant. The group taking antidepressants was further divided into those who scored higher or lower on a test of depression. The researchers observed the participants' steering, concentration, and scanning abilities as they made a series of common driving decisions, such as reacting to brake lights, stop signs or traffic signals while being distracted by animals, other cars, pylons, speed limit signs, helicopters or bicyclists.
The group that was both depressed (scoring high on the depression test) and taking antidepressants performed far worse than the control group on several tasks. They were found to lack concentration, as well as the overall ability to control the car. But participants who were taking antidepressants and were not depressed (scoring in the normal range on the test) performed about the same as those who were not medicated. The team believes it could be either the medication itself or the condition that caused the problems. "We already know that depression causes concentration problems," said study author Holly J. Dannewitz, according to HealthDay News. "And now it appears that people taking antidepressants who also have relatively higher depression scores fare significantly worse when attempting to perform a computerized simulation of driving."
This research is significant considering that the number of Americans taking antidepressants has tripled over the past decade. According to government statistics, 1 in 10 women currently takes some form of antidepressant medication. Dr. Dannewitz said that while there needs to be a larger study on the issue, "there certainly seems to be some sort of link" between depression, antidepressants and driving. "I think people who are depressed, especially those on antidepressants, should be aware of this if they are driving or doing anything that relies on concentration and reaction skills," Dr. Dannewitz told BBC.
The study findings were presented at the Annual Convention of the American Psychological Association in Boston on August 17.
That is the consensus of a new study dubbed "The Effects of Antidepressants on Cognitive and Driving Performance." In a simulation, Holly J. Dannewitz, Ph.D., and Thomas Petros, Ph.D., psychologists at the University of North Dakota, measured the driving skills of 60 people; 29 who were not medicated (other than contraceptives in some cases) and 31 who were taking at least one type of antidepressant. The group taking antidepressants was further divided into those who scored higher or lower on a test of depression. The researchers observed the participants' steering, concentration, and scanning abilities as they made a series of common driving decisions, such as reacting to brake lights, stop signs or traffic signals while being distracted by animals, other cars, pylons, speed limit signs, helicopters or bicyclists.
The group that was both depressed (scoring high on the depression test) and taking antidepressants performed far worse than the control group on several tasks. They were found to lack concentration, as well as the overall ability to control the car. But participants who were taking antidepressants and were not depressed (scoring in the normal range on the test) performed about the same as those who were not medicated. The team believes it could be either the medication itself or the condition that caused the problems. "We already know that depression causes concentration problems," said study author Holly J. Dannewitz, according to HealthDay News. "And now it appears that people taking antidepressants who also have relatively higher depression scores fare significantly worse when attempting to perform a computerized simulation of driving."
This research is significant considering that the number of Americans taking antidepressants has tripled over the past decade. According to government statistics, 1 in 10 women currently takes some form of antidepressant medication. Dr. Dannewitz said that while there needs to be a larger study on the issue, "there certainly seems to be some sort of link" between depression, antidepressants and driving. "I think people who are depressed, especially those on antidepressants, should be aware of this if they are driving or doing anything that relies on concentration and reaction skills," Dr. Dannewitz told BBC.
The study findings were presented at the Annual Convention of the American Psychological Association in Boston on August 17.
Youth Suicides on an Upward Trend
talBeing a teen isn't easy—it's a time of growing self-identity, pressure to fit in socially and to perform academically accompanied by the awakening of sexual feelings, which can bring about a great deal of confusion and anxiety. And life can feel even more difficult for teens that have additional problems to deal with, such as living in violent or abusive environments or experiencing a stressful life event, such as the death of a loved one, divorce, or a breakup with a boyfriend or girlfriend. For a growing number of teens, suicide may appear to be a solution to their problems and stress. After more than a decade of declines, there was an 18 percent increase in suicide rates for American youth under age 19 in 2004, with the trend persisting in 2005, according to the U.S. Centers for Disease Control and Prevention (CDC). So, what is fueling this spike in youth suicide?
Jeff Bridge, an investigator in the Center for Innovation in Pediatric Practice from Nationwide Children's Hospital in Columbus, Ohio, and colleagues studied suicide trends among adolescents from the National Vital Statistics Systems at the CDC. They found that, based on suicide rate trends from 1996 to 2003, the rates of suicide among youths aged 10 to 19 were higher in 2004 and 2005 than had been expected. In 2004, there were 326 more suicides than expected and in 2005, there were 292 more suicides than expected. "This is significant, because pediatric suicide rates in the U.S. had been declining steadily for a decade until 2004, when the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent, the largest single-year increase in the past 15 years," Bridge said.
Some experts believe the increase could be due to the reluctance of doctors to prescribe anti-depressant medications after a public health advisory issued by the U.S. Food and Drug Administration (FDA) in October of 2003 warned health care providers of an increased risk of suicide attempts or suicide-related behavior among children and teens taking SSRI's, or selective serotonin reuptake inhibitors. Since the warning and subsequent label revisions, there has been a 20 percent decline in the drugs' use. Dr. David Fassler, a psychiatry professor at the University of Vermont, who wasn't involved in the new study, said the report suggests a "very disturbing" upward trend that correlates with a decline in teen use of antidepressants, according to the Associated Press. Dr. Fassler is among those who believe the drugs' benefits, including treating depression that is the leading cause of suicide, outweigh their risks.
Bridge said that, while a link between the warnings and suicide risks has not been established, there are other factors that could be contributing to the increase in youth suicides. They include the influence of Internet social networking sites, an increase in suicide among U.S. troops returning home from Iraq and Afghanistan, higher rates of untreated or undiagnosed depression, and access to firearms. Nearly 60 percent of all suicides in the United States are committed with a gun. "We now need to consider the possibility that this increase is an indicator of an emerging public health crisis. Studies to identify causal factors are important next steps," he added.
Diana Zuckerman, president of the National Research Center for Women and Families, also thinks that untreated depression may play a role in the increased suicide rate, but says there are other reasons as well. For older teens, the increase may be due in part to the sour economy. "When the economy is bad, and jobs are harder to find, it's a tough time for kids who are trying to get a job," she said. Zuckerman also noted the stressors of getting into college and being able to afford it. However, overall, she thinks that children are more isolated, even from their families, than ever before. "Kids and family members are spending more and more time apart," she said. "Apart might mean being on the computer. Kids and their families are not watching TV together, they're not eating meals together, they are not talking to each other nearly as much."
Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, according to the CDC, surpassed only by accidents and homicide. The reasons behind a teen's suicide or attempted suicide can be complex and while it can be difficult for adults to remember how it felt to be a teen-to be caught in that gray area between childhood and adulthood-parents should be aware of the signs of adolescents who may try to kill themselves. Many of the signs and symptoms of suicidal feelings are similar to those of depression:Change in eating and sleeping habitsWithdrawal from friends, family and regular activitiesViolent actions, rebellious behavior, or running awayDrug and alcohol useUnusual neglect of personal appearanceMarked personality changeLoss of interest in pleasurable activitiesPersistent boredom, difficulty concentrating, or a decline in the quality of schoolworkFrequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, and fatigueNot tolerating praise or rewards
They may also talk about suicide or death or "going away," or talk about feeling hopeless or guilty. If one or more of these signs occurs, parents should talk to their child about their concerns and seek professional help from a physician or a qualified mental health professional. With an adequate support network of family and friends, along with appropriate treatment, children and teens that are suicidal can heal and return to a healthier path of development.
The study findings were published in the September 3 issue of the Journal of the American Medical Association.
Jeff Bridge, an investigator in the Center for Innovation in Pediatric Practice from Nationwide Children's Hospital in Columbus, Ohio, and colleagues studied suicide trends among adolescents from the National Vital Statistics Systems at the CDC. They found that, based on suicide rate trends from 1996 to 2003, the rates of suicide among youths aged 10 to 19 were higher in 2004 and 2005 than had been expected. In 2004, there were 326 more suicides than expected and in 2005, there were 292 more suicides than expected. "This is significant, because pediatric suicide rates in the U.S. had been declining steadily for a decade until 2004, when the suicide rate among U.S. youth younger than 20 years of age increased by 18 percent, the largest single-year increase in the past 15 years," Bridge said.
Some experts believe the increase could be due to the reluctance of doctors to prescribe anti-depressant medications after a public health advisory issued by the U.S. Food and Drug Administration (FDA) in October of 2003 warned health care providers of an increased risk of suicide attempts or suicide-related behavior among children and teens taking SSRI's, or selective serotonin reuptake inhibitors. Since the warning and subsequent label revisions, there has been a 20 percent decline in the drugs' use. Dr. David Fassler, a psychiatry professor at the University of Vermont, who wasn't involved in the new study, said the report suggests a "very disturbing" upward trend that correlates with a decline in teen use of antidepressants, according to the Associated Press. Dr. Fassler is among those who believe the drugs' benefits, including treating depression that is the leading cause of suicide, outweigh their risks.
Bridge said that, while a link between the warnings and suicide risks has not been established, there are other factors that could be contributing to the increase in youth suicides. They include the influence of Internet social networking sites, an increase in suicide among U.S. troops returning home from Iraq and Afghanistan, higher rates of untreated or undiagnosed depression, and access to firearms. Nearly 60 percent of all suicides in the United States are committed with a gun. "We now need to consider the possibility that this increase is an indicator of an emerging public health crisis. Studies to identify causal factors are important next steps," he added.
Diana Zuckerman, president of the National Research Center for Women and Families, also thinks that untreated depression may play a role in the increased suicide rate, but says there are other reasons as well. For older teens, the increase may be due in part to the sour economy. "When the economy is bad, and jobs are harder to find, it's a tough time for kids who are trying to get a job," she said. Zuckerman also noted the stressors of getting into college and being able to afford it. However, overall, she thinks that children are more isolated, even from their families, than ever before. "Kids and family members are spending more and more time apart," she said. "Apart might mean being on the computer. Kids and their families are not watching TV together, they're not eating meals together, they are not talking to each other nearly as much."
Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, according to the CDC, surpassed only by accidents and homicide. The reasons behind a teen's suicide or attempted suicide can be complex and while it can be difficult for adults to remember how it felt to be a teen-to be caught in that gray area between childhood and adulthood-parents should be aware of the signs of adolescents who may try to kill themselves. Many of the signs and symptoms of suicidal feelings are similar to those of depression:Change in eating and sleeping habitsWithdrawal from friends, family and regular activitiesViolent actions, rebellious behavior, or running awayDrug and alcohol useUnusual neglect of personal appearanceMarked personality changeLoss of interest in pleasurable activitiesPersistent boredom, difficulty concentrating, or a decline in the quality of schoolworkFrequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, and fatigueNot tolerating praise or rewards
They may also talk about suicide or death or "going away," or talk about feeling hopeless or guilty. If one or more of these signs occurs, parents should talk to their child about their concerns and seek professional help from a physician or a qualified mental health professional. With an adequate support network of family and friends, along with appropriate treatment, children and teens that are suicidal can heal and return to a healthier path of development.
The study findings were published in the September 3 issue of the Journal of the American Medical Association.
Genetic Traits Link to Bipolar Disorder
Two genes in the brain that control the activity of the nerve cells may play a big role in a person's risk for developing bipolar disorder, which is marked by dramatic swings from being depressed to manic behavior and affects between one and three percent of the population worldwide. While identifying these genes is important, it is not expected that it will lead to a genetic test for the risk of bipolar disorder. It could, however, help unravel the mystery of how it arises and could lead to better treatments
A team of international scientists examined the genomes of approximately 10,956 people that were mainly from the United States and Britain. This was including 4,387 people with the disorder, also often known as manic-depression.
The scientists found that the people with the disorder were more likely to have certain variants of the ANK3 and CACNA1C genes. The proteins that these two genes make help govern the flow of calcium ions and sodium in and out of neurons in the brain, which in turn influences the activity of the nerve cells.
The person who helped lead the study, Nick Craddock of Britain's Cardiff University, said, "The key importance of this is that it gives us a clear idea of the sorts of chemicals and mechanisms in the brain that are involved in bipolar disorder. Over a number of years, that will help researchers to develop better approaches to diagnosis and treatment."
Because this disorder has a history of running in families, scientists have been trying to pinpoint the genes that are involved in bipolar disorder. This study was the largest genetic analysis of it kind on bipolar disorder.
This disorder of the brain can cause extreme shifts in mood, energy and general ability to function. Bipolar disorder is marked by high periods of elation or irritability which is followed by periods of sadness and hopelessness that could last for months.
The researchers stated that proper function of neurons in the brain depends on a delicate balance between of calcium and sodium. Our brains operate on how quickly sodium and calcium are moving in and out of cells and the amount that goes in and out. The findings of this study suggest that this disorder may stem at least in part from malfunctions in the flow of these ions, which are the chemicals that are electrically charged.
There is a need for much better treatment for this disorder. Lithium, which is the most common treatment, only helps about two-thirds of those with bipolar disorder and can cause mild shakiness, drowsiness, and weight gain.
The research was funded in part by the U.S government's National Institutes of Health. The director of the NIH's National Institute of Mental Health, Dr. Thomas Insel, said that the findings may help solve the puzzle that is bipolar disorder. "It's not going to tell us the whole story -- it doesn't give you the whole puzzle -- but it's something to build on."
Craddock said that identifying the two gene variants will probably not be helpful in determining a person's risk for bipolar disorder because many people who do not have this disorder will have the same genes.
A team of international scientists examined the genomes of approximately 10,956 people that were mainly from the United States and Britain. This was including 4,387 people with the disorder, also often known as manic-depression.
The scientists found that the people with the disorder were more likely to have certain variants of the ANK3 and CACNA1C genes. The proteins that these two genes make help govern the flow of calcium ions and sodium in and out of neurons in the brain, which in turn influences the activity of the nerve cells.
The person who helped lead the study, Nick Craddock of Britain's Cardiff University, said, "The key importance of this is that it gives us a clear idea of the sorts of chemicals and mechanisms in the brain that are involved in bipolar disorder. Over a number of years, that will help researchers to develop better approaches to diagnosis and treatment."
Because this disorder has a history of running in families, scientists have been trying to pinpoint the genes that are involved in bipolar disorder. This study was the largest genetic analysis of it kind on bipolar disorder.
This disorder of the brain can cause extreme shifts in mood, energy and general ability to function. Bipolar disorder is marked by high periods of elation or irritability which is followed by periods of sadness and hopelessness that could last for months.
The researchers stated that proper function of neurons in the brain depends on a delicate balance between of calcium and sodium. Our brains operate on how quickly sodium and calcium are moving in and out of cells and the amount that goes in and out. The findings of this study suggest that this disorder may stem at least in part from malfunctions in the flow of these ions, which are the chemicals that are electrically charged.
There is a need for much better treatment for this disorder. Lithium, which is the most common treatment, only helps about two-thirds of those with bipolar disorder and can cause mild shakiness, drowsiness, and weight gain.
The research was funded in part by the U.S government's National Institutes of Health. The director of the NIH's National Institute of Mental Health, Dr. Thomas Insel, said that the findings may help solve the puzzle that is bipolar disorder. "It's not going to tell us the whole story -- it doesn't give you the whole puzzle -- but it's something to build on."
Craddock said that identifying the two gene variants will probably not be helpful in determining a person's risk for bipolar disorder because many people who do not have this disorder will have the same genes.
National Suicide Prevention Week
Standing on the Golden Gate Bridge, with the fog whipping through your hair, watching the tourists take pictures, couples falling in love, and San Francisco bustling across the way is nothing short of beautiful. Sadly, a lot of people have used it as their last escape, a way of welcoming death from a beautiful place, a kind of suicidal paradise. Since its completion, the Golden Gate Bridge has seen over 1,300 people lose their life.
September 7th to 13th is National Suicide Prevention Week. Anyone who has known a victim of suicide or has felt some form of depression themselves knows the emptiness that suicide or suicidal thoughts can bring. Depression is the most common cause of suicide, with 80 percent of depression left untreated. According to the U.S. Centers for Disease Control and Prevention (CDC) 2008 report suicide is the 11th cause of death in Americans with over 32,000 deaths reported each year along with 395,000 treated cases of near-fatal self-inflicted wounds.
Recently there have been links to suicide cases due to an involvement of prescription drugs that cause mood swings, depression, and general irrational behavior. HealthNews reported a few months ago that warnings of suicidal tendencies will be listed under new Federal Drug Administration (FDA) warnings on epilepsy medications. The FDA is also underway looking into a connection between the popular allergy and asthma drug Singulair to possible changes in behavior and suicidal thoughts. Headlines were made last year when pro-wrestler Chris Benoit's drug habits were put into question as to the double murder-suicide of his wife, young son, and himself, again wondering if the constant use of steroids—which are known to cause paranoia, violent mood swings, and even depression—are to blame.
Most suicides can be prevented if the person is able to get help. However, some studies have shown that most people close to the affected person don't even know anything is wrong until it's too late. The hardest part of suicide is realizing you could have helped someone save their life. The six main risk factors of suicide are: previous suicide attempts, history of mental illness or depression, family history of violence or suicide, physical illness, drug or alcohol abuse, and feeling alone.
In addition to Suicide Prevention Week, The International Association for Suicide Prevention (IASP), the World Health Organization (WHO), and the World Federation for Mental Health will host World Suicide Prevention Day on September 10th, 2008. Because over 1 million people lose their lives to suicide each year around the world, approximating one death every 40 seconds, suicide has become a national health issue. The American Association of Suicidology presents World Suicide Prevention Day's theme as "Think Globally, Plan Nationally, Act Locally," in the hopes of saving lives through better research of suicidal behaviors and more programs dedicated to active programs and services to counteract those behaviors.
The Golden Gate Bridge doesn't need to mar its waters with any more bodies in order to bring attention to suicide as a terrible, and preventable, disease. For more information on the triggers of suicide, how to prevent it, and how to get help click here.
September 7th to 13th is National Suicide Prevention Week. Anyone who has known a victim of suicide or has felt some form of depression themselves knows the emptiness that suicide or suicidal thoughts can bring. Depression is the most common cause of suicide, with 80 percent of depression left untreated. According to the U.S. Centers for Disease Control and Prevention (CDC) 2008 report suicide is the 11th cause of death in Americans with over 32,000 deaths reported each year along with 395,000 treated cases of near-fatal self-inflicted wounds.
Recently there have been links to suicide cases due to an involvement of prescription drugs that cause mood swings, depression, and general irrational behavior. HealthNews reported a few months ago that warnings of suicidal tendencies will be listed under new Federal Drug Administration (FDA) warnings on epilepsy medications. The FDA is also underway looking into a connection between the popular allergy and asthma drug Singulair to possible changes in behavior and suicidal thoughts. Headlines were made last year when pro-wrestler Chris Benoit's drug habits were put into question as to the double murder-suicide of his wife, young son, and himself, again wondering if the constant use of steroids—which are known to cause paranoia, violent mood swings, and even depression—are to blame.
Most suicides can be prevented if the person is able to get help. However, some studies have shown that most people close to the affected person don't even know anything is wrong until it's too late. The hardest part of suicide is realizing you could have helped someone save their life. The six main risk factors of suicide are: previous suicide attempts, history of mental illness or depression, family history of violence or suicide, physical illness, drug or alcohol abuse, and feeling alone.
In addition to Suicide Prevention Week, The International Association for Suicide Prevention (IASP), the World Health Organization (WHO), and the World Federation for Mental Health will host World Suicide Prevention Day on September 10th, 2008. Because over 1 million people lose their lives to suicide each year around the world, approximating one death every 40 seconds, suicide has become a national health issue. The American Association of Suicidology presents World Suicide Prevention Day's theme as "Think Globally, Plan Nationally, Act Locally," in the hopes of saving lives through better research of suicidal behaviors and more programs dedicated to active programs and services to counteract those behaviors.
The Golden Gate Bridge doesn't need to mar its waters with any more bodies in order to bring attention to suicide as a terrible, and preventable, disease. For more information on the triggers of suicide, how to prevent it, and how to get help click here.
Youngsters and Antipsychotics: Old vs. New
Contrary to popular belief, schizophrenia is not split personality. It is a serious brain disorder—the most chronic and disabling of the major mental illnesses—that distorts the way a person acts, thinks, expresses emotions, perceives reality and relates to others. No one knows exactly what causes schizophrenia, but genetic makeup and brain chemistry may play a role. There is no cure for schizophrenia but medicines can relieve many of the symptoms. A new class of drugs called atypical antipsychotics was developed in the 1990s and has become the drugs of choice for treating children and teenagers. However, a new government study has found that these medicines are no more effective than older, less expensive drugs and are more likely to cause some harmful side effects.
For the study, dubbed "The Treatment of Early Onset Schizophrenia Study" (TEOSS), researchers, led by Dr. Linmarie Sikich of the University of North Carolina, recruited 119 young people ages 8 to 19 who suffer from psychotic symptoms. They were given either Zyprexa from Eli Lilly, Risperdal from Johnson and Johnson, or an older drug called molindone, or Moban, plus benztropine, a medication often used to reduce side effects like uncontrolled shaking or tremors that can be associated with molindone. Neither the patients nor the doctors treating them knew which drug was being taken. The study was monitored throughout by a National Institute of Mental Health (NIMH) oversight board to ensure the children’s safety.
After eight weeks of treatment, 50 percent of those taking molindone showed improvement in their symptoms, compared to 46 percent who were taking Risperdal and 34 percent of those taking Zyprexa. Statistically, there was no significant difference among the improvements seen in the three groups. However, half of the children in the study stopped taking their drug within the two months, either because it had no effect or was causing serious side effects, including rapid weight gain. The Risperdal group gained an average of nine pounds, and the Zyprexa group gained an average of 13 pounds before the oversight board ordered they be taken off the drug. Levels of a hormone, prolactin, also rose among patients taking Risperdal, which could trigger early menstruation in girls and cause growth of breast tissue in boys.
Both the Risperdal group and the Zyprexa group also showed changes in cholesterol and insulin levels, which are known risk factors for diabetes, where those taking molindone gained less than one pound, on average, and showed little metabolic change. They did, however, have more akathisia—a movement disorder involving restlessness and need to fidget. “All three of these drugs have different side effect profiles, but the newer drugs are much more likely to cause weigh gain,” said Dr. Sikich.
Dr. Sikich points out that almost all children and adolescents now treated for schizophrenia begin treatment on the newer, atypical drugs. Prescription rates for these newer drugs have increased more than fivefold for children over the past 12 years. “Atypical antipsychotics are commonly used to treat kids with EOSS, but these results question the wisdom of that approach,” she said. “They also remind us that we need to develop safer, more effective medications to treat these children, given the limited effectiveness of both the atypical and the conventional medications.”
Study coauthor Jeffery Lieberman, M.D., of Columbia University Medical Center, noted that the TEOSS results are the first documented evidence of how newer antipsychotics compare to older ones when treating children and adolescents with schizophrenia. “Doctors need to educate families about the potentially serious side effects these drugs can have so that strategies can be put into place to address them,” he noted. The TEOSS results are similar to those found in the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), which found the newer antipsychotics no more effective than older ones in treating adults with schizophrenia.
Representatives for Eli Lilly and Johnson and Johnson told the Times that their drugs weren’t approved to treat schizophrenia in children and that there was a need for new therapies, given the small number of options for kids. Eli Lilly spokesman, Jamaison Schuler, pointed out that the new study had not lasted long enough to pick up well established, long-term side effects associated with the older drugs, which can include rigidity, persistent muscle spasms, tremors, and restlessness.Of the estimated 3 million Americans suffering from schizophrenia, about 1 million are children and teenagers. People with schizophrenia often have problems functioning in society and in relationships. In adolescents, the first signs can include a change in friends, a drop in grades, sleep problems, and irritability. But because many normal adolescents exhibit these behaviors as well, it can be difficult for doctors to make a diagnosis at this stage. “Schizophrenia and schizophrenia-related disorders are rare in childhood. But when they do occur, those afflicted generally have more severe symptoms and a worse prognosis than those who develop the disorder in adulthood,” said NIMH Director Thomas R. Insel, M.D. “The newer atypical antipsychotics are often used to treat these children, but until now, it has been unclear how effective and safe they really are in children. The side effects of the newer medications should be factored into making treatment decisions.”
The study was published online September 15, 2008, in the American Journal of Psychiatry.
For the study, dubbed "The Treatment of Early Onset Schizophrenia Study" (TEOSS), researchers, led by Dr. Linmarie Sikich of the University of North Carolina, recruited 119 young people ages 8 to 19 who suffer from psychotic symptoms. They were given either Zyprexa from Eli Lilly, Risperdal from Johnson and Johnson, or an older drug called molindone, or Moban, plus benztropine, a medication often used to reduce side effects like uncontrolled shaking or tremors that can be associated with molindone. Neither the patients nor the doctors treating them knew which drug was being taken. The study was monitored throughout by a National Institute of Mental Health (NIMH) oversight board to ensure the children’s safety.
After eight weeks of treatment, 50 percent of those taking molindone showed improvement in their symptoms, compared to 46 percent who were taking Risperdal and 34 percent of those taking Zyprexa. Statistically, there was no significant difference among the improvements seen in the three groups. However, half of the children in the study stopped taking their drug within the two months, either because it had no effect or was causing serious side effects, including rapid weight gain. The Risperdal group gained an average of nine pounds, and the Zyprexa group gained an average of 13 pounds before the oversight board ordered they be taken off the drug. Levels of a hormone, prolactin, also rose among patients taking Risperdal, which could trigger early menstruation in girls and cause growth of breast tissue in boys.
Both the Risperdal group and the Zyprexa group also showed changes in cholesterol and insulin levels, which are known risk factors for diabetes, where those taking molindone gained less than one pound, on average, and showed little metabolic change. They did, however, have more akathisia—a movement disorder involving restlessness and need to fidget. “All three of these drugs have different side effect profiles, but the newer drugs are much more likely to cause weigh gain,” said Dr. Sikich.
Dr. Sikich points out that almost all children and adolescents now treated for schizophrenia begin treatment on the newer, atypical drugs. Prescription rates for these newer drugs have increased more than fivefold for children over the past 12 years. “Atypical antipsychotics are commonly used to treat kids with EOSS, but these results question the wisdom of that approach,” she said. “They also remind us that we need to develop safer, more effective medications to treat these children, given the limited effectiveness of both the atypical and the conventional medications.”
Study coauthor Jeffery Lieberman, M.D., of Columbia University Medical Center, noted that the TEOSS results are the first documented evidence of how newer antipsychotics compare to older ones when treating children and adolescents with schizophrenia. “Doctors need to educate families about the potentially serious side effects these drugs can have so that strategies can be put into place to address them,” he noted. The TEOSS results are similar to those found in the NIMH-funded Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), which found the newer antipsychotics no more effective than older ones in treating adults with schizophrenia.
Representatives for Eli Lilly and Johnson and Johnson told the Times that their drugs weren’t approved to treat schizophrenia in children and that there was a need for new therapies, given the small number of options for kids. Eli Lilly spokesman, Jamaison Schuler, pointed out that the new study had not lasted long enough to pick up well established, long-term side effects associated with the older drugs, which can include rigidity, persistent muscle spasms, tremors, and restlessness.Of the estimated 3 million Americans suffering from schizophrenia, about 1 million are children and teenagers. People with schizophrenia often have problems functioning in society and in relationships. In adolescents, the first signs can include a change in friends, a drop in grades, sleep problems, and irritability. But because many normal adolescents exhibit these behaviors as well, it can be difficult for doctors to make a diagnosis at this stage. “Schizophrenia and schizophrenia-related disorders are rare in childhood. But when they do occur, those afflicted generally have more severe symptoms and a worse prognosis than those who develop the disorder in adulthood,” said NIMH Director Thomas R. Insel, M.D. “The newer atypical antipsychotics are often used to treat these children, but until now, it has been unclear how effective and safe they really are in children. The side effects of the newer medications should be factored into making treatment decisions.”
The study was published online September 15, 2008, in the American Journal of Psychiatry.
No Health Without Mental Health
“Let us recognize that there can be no health without mental health.” Those were the profound words of UN Secretary General Ban Ki-moon on October 10, a day earmarked since 1992 as World Mental Health Day. In his message, he also emphasized that mental health is paramount to a person’s “well-being, family relationships and an individual’s ability to contribute to society.” But on a grave note, he reminded us that because resources are not only “insufficient, inequitably distributed and inefficiently used,” a large majority of people with mental disorders receive no care at all. “Scaling-up services should be a priority,” he said.
The World Health Organization’s Mental Health Gap Action Program is designed to do just that. Launched this month, the program highlights the huge treatment gap for a number of mental, neurological and substance use disorders and identifies strategies for “scaling up” mental health care using cost-effective interventions in resource-constrained settings. Strategies include assessing an individual countries needs and resources, developing sound mental health policy and legislation, and increasing human and financial resources. The program calls on all partners, including governments, donors and mental care stakeholders to join together for advocacy and action to make this program successful.
Unfortunately, mental disorders generally ranks low on the public agenda, with most countries allocating less than 2 percent of their health budget to mental health care, according to WHO. Not only are mental health resources scarce worldwide, they are distributed inequitably among different regions. Data indicates that in developing countries, 36 percent of all mental health professionals work in mental hospitals located mostly in urban areas, far from the reach of rural population. “We need to reinforce partnerships, accelerate efforts, scale up interventions, increase investments towards providing services to those who do not have any, and the political will to see all this through,” said Dr. Shigeru Omi, WHO Regional Director for the Western Pacific. Community and economic development can also be used to restore and enhance mental health, the doctor said.
With proper care and medication, 450 million people worldwide could benefit from treatment for diseases such as depression, schizophrenia, and epilepsy and begin to lead healthy lives—even in areas where resources are scarce. For example, poor countries could provide basic treatment for schizophrenia, bipolar disorder, depression and alcohol abuse by spending a mere 20 cents for every person in the country each year. And for $5 a year per person, the nine of ten people suffering from epilepsy across Africa who go untreated could have access to anticonvulsant drugs.
“Governments across the world need to see mental health as a vital component of primary health care. We need to change policy and practice,” said WHO Director-General Margaret Chan. “Only then can we get the essential mental health services to the tens of millions in need.”
The World Health Organization’s Mental Health Gap Action Program is designed to do just that. Launched this month, the program highlights the huge treatment gap for a number of mental, neurological and substance use disorders and identifies strategies for “scaling up” mental health care using cost-effective interventions in resource-constrained settings. Strategies include assessing an individual countries needs and resources, developing sound mental health policy and legislation, and increasing human and financial resources. The program calls on all partners, including governments, donors and mental care stakeholders to join together for advocacy and action to make this program successful.
Unfortunately, mental disorders generally ranks low on the public agenda, with most countries allocating less than 2 percent of their health budget to mental health care, according to WHO. Not only are mental health resources scarce worldwide, they are distributed inequitably among different regions. Data indicates that in developing countries, 36 percent of all mental health professionals work in mental hospitals located mostly in urban areas, far from the reach of rural population. “We need to reinforce partnerships, accelerate efforts, scale up interventions, increase investments towards providing services to those who do not have any, and the political will to see all this through,” said Dr. Shigeru Omi, WHO Regional Director for the Western Pacific. Community and economic development can also be used to restore and enhance mental health, the doctor said.
With proper care and medication, 450 million people worldwide could benefit from treatment for diseases such as depression, schizophrenia, and epilepsy and begin to lead healthy lives—even in areas where resources are scarce. For example, poor countries could provide basic treatment for schizophrenia, bipolar disorder, depression and alcohol abuse by spending a mere 20 cents for every person in the country each year. And for $5 a year per person, the nine of ten people suffering from epilepsy across Africa who go untreated could have access to anticonvulsant drugs.
“Governments across the world need to see mental health as a vital component of primary health care. We need to change policy and practice,” said WHO Director-General Margaret Chan. “Only then can we get the essential mental health services to the tens of millions in need.”
Long Term Psychoanalytic Therapy Found To Be Valuable
It seems, with the hustle and bustle of today’s environment many prefer whatever is quickest, from grabbing a bite to eat at a fast food joint to in-and-out medical care. However, the quickest solution may not always be the best. Whether it is a result of rampant drug therapy or the busy lives we live, extended psychoanalytic therapy through discussion with a trained therapist has seemed to dwindle away. People may want to think again about the quick fix. In a recent study there is evidence showing “talk therapy" can be very effective in treating chronic mental problems such as depression, impulsive actions, mood instability, and chaotic relationships. Administering a drug for mental illness may give the quickest relief, but it probably won’t actually cure the cause. A continued regime of meeting with a professional to talk about one's life, tthe good and the bad, may be a better solution for long term care.
An article recently published in the Journal of the American Medical Association, outlined a review of 23 studies involving 1,053 patients who underwent intensive psychoanalytic therapy. Of the 23 studies, eleven were randomized controlled trials, and 12 were observational studies. The authors of the study found psychoanalytic therapy, sometimes given as much as three times a week, and for over a year, resulted in reducing the symptoms of the patient’s problems significantly compared to shorter term therapies. In fact, the number of therapy sessions was directly related back to the improvements made in the patients. The article encourages scientist to provide more testing of c therapy.
Falk Leichsenring, a professor of psychotherapy research in the department of psychosomatic medicine and psychotherapy at the University of Giessen in Germany and the study's lead author stated, "With regard to overall effectiveness, on average, patients with complex mental disorders were better off after treatment with long-term psychodynamic psychotherapy than 96 percent of the patients in the comparison groups. Thus, this meta-analysis provides evidence that long-term psychodynamic psychotherapy is an effective treatment for complex mental disorders." According to Leichsenring, psychodynamic therapy puts the focus on developing the relationship between the therapist and patient which is much different than the shorter-term forms of therapy. Analysis found the overall resolution of the target problems were superior for those who shared in long term treatment than compared to the other groups.
Have you ever had a doctor give you a prescription and tell you to make sure to take it all? They tell us this because you may begin to feel better before finished with the prescription, but you need the whole prescription to prevent relapse or to complete treatment. This seems to also be the same for patients with complex mental disorders. They should continue long term treatment based on the current study, even though one may feel better with only a few psychotherapy visits it is better to continue attending therapy for the best results. Because insurance companies don’t always want to pay for the long term treatment it makes it difficult for some patients to continue therapy. Some insurance companies feel medications and short term therapies are more cost effective says Dr. Charles Goodstein, with the New York University School of Medicine and Langone Medical Center in New York City. He also states "This study provides a great value for doctors and for patients, and one would hope could have an influence on policy decisions."
An article recently published in the Journal of the American Medical Association, outlined a review of 23 studies involving 1,053 patients who underwent intensive psychoanalytic therapy. Of the 23 studies, eleven were randomized controlled trials, and 12 were observational studies. The authors of the study found psychoanalytic therapy, sometimes given as much as three times a week, and for over a year, resulted in reducing the symptoms of the patient’s problems significantly compared to shorter term therapies. In fact, the number of therapy sessions was directly related back to the improvements made in the patients. The article encourages scientist to provide more testing of c therapy.
Falk Leichsenring, a professor of psychotherapy research in the department of psychosomatic medicine and psychotherapy at the University of Giessen in Germany and the study's lead author stated, "With regard to overall effectiveness, on average, patients with complex mental disorders were better off after treatment with long-term psychodynamic psychotherapy than 96 percent of the patients in the comparison groups. Thus, this meta-analysis provides evidence that long-term psychodynamic psychotherapy is an effective treatment for complex mental disorders." According to Leichsenring, psychodynamic therapy puts the focus on developing the relationship between the therapist and patient which is much different than the shorter-term forms of therapy. Analysis found the overall resolution of the target problems were superior for those who shared in long term treatment than compared to the other groups.
Have you ever had a doctor give you a prescription and tell you to make sure to take it all? They tell us this because you may begin to feel better before finished with the prescription, but you need the whole prescription to prevent relapse or to complete treatment. This seems to also be the same for patients with complex mental disorders. They should continue long term treatment based on the current study, even though one may feel better with only a few psychotherapy visits it is better to continue attending therapy for the best results. Because insurance companies don’t always want to pay for the long term treatment it makes it difficult for some patients to continue therapy. Some insurance companies feel medications and short term therapies are more cost effective says Dr. Charles Goodstein, with the New York University School of Medicine and Langone Medical Center in New York City. He also states "This study provides a great value for doctors and for patients, and one would hope could have an influence on policy decisions."
Freud’s Talk-Show Therapy Makes a Comeback
Freud’s popularity generally went away with the horse and buggy when the world turned to technology for all the answers and his “talking cures” for psychoanalytical behavior became old news. A new study conducted in Germany looked back at 23 studies of 1,053 patients with a variety of mental issues from anxiety to depression, anorexia, and borderline personality disorder.
Known as psychodynamic therapy, the idea has morphed from its roots in Sigmund Freud’s controversial book of analysis The Interpretation of Dreams from 1900 when he laid out the blueprint for how we think of psychoanalysis. Without Freud we wouldn’t discuss someone having an inflated head as the word “ego,” and we probably wouldn’t look inside ourselves to solve most of our mental deficiencies. Freud taught that our underlying behavior is a direct result of our thoughts and feelings and that getting to the bottom of those subconscious thoughts and feelings will help alleviate our mental blocks.
The German scientists wrote that psychodynamic therapy—used up to three times per week on patients, sometimes for over a year—was able to relieve some symptoms of mental problems at a significantly higher rate than shorter-term methods. Published on October 1 in The Journal of the American Medical Association, the researchers called for more testing and practice of this therapy before it becomes part of our horse and buggy past for good. Their objective in this study was to investigate the effects of long-term psychodynamic psychotherapy (LTPP) in order to fully examine the results of personality disorders, disorders of the mind, depression and anxiety disorders.
Generally there are four types of psychoanalytic therapy with the most popular being cognitive behavioral therapy in which new U.S. studies have shown help children and teens both individual settings and group therapy sessions to reduce stress, depression and other mental traumas they may be trying to work out. The popularity of this cognitive behavioral type of therapy is also convenient as the average number of sessions anyone involved in this rapid therapy attends is 16. Since the high praise of shorter-term therapies has been standard, long-term therapy like Freud’s has long been deemed unnecessary. University of Wisconsin’s chairman of the counseling psychology department Bruce E. Wampold considers this new study to be on its way to proving the standard wrong, “… this review certainly does seem to contradict the notion that cognitive or other short-term therapies are better than any others,” he said, “When it’s done well, psychodynamic therapy appears to be just as effective as any other for some patients, and this strikes me as a turning point.”.
Research took place at the University of Giessen by Dr. Falk Leichsenring and at the University Medical Center Hamburg-Eppendorf by Sven Rabung. Dr. Leichsenring wrote via email message, “Psychodynamic therapy showed significant, large and stable treatment effects which even significantly increased between the end of treatment and follow-up assessment.”
t’s clear that more time and attention is needed to help psychodynamic therapy succeed in a technology-filled world where medical diagnoses can be sent to your iPhone and when cars run out of gas they rely on electricity. Although the research wasn’t specifically noted how much time is needed for psychodynamic therapy to succeed, the studies were done using varying lengths of time and with so little evidence to look back on, the research needs to be explored further. A psychiatrist from Columbia, Dr. Andrew J. Gerber, said, “this paper suggests that you’ve got to get into longer-term therapy to make improvements last.” Even in an online world where you can attend classes over the internet never meeting your teacher, do your grocery and Christmas shopping without leaving the comfort of your desk chair, and date without having to pay for dinner—if coffee shops are any indication—Freud’s talk-show type of therapy is still alive and well.
Known as psychodynamic therapy, the idea has morphed from its roots in Sigmund Freud’s controversial book of analysis The Interpretation of Dreams from 1900 when he laid out the blueprint for how we think of psychoanalysis. Without Freud we wouldn’t discuss someone having an inflated head as the word “ego,” and we probably wouldn’t look inside ourselves to solve most of our mental deficiencies. Freud taught that our underlying behavior is a direct result of our thoughts and feelings and that getting to the bottom of those subconscious thoughts and feelings will help alleviate our mental blocks.
The German scientists wrote that psychodynamic therapy—used up to three times per week on patients, sometimes for over a year—was able to relieve some symptoms of mental problems at a significantly higher rate than shorter-term methods. Published on October 1 in The Journal of the American Medical Association, the researchers called for more testing and practice of this therapy before it becomes part of our horse and buggy past for good. Their objective in this study was to investigate the effects of long-term psychodynamic psychotherapy (LTPP) in order to fully examine the results of personality disorders, disorders of the mind, depression and anxiety disorders.
Generally there are four types of psychoanalytic therapy with the most popular being cognitive behavioral therapy in which new U.S. studies have shown help children and teens both individual settings and group therapy sessions to reduce stress, depression and other mental traumas they may be trying to work out. The popularity of this cognitive behavioral type of therapy is also convenient as the average number of sessions anyone involved in this rapid therapy attends is 16. Since the high praise of shorter-term therapies has been standard, long-term therapy like Freud’s has long been deemed unnecessary. University of Wisconsin’s chairman of the counseling psychology department Bruce E. Wampold considers this new study to be on its way to proving the standard wrong, “… this review certainly does seem to contradict the notion that cognitive or other short-term therapies are better than any others,” he said, “When it’s done well, psychodynamic therapy appears to be just as effective as any other for some patients, and this strikes me as a turning point.”.
Research took place at the University of Giessen by Dr. Falk Leichsenring and at the University Medical Center Hamburg-Eppendorf by Sven Rabung. Dr. Leichsenring wrote via email message, “Psychodynamic therapy showed significant, large and stable treatment effects which even significantly increased between the end of treatment and follow-up assessment.”
t’s clear that more time and attention is needed to help psychodynamic therapy succeed in a technology-filled world where medical diagnoses can be sent to your iPhone and when cars run out of gas they rely on electricity. Although the research wasn’t specifically noted how much time is needed for psychodynamic therapy to succeed, the studies were done using varying lengths of time and with so little evidence to look back on, the research needs to be explored further. A psychiatrist from Columbia, Dr. Andrew J. Gerber, said, “this paper suggests that you’ve got to get into longer-term therapy to make improvements last.” Even in an online world where you can attend classes over the internet never meeting your teacher, do your grocery and Christmas shopping without leaving the comfort of your desk chair, and date without having to pay for dinner—if coffee shops are any indication—Freud’s talk-show type of therapy is still alive and well.
Pelvic Floor Disorders: Help Is On the Way
Are you one of the thousands of women who have a mishap when you laugh, cough or sneeze? If so, you probably suffer from some form of pelvic floor disorder—common among 24 percent of the female population—with often painful and embarrassing side effects. And ladies, if you don’t already have pelvic floor problems, by the time you reach 80 there is a 50 percent chance you will. Thankfully, there is currently research looking to improve treatments for these disorders.
The National Institutes of Health, funded research that discovered almost one quarter of women suffer from some form of pelvic floor disorder and a woman's odds of developing the disorder increase as they grow older. The disorder affects 40 percent of women from 60 to 79, and for women over 80, their risk increases to 50 percent. The research is the first analysis of a national sample to show the extent of those affected by the disorder.
A woman’s pelvic floor is made up of muscles and ligaments that form a sling and support the bladder, bowels, and uterus. Pelvic floor disorders occur once the sling, of muscle and ligaments, wear down and stretch. There are three main disorders that result from this breakdown, pelvic organ prolapse, urinary incontinence, and fecal incontinence.
When the uterus, bladder, and bowels collapse, into the vaginal canal, it is called pelvic organ collapse. It can be very uncomfortable, because of the pressure from the organs into the vagina area. The organs can potentially extend into the vaginal canal, which can limit physical activities and even put a halt to intercourse.
When one loses bladder control the disorder is known as urinary incontinence, another pelvic floor disorder. Wetting our underwear is very embarrassing as we age. Urinary incontinence is common, but not a normal part of the aging process. Though it is common for childbirth and menopause to cause urine leakage problems, it isn’t a guaranteed consequence. As if wetting your pants wasn’t enough, another form of pelvic floor disorders comes with possible accidents with your bowel movements. Bowel accidents can be caused like the other disorders from muscle damage in the pelvic floor, but causes also include constipation, nerve damage and diarrhea. Bowel incontinence can range from occasional to complete loss of bowel control.
The study, recently released in the September 17, 2008 Journal of the American Medical Association, was conducted to prevent pelvic floor disorders in women through better diagnosis, treatment and prevention. The study conducted by the BIH’s Pelvic Floor Disorders Network’s and lead author Ingrid Nygaard, M.D., M.S., of the University of Utah, School of Medicine, included a questionnaire on pelvic floor disorders in the 2005-2006 periodic National Health and Nutrition Examination Survey (NHANES) of the U.S. population. The study included 1,961 non-pregnant women over the age of 20, and were evaluated by the team of researchers based on the questionnaire in regards to their pelvic floor disorder symptoms. Almost 24 percent of the women had signs of a pelvic floor disorder, but the majority had urinary incontinence symptoms. Based on the study, women not overweight have better odds of avoiding pelvic floor disorders, compared to women overweight or obese. The cases of pelvic floor disorders increased based on the number of women who had given birth. Women who had given birth three times or more had a 32.4 percent chance of having the disorder compared to 24.6 percent chance for those giving birth twice, 18.4 with one child and 12.8 percent for those who had never given birth. Treatment for pelvic floor disorders varies depending on the severity of the symptoms. Currently treatments are surgery, therapies, strengthening muscles to support organs, use of vaginal devices to support pelvic organs such as the bladder, and medications.
No one ever wants to worry about the embarrassment of wetting or soiling their pants. However, it seems many women throughout the U.S. endure the embarrassment and pain caused from pelvic floor disorders. Duane Alexander, M.D., director of the NIH’s Eunice Kennedy Shriver stated, "The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them." While operations and treatments are currently available to help with treating pelvic floor disorders it seems based on the numbers from this current study, there is definitely room for improvement with diagnosis, treatment and even prevention. Hopefully, through more research and studies we will see new options for treatment and prevention of the embarrassing and sometimes painful disorder.
The National Institutes of Health, funded research that discovered almost one quarter of women suffer from some form of pelvic floor disorder and a woman's odds of developing the disorder increase as they grow older. The disorder affects 40 percent of women from 60 to 79, and for women over 80, their risk increases to 50 percent. The research is the first analysis of a national sample to show the extent of those affected by the disorder.
A woman’s pelvic floor is made up of muscles and ligaments that form a sling and support the bladder, bowels, and uterus. Pelvic floor disorders occur once the sling, of muscle and ligaments, wear down and stretch. There are three main disorders that result from this breakdown, pelvic organ prolapse, urinary incontinence, and fecal incontinence.
When the uterus, bladder, and bowels collapse, into the vaginal canal, it is called pelvic organ collapse. It can be very uncomfortable, because of the pressure from the organs into the vagina area. The organs can potentially extend into the vaginal canal, which can limit physical activities and even put a halt to intercourse.
When one loses bladder control the disorder is known as urinary incontinence, another pelvic floor disorder. Wetting our underwear is very embarrassing as we age. Urinary incontinence is common, but not a normal part of the aging process. Though it is common for childbirth and menopause to cause urine leakage problems, it isn’t a guaranteed consequence. As if wetting your pants wasn’t enough, another form of pelvic floor disorders comes with possible accidents with your bowel movements. Bowel accidents can be caused like the other disorders from muscle damage in the pelvic floor, but causes also include constipation, nerve damage and diarrhea. Bowel incontinence can range from occasional to complete loss of bowel control.
The study, recently released in the September 17, 2008 Journal of the American Medical Association, was conducted to prevent pelvic floor disorders in women through better diagnosis, treatment and prevention. The study conducted by the BIH’s Pelvic Floor Disorders Network’s and lead author Ingrid Nygaard, M.D., M.S., of the University of Utah, School of Medicine, included a questionnaire on pelvic floor disorders in the 2005-2006 periodic National Health and Nutrition Examination Survey (NHANES) of the U.S. population. The study included 1,961 non-pregnant women over the age of 20, and were evaluated by the team of researchers based on the questionnaire in regards to their pelvic floor disorder symptoms. Almost 24 percent of the women had signs of a pelvic floor disorder, but the majority had urinary incontinence symptoms. Based on the study, women not overweight have better odds of avoiding pelvic floor disorders, compared to women overweight or obese. The cases of pelvic floor disorders increased based on the number of women who had given birth. Women who had given birth three times or more had a 32.4 percent chance of having the disorder compared to 24.6 percent chance for those giving birth twice, 18.4 with one child and 12.8 percent for those who had never given birth. Treatment for pelvic floor disorders varies depending on the severity of the symptoms. Currently treatments are surgery, therapies, strengthening muscles to support organs, use of vaginal devices to support pelvic organs such as the bladder, and medications.
No one ever wants to worry about the embarrassment of wetting or soiling their pants. However, it seems many women throughout the U.S. endure the embarrassment and pain caused from pelvic floor disorders. Duane Alexander, M.D., director of the NIH’s Eunice Kennedy Shriver stated, "The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them." While operations and treatments are currently available to help with treating pelvic floor disorders it seems based on the numbers from this current study, there is definitely room for improvement with diagnosis, treatment and even prevention. Hopefully, through more research and studies we will see new options for treatment and prevention of the embarrassing and sometimes painful disorder.
U.S. Suicide Rates on the Rise for Middle-Aged Adults
For the first time in ten years, the suicide rate is increasing. But this time it’s not teens, young adults and elderly white men who are taking their own lives as rates have indicated in the past. Instead, more deaths are occurring among white, middle-aged men and women.
On the whole, the U.S. suicide rate has risen by 0.7 percent annually between the years of 1999 and 2005, resulting in 11 suicides per 100,000 people, up from 10.5 suicides per 100,000. Yet, the increase was notably higher among white men and women in the age range from 40 to 64. In comparison, the rates for African-Americans, Asian Americans and Native Americans declined or remained the same.
Among men within the middle-aged group, a 2.7 percent increase in the number of incidents of suicide has been noted, while a 3.9 percent rise has been recorded in women of the same age group. The information is according to a new report from the Johns Hopkins Bloomberg School of Public Health's Center for Injury Research and Policy that was recently published in the American Journal of Preventive Medicine.
Using data from the Centers for Disease Control (CDC), the study also discovered that the methods by which people are taking their own lives are changing. Although suicide by firearms decreased only a little more than 1 percent annually between 1999 and 2005 and still accounts for more than half of the deaths at 52 percent, death by hanging and suffocation rose by an average of almost 5 percent, now accounting for 22 percent of suicides. In addition, poisonings increased by about 2 percent and are responsible for18 percent of deaths.
In a statement, study author Susan Baker remarked, “While it would be straightforward to attribute the results to a rise in so-called mid-life crises, recent studies find that middle age is mostly a time of relative security and emotional well-being.” She acknowledged that the study did not investigate reasons for middle-aged Americans taking their lives.
Another factor not addressed in the research was whether an increase in the use of anti-depressants from 154 million prescriptions in 2002 to almost 170 million in 2005 could have had an effect on the number of suicide incidents. The Food and Drug Administration (FDA) has linked these drugs to suicidal behavior in teens and young adults.
According to Paula Clayton, medical director of the American Foundation for Suicide Prevention, possibilities for the rising suicide rate include the abuse of prescription painkillers that can raise the risk of suicide as well as less use of hormone replacement therapy for prevention of depression after the therapy was linked to an increased risk of cancer. Other causes may be associated with anxieties surrounding terrorism after 9/11 coupled with suicides among Iraq and Afghanistan war vets could be a cause of the increase. In addition, Clayton said that over 90 percent of suicides are associated with psychiatric disorders, and deteriorating access to treatment may part of the explanation.
Another connection to the rate of suicide may be found in The Baby Boomer hypothesis. According to a large study regarding happiness in America conducted earlier this year, Baby Boomers (born between 1946 and 1964) were the least happy age group of all those surveyed. Researchers performed the analysis at the University of Chicago and the report was published in the American Sociological Review.
On the whole, the U.S. suicide rate has risen by 0.7 percent annually between the years of 1999 and 2005, resulting in 11 suicides per 100,000 people, up from 10.5 suicides per 100,000. Yet, the increase was notably higher among white men and women in the age range from 40 to 64. In comparison, the rates for African-Americans, Asian Americans and Native Americans declined or remained the same.
Among men within the middle-aged group, a 2.7 percent increase in the number of incidents of suicide has been noted, while a 3.9 percent rise has been recorded in women of the same age group. The information is according to a new report from the Johns Hopkins Bloomberg School of Public Health's Center for Injury Research and Policy that was recently published in the American Journal of Preventive Medicine.
Using data from the Centers for Disease Control (CDC), the study also discovered that the methods by which people are taking their own lives are changing. Although suicide by firearms decreased only a little more than 1 percent annually between 1999 and 2005 and still accounts for more than half of the deaths at 52 percent, death by hanging and suffocation rose by an average of almost 5 percent, now accounting for 22 percent of suicides. In addition, poisonings increased by about 2 percent and are responsible for18 percent of deaths.
In a statement, study author Susan Baker remarked, “While it would be straightforward to attribute the results to a rise in so-called mid-life crises, recent studies find that middle age is mostly a time of relative security and emotional well-being.” She acknowledged that the study did not investigate reasons for middle-aged Americans taking their lives.
Another factor not addressed in the research was whether an increase in the use of anti-depressants from 154 million prescriptions in 2002 to almost 170 million in 2005 could have had an effect on the number of suicide incidents. The Food and Drug Administration (FDA) has linked these drugs to suicidal behavior in teens and young adults.
According to Paula Clayton, medical director of the American Foundation for Suicide Prevention, possibilities for the rising suicide rate include the abuse of prescription painkillers that can raise the risk of suicide as well as less use of hormone replacement therapy for prevention of depression after the therapy was linked to an increased risk of cancer. Other causes may be associated with anxieties surrounding terrorism after 9/11 coupled with suicides among Iraq and Afghanistan war vets could be a cause of the increase. In addition, Clayton said that over 90 percent of suicides are associated with psychiatric disorders, and deteriorating access to treatment may part of the explanation.
Another connection to the rate of suicide may be found in The Baby Boomer hypothesis. According to a large study regarding happiness in America conducted earlier this year, Baby Boomers (born between 1946 and 1964) were the least happy age group of all those surveyed. Researchers performed the analysis at the University of Chicago and the report was published in the American Sociological Review.
Improving Women’s Sexual Dysfunction With Medication
Poor sexual function reduces quality of life dramatically. In men, this is called impotence or erectile dysfunction (ED). For women, this is called sexual dysfunction, or female sexual arousal disorder.
This occurs commonly in people with serious chronic illnesses, such as diabetes, high blood pressure and the medicines that treat it, and cardiovascular disease. But both in men and women, other causes of reduced sex drive and poor sexual function include smoking, excess alcohol, reduced body hormones (such as reduced testosterone with age, or reduced hormones in menopause), spinal injury, side effects of medicines, stress, anxiety, depression, and fatigue. In men, excess pelvic or genital pressure, such as long duration bicycle riding, has been reported to cause problems, In women, prior sexual trauma (including rape), dry vagina, reactions to contraceptive devices, vaginal infections, and pregnancy or breastfeeding can produce reduced sexual function or sex drive. So evaluation by the physician is important to determine the cause in an individual.
One of the circumstances in which this becomes most important is when patients are treated with anti-depressant therapy. When this occurs, sexual dysfunction occurs in up to 70% of individuals who have received these medications for serious depression. Because of this, such individuals often stop taking the anti-depressants because sexual dysfunction is so severe. This leads to increased problems with depression, and a further reduction in quality of life. However, even when patients continue to take their anti-depression medications, sexual dysfunction can occur, and it further disrupts their lives.
An important recent study was reported by Dr. H. George Nurnberg of the University of New Mexico and his co-authors (JAMA, Volume 300, page 395, 2008). In this important study, 98 women who were taking anti-depressants for depression and whose depression was improved, but who were also complaining of sexual dysfunction were evaluated, and randomly took either sildenafil (50 mg per day increasing up to 100 mg before sexual activity) or a placebo. The authors used as a clear objective measure of sexual activity, the clinical global impression scale which was rated by clinicians and the patient. This test measured changes in many aspects of sexual function. These scores ranged from 1 which was normal up to 7 which was the most extreme problems in sexual function.
These results were very significant. Women who were treated with sildenafil had an improvement in their clinical global impression sexual function score of 1.9, compared to only 1.1 in patients taking placebo. The difference of 0.8 was highly significant, representing over a 15% improvement in the sexual function score.
The greatest effects of sildenafil were in increased orgasm (over 30% improvement), increased enjoyment (over 20% improvement), and higher overall satisfaction (over 10% improvement). The patients did complain of occasional mild headaches, flushing, or indigestion. Importantly, no patients withdrew because of any serious adverse effects. Patients continued to take the Sildenafil to achieve the improvement in sexual function.
Why is this important to us? Most patients NEVER discuss either depression or sexual function with their physicians. The most critical lesson is that everyone needs to discuss with their physician if they are having any problems with depressed mood, and any difficulties with sexual arousal, sexual satisfaction, or orgasm. Also, it is important to realize that many doctors are not aware of what types of treatment are available to improve sexual dysfunction in patients. Therefore, getting a second opinion from a consultant who specializes in sexual dysfunction may be important so that the newest type of treatments can be used to relieve sexual dysfunction. Your doctor can help find this specialist with you. If you have sexual problems, be certain to ask your doctor if medicines such as sildenafil might help you.
Your physician is your best friend in improving all kinds of problems that you have. Don’t be embarrassed to discuss anything with them.
This occurs commonly in people with serious chronic illnesses, such as diabetes, high blood pressure and the medicines that treat it, and cardiovascular disease. But both in men and women, other causes of reduced sex drive and poor sexual function include smoking, excess alcohol, reduced body hormones (such as reduced testosterone with age, or reduced hormones in menopause), spinal injury, side effects of medicines, stress, anxiety, depression, and fatigue. In men, excess pelvic or genital pressure, such as long duration bicycle riding, has been reported to cause problems, In women, prior sexual trauma (including rape), dry vagina, reactions to contraceptive devices, vaginal infections, and pregnancy or breastfeeding can produce reduced sexual function or sex drive. So evaluation by the physician is important to determine the cause in an individual.
One of the circumstances in which this becomes most important is when patients are treated with anti-depressant therapy. When this occurs, sexual dysfunction occurs in up to 70% of individuals who have received these medications for serious depression. Because of this, such individuals often stop taking the anti-depressants because sexual dysfunction is so severe. This leads to increased problems with depression, and a further reduction in quality of life. However, even when patients continue to take their anti-depression medications, sexual dysfunction can occur, and it further disrupts their lives.
An important recent study was reported by Dr. H. George Nurnberg of the University of New Mexico and his co-authors (JAMA, Volume 300, page 395, 2008). In this important study, 98 women who were taking anti-depressants for depression and whose depression was improved, but who were also complaining of sexual dysfunction were evaluated, and randomly took either sildenafil (50 mg per day increasing up to 100 mg before sexual activity) or a placebo. The authors used as a clear objective measure of sexual activity, the clinical global impression scale which was rated by clinicians and the patient. This test measured changes in many aspects of sexual function. These scores ranged from 1 which was normal up to 7 which was the most extreme problems in sexual function.
These results were very significant. Women who were treated with sildenafil had an improvement in their clinical global impression sexual function score of 1.9, compared to only 1.1 in patients taking placebo. The difference of 0.8 was highly significant, representing over a 15% improvement in the sexual function score.
The greatest effects of sildenafil were in increased orgasm (over 30% improvement), increased enjoyment (over 20% improvement), and higher overall satisfaction (over 10% improvement). The patients did complain of occasional mild headaches, flushing, or indigestion. Importantly, no patients withdrew because of any serious adverse effects. Patients continued to take the Sildenafil to achieve the improvement in sexual function.
Why is this important to us? Most patients NEVER discuss either depression or sexual function with their physicians. The most critical lesson is that everyone needs to discuss with their physician if they are having any problems with depressed mood, and any difficulties with sexual arousal, sexual satisfaction, or orgasm. Also, it is important to realize that many doctors are not aware of what types of treatment are available to improve sexual dysfunction in patients. Therefore, getting a second opinion from a consultant who specializes in sexual dysfunction may be important so that the newest type of treatments can be used to relieve sexual dysfunction. Your doctor can help find this specialist with you. If you have sexual problems, be certain to ask your doctor if medicines such as sildenafil might help you.
Your physician is your best friend in improving all kinds of problems that you have. Don’t be embarrassed to discuss anything with them.
ConsumerLab Finds Quality Issues With Some Menopause Supplements
Menopause, often referred to as “the change of life,” is the time in a woman’s life when her period stops. Leading up to menopause, a woman’s body slowly makes less and less of the hormones estrogen and progesterone. These changes affect every woman differently. While many women do not need any special treatment for menopause, some women may have such troublesome symptoms that they need treatment. Hormone replacement therapy (HRT) is traditionally used to help women deal with the more difficult symptoms of menopause, such as hot flashes and vaginal dryness, but the treatment is not risk free and may increase some women’s chances of blood clots, heart attack, stroke, breast cancer and gallbladder disease. Given these risks, some women decide to take herbal or other plant-based products such as soy, black cohosh, red clover, wild yam, dong quai, and valerian root to help relieve their symptoms. These ‘natural’ products may sound safe, but recent testing by ConsumerLab.com reveals that may not always be the case.
ConsumerLab tested and compared 19 menopause supplements made with black cohosh, soy isoflavones, and red clover isoflavones, as well as progesterone creams. Although many products provided ingredients that may be effective, a few contained little of their listed ingredient or were contaminated with lead. Highlights from the report include the following:
Quality Problems:One supplement provided only 30% of the isoflavones that it was “guaranteed to contain.” Another supplement provided only 65% of its claimed amount of glycitein, a specific isoflavone.Lead contamination was detected in one supplement.Two products violated FDA labeling requirements by not specifying the plant parts used as ingredients.
Soy Isoflavones: Seven products met ConsumerLab.com’s quality standards and provided the “50 mg to 70 mg” of total soy isoflavones associated by some researchers with reducing menopause-related hot flashes. Two of these supplements also provided 15 mg or more of the specific isoflavone genistein, an amount considered to be particularly important in such treatment.
Black cohosh: Six black-cohosh-containing supplements met quality standards.
Progesterone: Three creams were found to provide their listed amount of progesterone, ranging from 15 to 21 mg per gram.
Brands included in the report are Balance, Herbalife, Kevala, Life-flo, LifeWise, Natrol, Nature's Answer, Nature's Bounty, Nature Made, NOW, Nutrilite, Oöna, Puritan's Pride, Rainbow Light, Swanson, TruNature (Costco), Vitamin Shoppe, Vitamin World, and Vitanica. Of the 19 products tested, 13 were selected by ConsumerLab.com and six others were tested at the request of their manufacturers through ConsumerLab.com’s Voluntary Certification Program. Five additional products listed in the report are similar to ones that passed testing but are sold under different brand names. The report also provides information about the effectiveness, dosage, and potential side effects of each type of supplement as well as consumer tips for buying and using these them.
This report, as well as reviews of other popular types of supplements, is available at www.consumerlab.com. ConsumerLab is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester County, New York and has no ownership from, or interest in, companies that manufacture, sell, or distribute consumer products. Subscription to ConsumerLab.com is available online.
ConsumerLab tested and compared 19 menopause supplements made with black cohosh, soy isoflavones, and red clover isoflavones, as well as progesterone creams. Although many products provided ingredients that may be effective, a few contained little of their listed ingredient or were contaminated with lead. Highlights from the report include the following:
Quality Problems:One supplement provided only 30% of the isoflavones that it was “guaranteed to contain.” Another supplement provided only 65% of its claimed amount of glycitein, a specific isoflavone.Lead contamination was detected in one supplement.Two products violated FDA labeling requirements by not specifying the plant parts used as ingredients.
Soy Isoflavones: Seven products met ConsumerLab.com’s quality standards and provided the “50 mg to 70 mg” of total soy isoflavones associated by some researchers with reducing menopause-related hot flashes. Two of these supplements also provided 15 mg or more of the specific isoflavone genistein, an amount considered to be particularly important in such treatment.
Black cohosh: Six black-cohosh-containing supplements met quality standards.
Progesterone: Three creams were found to provide their listed amount of progesterone, ranging from 15 to 21 mg per gram.
Brands included in the report are Balance, Herbalife, Kevala, Life-flo, LifeWise, Natrol, Nature's Answer, Nature's Bounty, Nature Made, NOW, Nutrilite, Oöna, Puritan's Pride, Rainbow Light, Swanson, TruNature (Costco), Vitamin Shoppe, Vitamin World, and Vitanica. Of the 19 products tested, 13 were selected by ConsumerLab.com and six others were tested at the request of their manufacturers through ConsumerLab.com’s Voluntary Certification Program. Five additional products listed in the report are similar to ones that passed testing but are sold under different brand names. The report also provides information about the effectiveness, dosage, and potential side effects of each type of supplement as well as consumer tips for buying and using these them.
This report, as well as reviews of other popular types of supplements, is available at www.consumerlab.com. ConsumerLab is a leading provider of consumer information and independent evaluations of products that affect health and nutrition. The company is privately held and based in Westchester County, New York and has no ownership from, or interest in, companies that manufacture, sell, or distribute consumer products. Subscription to ConsumerLab.com is available online.
New Radiation Therapies and Shorter Treatment Times Effective on Breast Cancer
A more powerful, yet shorter treatment with radiation therapy has been found to be equally effective as the long-established extended course of treatment for many breast cancer patients, according to Canadian researchers. After 12 years of monitoring a large group of breast cancer patients, the researchers have reported that three weeks of radiation treatment are just as successful as the normally endured schedule of five to seven weeks of daily treatment for women diagnosed with early-stage breast cancers. The findings are strong evidence that the necessary course of radiation can safely be reduced, making life easier for patients while reducing clinic waiting lists and allowing treatment of more women without the additional costs of purchasing more equipment.
Experts agree that the new findings could change the U.S. standard of care and offer women the welcome chance to complete their treatment faster, allowing them to get on with their normal lives. In the United States alone, approximately 180,000 women are diagnosed with breast cancer annually. Although most need radiation, 30 to 40 percent of these patients may be candidates for the abbreviated treatment that currently is widely available in Canada and parts of Europe and scarcely found in the U.S.
The most ideal candidates for the shorter radiation treatment are women with early breast cancers that have not spread to the lymph nodes and have had the cancer removed by lumpectomy. Although women with such early stage cancers often do not need to undergo chemotherapy, radiation is used to keep cancer from returning in the breast where it occurred by killing any remaining tumor cells that may have escaped surgery. Cancer cells are more vulnerable to radiation than are normal, healthy cells.
With survival rates in the first five years having reached 98 percent of women with early-stage cancers, considering the quality of life of patients is now a real possibility when deciding treatment options. Currently, some women who could have the option of a lumpectomy followed by radiation choose to have a mastectomy in order to avoid radiation, because they cannot travel to a clinic for daily treatments.
The study participants included 1,234 women who began treatment between 1993 and 1996 at one of eight hospitals. Half of the participants underwent the standard regimen of 25 treatments in 35 days consisting of five treatments per week for five weeks, while the other half received 16 treatments in only 22 days. The shorter treatment utilized a higher daily dose of radiation although the total cumulative dose was lower.
During the 12 year study, the outcome concerns remained that a lower overall dose could allow for recurrences and that the higher daily doses could cause damage to breast tissue, the heart or the lungs since radiation injuries can take up to a decade to become evident. However, the findings showed no significant differences between the groups after 10 years. Both recurrence rates were 6 to 7 percent, with approximately 70 percent of both groups experiencing a little discoloration, scarring, or shrinkage from the radiation therapy.
Dr. Timothy Whelan, lead author of the study and director of the supportive cancer care research unit at the Juravinski Cancer Center in Hamilton, Ontario commented regarding the shorter treatment, “Our patients really like it because it’s much more convenient.” He also noted that, “It’s preferred because…in Canada there may be more distance to travel to a radiation facility."
According to Whelan, the new findings reflect a longer-term follow-up than those presented five years ago. Referring to the shorter but more intense radiation treatments he said, "We first presented our results five years ago, but many oncologists were reluctant to adopt this. They were concerned about long-term effects."
Healthcare providers continue to experiment with new ways to treat only affected parts of the breast rather than the breast in its entirety, to make the treatment safer by avoid exposure of the heart and lungs to radiation.
In a second study presented at the recent ASTRO conference, Dr. Peter Beitsch, a surgical oncologist at Medical City Dallas Hospital, Dallas, used a type of accelerated partial breast irradiation (APBI) that utilizes a radiation seed implant known as balloon brachytherapy. Beitsch said that the implants work very well as an alternative to whole breast radiation. Once a tumor is surgically removed a small balloon is inserted into the cavity and a catheter is attached to the balloon, which carries a high radiation dose by means of tiny radioactive seeds.
Beitsch used the Mammosite Radiation Therapy System, which was approved by the FDA in 2002, in the post-approval study funded by the manufacturer. Of the more than 1400 women in the study, Beitsch reported on 400 followed for almost 4 years now. The study found that the rate of early complications, as well as cosmetic results, were similar to those of patients receiving standard therapy. There were about 2 percent of tumor recurrences. When compared to the zero to 5 percent range of recurrences for whole breast radiation, the results are comparable.
According to Beitsch, women age 45 or older with tumors of three centimeters or less and a diagnosis of ductal cancer or ductal cancer in situ (DCIS) are the best candidates for the seed therapy. This accounts for about 40 percent of women diagnosed with breast cancer.In yet a third study presented at the conference, proton therapy, a form of external beam radiation therapy, reportedly reduced the risk for the development of a secondary malignancy in cancer patients by double when compared to traditional radiation therapy that uses photons.
Proton therapy is targeted radiation that distributes less radiation to the areas surrounding the cancer than photon radiation. Nevertheless, with proton therapy, neutrons are produced and scattered, causing some experts to fear that the scatter radiation could increase the chances for secondary cancer.
In the study, 503 patients with different cancers who underwent proton therapy were compared to 1,600 patients who had photon therapy. After a year or more of monitoring, only 6.4 percent of the proton therapy patients developed a second cancer, compared to 12.8 percent of the traditional photon therapy patients. These results suggest that fears about scatter radiation may be unjustified.
Experts agree that the new findings could change the U.S. standard of care and offer women the welcome chance to complete their treatment faster, allowing them to get on with their normal lives. In the United States alone, approximately 180,000 women are diagnosed with breast cancer annually. Although most need radiation, 30 to 40 percent of these patients may be candidates for the abbreviated treatment that currently is widely available in Canada and parts of Europe and scarcely found in the U.S.
The most ideal candidates for the shorter radiation treatment are women with early breast cancers that have not spread to the lymph nodes and have had the cancer removed by lumpectomy. Although women with such early stage cancers often do not need to undergo chemotherapy, radiation is used to keep cancer from returning in the breast where it occurred by killing any remaining tumor cells that may have escaped surgery. Cancer cells are more vulnerable to radiation than are normal, healthy cells.
With survival rates in the first five years having reached 98 percent of women with early-stage cancers, considering the quality of life of patients is now a real possibility when deciding treatment options. Currently, some women who could have the option of a lumpectomy followed by radiation choose to have a mastectomy in order to avoid radiation, because they cannot travel to a clinic for daily treatments.
The study participants included 1,234 women who began treatment between 1993 and 1996 at one of eight hospitals. Half of the participants underwent the standard regimen of 25 treatments in 35 days consisting of five treatments per week for five weeks, while the other half received 16 treatments in only 22 days. The shorter treatment utilized a higher daily dose of radiation although the total cumulative dose was lower.
During the 12 year study, the outcome concerns remained that a lower overall dose could allow for recurrences and that the higher daily doses could cause damage to breast tissue, the heart or the lungs since radiation injuries can take up to a decade to become evident. However, the findings showed no significant differences between the groups after 10 years. Both recurrence rates were 6 to 7 percent, with approximately 70 percent of both groups experiencing a little discoloration, scarring, or shrinkage from the radiation therapy.
Dr. Timothy Whelan, lead author of the study and director of the supportive cancer care research unit at the Juravinski Cancer Center in Hamilton, Ontario commented regarding the shorter treatment, “Our patients really like it because it’s much more convenient.” He also noted that, “It’s preferred because…in Canada there may be more distance to travel to a radiation facility."
According to Whelan, the new findings reflect a longer-term follow-up than those presented five years ago. Referring to the shorter but more intense radiation treatments he said, "We first presented our results five years ago, but many oncologists were reluctant to adopt this. They were concerned about long-term effects."
Healthcare providers continue to experiment with new ways to treat only affected parts of the breast rather than the breast in its entirety, to make the treatment safer by avoid exposure of the heart and lungs to radiation.
In a second study presented at the recent ASTRO conference, Dr. Peter Beitsch, a surgical oncologist at Medical City Dallas Hospital, Dallas, used a type of accelerated partial breast irradiation (APBI) that utilizes a radiation seed implant known as balloon brachytherapy. Beitsch said that the implants work very well as an alternative to whole breast radiation. Once a tumor is surgically removed a small balloon is inserted into the cavity and a catheter is attached to the balloon, which carries a high radiation dose by means of tiny radioactive seeds.
Beitsch used the Mammosite Radiation Therapy System, which was approved by the FDA in 2002, in the post-approval study funded by the manufacturer. Of the more than 1400 women in the study, Beitsch reported on 400 followed for almost 4 years now. The study found that the rate of early complications, as well as cosmetic results, were similar to those of patients receiving standard therapy. There were about 2 percent of tumor recurrences. When compared to the zero to 5 percent range of recurrences for whole breast radiation, the results are comparable.
According to Beitsch, women age 45 or older with tumors of three centimeters or less and a diagnosis of ductal cancer or ductal cancer in situ (DCIS) are the best candidates for the seed therapy. This accounts for about 40 percent of women diagnosed with breast cancer.In yet a third study presented at the conference, proton therapy, a form of external beam radiation therapy, reportedly reduced the risk for the development of a secondary malignancy in cancer patients by double when compared to traditional radiation therapy that uses photons.
Proton therapy is targeted radiation that distributes less radiation to the areas surrounding the cancer than photon radiation. Nevertheless, with proton therapy, neutrons are produced and scattered, causing some experts to fear that the scatter radiation could increase the chances for secondary cancer.
In the study, 503 patients with different cancers who underwent proton therapy were compared to 1,600 patients who had photon therapy. After a year or more of monitoring, only 6.4 percent of the proton therapy patients developed a second cancer, compared to 12.8 percent of the traditional photon therapy patients. These results suggest that fears about scatter radiation may be unjustified.
Computer-Aided Mammogram Readings Prove Effective In Breast Cancer Detection
Research has already proven that the screening of mammography results is enhanced considerably when two readers analyze the results as opposed to only one. Although this has become a standard practice in Europe, it is not widely used in the U.S. However, according to a group of British researchers, it has now been shown that a single reader can use computer assistance in performing the analysis with the effectiveness of having two readers according to a new study.
Mammograms are performed women to screen for early signs of breast cancer. In the United States, X-rays are read by single radiologists, which allows for cancers to sometimes be missed. Experts maintain that there are not enough radiologists available to be able to give mammograms two readings. In addition, insurers will not pay for a second reading.
Computer-aided detection (CAD) was developed to assist radiologists in spotting more cancers. These computer programs were approved ten years ago and Medicare will pay an additional $15 for the use of CAD. However, CAD is currently only used for about one third of U.S. mammograms due to concerns regarding the accuracy of the technology.
Dr. Fiona J. Gilbert, from the University of Aberdeen in the UK, and colleagues conducted a randomized controlled trial that involved 31,057 women’s mammograms in comparing single reading utilizing CAD with double reading. The study found that the sensitivity, specificity, and positive predictive value for the two reading practices were about the same.
The research found that double readings detected 87.7 percent of cancers whereas single reading with computer assistance detected 87.2 percent. The actual numbers of cancers detected were 198 out of 227 for the single reader with CAD, compared to 199 for the two readers. In addition, 3.4 percent of women were recalled for further assessment where double reading was used, white the rate for single reading plus computer assistance was slightly higher at 3.9 percent.
The study results for the CAD single reading included sensitivity at 87.2 percent, specificity at 96.9 percent and a positive predictive value of 18 percent. For the double reading the percentages were 87.7 for sensitivity, 97.4 for specificity and 21.1 for a positive predictive value.
According to the authors, “Double reading, which is recognized as the best method for the detection of small invasive cancers, is often difficult to achieve in practice because of costs and the need for two readers.” In addition, they noted, “Where single reading is standard practice, computer-aided detection has the potential to improve cancer-detection rates to the level achieved by double reading.”
Dr. Gilbert said that CAD could be used by Britain's national health service to expand screening. The service currently offers the test every three years to women 50 to 70. In comparison, the U.S. government recommends mammograms every one-two years beginning at age 40.
Cancer Research UK, an independent organization dedicated to cancer research, and The National Health Service Center Screening Program funded the research. The report is published The New England Journal of Medicine.
Mammograms are performed women to screen for early signs of breast cancer. In the United States, X-rays are read by single radiologists, which allows for cancers to sometimes be missed. Experts maintain that there are not enough radiologists available to be able to give mammograms two readings. In addition, insurers will not pay for a second reading.
Computer-aided detection (CAD) was developed to assist radiologists in spotting more cancers. These computer programs were approved ten years ago and Medicare will pay an additional $15 for the use of CAD. However, CAD is currently only used for about one third of U.S. mammograms due to concerns regarding the accuracy of the technology.
Dr. Fiona J. Gilbert, from the University of Aberdeen in the UK, and colleagues conducted a randomized controlled trial that involved 31,057 women’s mammograms in comparing single reading utilizing CAD with double reading. The study found that the sensitivity, specificity, and positive predictive value for the two reading practices were about the same.
The research found that double readings detected 87.7 percent of cancers whereas single reading with computer assistance detected 87.2 percent. The actual numbers of cancers detected were 198 out of 227 for the single reader with CAD, compared to 199 for the two readers. In addition, 3.4 percent of women were recalled for further assessment where double reading was used, white the rate for single reading plus computer assistance was slightly higher at 3.9 percent.
The study results for the CAD single reading included sensitivity at 87.2 percent, specificity at 96.9 percent and a positive predictive value of 18 percent. For the double reading the percentages were 87.7 for sensitivity, 97.4 for specificity and 21.1 for a positive predictive value.
According to the authors, “Double reading, which is recognized as the best method for the detection of small invasive cancers, is often difficult to achieve in practice because of costs and the need for two readers.” In addition, they noted, “Where single reading is standard practice, computer-aided detection has the potential to improve cancer-detection rates to the level achieved by double reading.”
Dr. Gilbert said that CAD could be used by Britain's national health service to expand screening. The service currently offers the test every three years to women 50 to 70. In comparison, the U.S. government recommends mammograms every one-two years beginning at age 40.
Cancer Research UK, an independent organization dedicated to cancer research, and The National Health Service Center Screening Program funded the research. The report is published The New England Journal of Medicine.
Hormone Replacement Therapy Reduces Some Risks for Women and Raises Others
Around the age of 50, some women start to lose control of their emotions, their hormones kick into high gear and then start to disappear, and their reproductive systems start shutting down, signaling the end of the fertile period of their life. For some women this shift can be quite challenging indicated by mood swings, hot flashes, and the emotional repercussions of the loss of fertility when the ovaries stop producing. Although this transition is a natural state in a woman’s life, the rapidly fluctuating hormones can cause an imbalance and leave a woman feeling like she’s on an emotional rollercoaster without an end. When the hormones do eventually stop, women can experience hormone withdrawal symptoms in post-menopause and some are prescribed a treatment to prevent these symptoms by administering an artificial boost of the diminished hormones like estrogen, progesterone, and testosterone in some cases. This treatment is called hormone replacement therapy (HRT) in the United States or just hormone therapy (HT) in Britain.
Lauded as the largest hormone study since the Women’s Health Initiative started recording the results in postmenopausal women in 1991, a new Danish study followed 700,000 postmenopausal women to record their risk of heart problems during the period of HRT use from 1995 to 2001. The Danish study, published in European Heart Journal on October 1, used records of prescription use and heart attacks following otherwise healthy Danish women aged 51 to 69, using estrogen therapy and estrogen therapy with progestin. The results for dangerous risks involved are mixed overall but age and patterns of regular use were able to distinguish higher and lower risks.
The Copenhagen team reports on the validity of their findings of non-U.S. women in a seemingly postmenopausal state aged 51 to 69 even though the risk wasn’t clearly determined in the results, "Of note, our study had no information on menopausal status, although the majority of women in the young age group were postmenopausal due to the cutoff at 51 years." The investigators in Copenhagen continued to stand by their report concluding that it is, “potentially of great clinical importance”.
Lead author Dr. Ellen Løkkegaard, a gynecologist at Copenhagen's Rigshospitalet, believes her findings about other hormone treatments not covered in the U.S. study are valid even though her report overall found no increased heart attack risk among the hormone users. However, she did find that the younger women in the study ages 51 to 54 did show a 25 percent higher risk than the rest of the study’s volunteers. Løkkegaard says that the higher risk may be because the non-hormone users of the volunteer group weren’t completely postmenopausal yet and would naturally incur a lower risk of heart disease.
Before the end of the study however, the findings were potentially positive, with Dr. Løkkegaard praising the conclusion that her team’s main piece of good news to report that taking only estrogen every day and using progestin a few days during the month—which causes monthly vaginal bleeding—is a safer choice for the heart than taking both estrogen and progestin each day, which had 35 percent more risk attached to it. Although finding no real statistics of hormone use being related to the risk of heart attacks, Løkkegaard says, "For women with an intact uterus, cyclic combined therapy (causing menstrual bleedings) should be preferred instead of continuous combined therapy (not causing menstrual bleedings)….And for women without a uterus, dermal application via gel or patch is associated with a lower risk." Although most women in the United States use oral hormone replacement pills, the Danish study suggests that topical gels or patches may reduce the risk as they do not have the same blood-clotting or inflammation effects.
The Rigshopitalet trial in Copenhagen was put on hold in 2001 after almost six years because the data safety board concluded that women subjected to estrogen-progestin treatments had an increased risk of breast cancer, deep vein thrombosis (blood clots), and stroke. It should be noted also that this new study also did not take into account data on smoking habits, exercise routines, or other choices that affect heart attack risk. Only time will tell if these findings hold true and I am sure more trials will be conducted on the potentially harmful effects of hormone gels and patches, but the good news is that there is at least one way to reduce the risk of heart attack on postmenopausal women.
Lauded as the largest hormone study since the Women’s Health Initiative started recording the results in postmenopausal women in 1991, a new Danish study followed 700,000 postmenopausal women to record their risk of heart problems during the period of HRT use from 1995 to 2001. The Danish study, published in European Heart Journal on October 1, used records of prescription use and heart attacks following otherwise healthy Danish women aged 51 to 69, using estrogen therapy and estrogen therapy with progestin. The results for dangerous risks involved are mixed overall but age and patterns of regular use were able to distinguish higher and lower risks.
The Copenhagen team reports on the validity of their findings of non-U.S. women in a seemingly postmenopausal state aged 51 to 69 even though the risk wasn’t clearly determined in the results, "Of note, our study had no information on menopausal status, although the majority of women in the young age group were postmenopausal due to the cutoff at 51 years." The investigators in Copenhagen continued to stand by their report concluding that it is, “potentially of great clinical importance”.
Lead author Dr. Ellen Løkkegaard, a gynecologist at Copenhagen's Rigshospitalet, believes her findings about other hormone treatments not covered in the U.S. study are valid even though her report overall found no increased heart attack risk among the hormone users. However, she did find that the younger women in the study ages 51 to 54 did show a 25 percent higher risk than the rest of the study’s volunteers. Løkkegaard says that the higher risk may be because the non-hormone users of the volunteer group weren’t completely postmenopausal yet and would naturally incur a lower risk of heart disease.
Before the end of the study however, the findings were potentially positive, with Dr. Løkkegaard praising the conclusion that her team’s main piece of good news to report that taking only estrogen every day and using progestin a few days during the month—which causes monthly vaginal bleeding—is a safer choice for the heart than taking both estrogen and progestin each day, which had 35 percent more risk attached to it. Although finding no real statistics of hormone use being related to the risk of heart attacks, Løkkegaard says, "For women with an intact uterus, cyclic combined therapy (causing menstrual bleedings) should be preferred instead of continuous combined therapy (not causing menstrual bleedings)….And for women without a uterus, dermal application via gel or patch is associated with a lower risk." Although most women in the United States use oral hormone replacement pills, the Danish study suggests that topical gels or patches may reduce the risk as they do not have the same blood-clotting or inflammation effects.
The Rigshopitalet trial in Copenhagen was put on hold in 2001 after almost six years because the data safety board concluded that women subjected to estrogen-progestin treatments had an increased risk of breast cancer, deep vein thrombosis (blood clots), and stroke. It should be noted also that this new study also did not take into account data on smoking habits, exercise routines, or other choices that affect heart attack risk. Only time will tell if these findings hold true and I am sure more trials will be conducted on the potentially harmful effects of hormone gels and patches, but the good news is that there is at least one way to reduce the risk of heart attack on postmenopausal women.
Caffeine and Breast Cancer: Enjoy that Cup of Java
Caffeine is almost certainly the country’s most popular drug, with American adults consuming more than 300 milligrams of it every day. Caffeine is a natural component of chocolate, coffee and tea and is used in most colas and energy drinks. It is also found in diet pills and some over-the-counter pain relievers and medicines. Over the past 30 years, there have been more than 19,000 studies on caffeine and coffee in an attempt to determine its exact effects on the human body. While caffeine is known to have some negative effects such as increasing anxiety, stress, food cravings and inhibiting sleep, increasing the overall risk of breast cancer isn’t one of them, according to a recent study.
Earlier research focusing on women diagnosed with non-cancerous breast cancer revealed that, for these patients, cutting caffeine from their diet could improve symptoms. Since benign breast disease is considered a risk factor for developing the malignant form, the findings raised concerns that caffeine might also increase the risk for malignant breast cancer.
With this in mind, Dr. Shumin M. Zhang from the division of preventive medicine at Brigham and Women’s Hospital and Harvard Medical School in Boston, along with colleagues from Tokyo Women’s Medical University in Japan studied the diets of 38,432 women over the period of four years, between 1992 and 1995. All of the women were over the age of 45 and worked as health-care professionals, the majority being registered nurses. The researchers found that about 25 percent never drank coffee, and about another 25 percent drank either one cup or less per day. Almost 30 percent consumed two to three cups per day, while slightly more than 15 percent drank four or more cups daily.
Within 10 years of follow-up, 1,188 of the study participants developed invasive breast cancer. However, after taking the women’s dietary information into account, the researchers concluded that consuming caffeine in any of its forms was not significantly associated with overall breast cancer risk. However, those with a history of benign breast disease who consumed caffeine at the highest end of the scale did have a “borderline significantly increased risk” for developing the malignant form of the disease.
The team also found that high amounts of caffeine raised the risk for certain subgroups. Those at risk for developing certain forms of breast cancer known as estrogen and/or progesterone receptor-negative breast cancer rose by 68 percent with heavy caffeine consumption and the risk for developing tumors larger than two centimeters rose by 79 percent. Since these types of breast cancer and larger tumors are associated with poorer outcomes, the team notes that it’s important to continue to investigate the impact of caffeine on specific kinds of breast cancer, even if the general risk remains insignificant.
A study last year by nutrition researcher Walter Willett, MD and colleagues from the Harvard School of Public Health also found no association between coffee or caffeine consumption and an increase in breast cancer risk or between caffeine and ER/PR negative or large tumors. The study did suggest a slight increase in breast cancer risk among postmenopausal women. But Dr. Willett says women should not be overly worried by the subgroup finding. “I wouldn’t pay too much attention to this,” he tells WebMD. “The consistent thing in all the research is that nobody has seen an overall increase in breast cancer risk.”
Dr. Willett noted that after decades of researching caffeine, coffee and health, there is very little to suggest an impact, either positive or negative, on any cancer. “In fact, it is very hard to pin anything on coffee or caffeine at this time,” WebMD quoted him as saying. “It is fair to say that, so far, the overall balance of risks and benefits are on the side of benefits.”
Recent studies have shown that coffee and caffeine may have some significant medical benefits. A study by Harvard University examined 126,000 people over an 18-year period. Their findings indicated that people who drink one to three cups of coffee per day are up to 9 percent less likely to contract diabetes. Men who drank six or more cups of coffee a day slashed their chances by 54 percent and women by 30 percent. Other studies have shown similar results in the development of Parkinson’s disease, colon cancer, cirrhosis and gallstones. It has also been shown to be beneficial in asthma, stopping headaches, boosting mood and even preventing cavities.
But despite the recent findings, most doctors still recommend moderation in regard to caffeine intake. Researchers say women who drink heavy amounts of caffeine tend to have other not-so-healthy lifestyle habits that may be linked to breast cancer risk.
The Zhang study, funded by the National Institutes of Health, was published in the October 13 issue of Archives of Internal Medicine.
Earlier research focusing on women diagnosed with non-cancerous breast cancer revealed that, for these patients, cutting caffeine from their diet could improve symptoms. Since benign breast disease is considered a risk factor for developing the malignant form, the findings raised concerns that caffeine might also increase the risk for malignant breast cancer.
With this in mind, Dr. Shumin M. Zhang from the division of preventive medicine at Brigham and Women’s Hospital and Harvard Medical School in Boston, along with colleagues from Tokyo Women’s Medical University in Japan studied the diets of 38,432 women over the period of four years, between 1992 and 1995. All of the women were over the age of 45 and worked as health-care professionals, the majority being registered nurses. The researchers found that about 25 percent never drank coffee, and about another 25 percent drank either one cup or less per day. Almost 30 percent consumed two to three cups per day, while slightly more than 15 percent drank four or more cups daily.
Within 10 years of follow-up, 1,188 of the study participants developed invasive breast cancer. However, after taking the women’s dietary information into account, the researchers concluded that consuming caffeine in any of its forms was not significantly associated with overall breast cancer risk. However, those with a history of benign breast disease who consumed caffeine at the highest end of the scale did have a “borderline significantly increased risk” for developing the malignant form of the disease.
The team also found that high amounts of caffeine raised the risk for certain subgroups. Those at risk for developing certain forms of breast cancer known as estrogen and/or progesterone receptor-negative breast cancer rose by 68 percent with heavy caffeine consumption and the risk for developing tumors larger than two centimeters rose by 79 percent. Since these types of breast cancer and larger tumors are associated with poorer outcomes, the team notes that it’s important to continue to investigate the impact of caffeine on specific kinds of breast cancer, even if the general risk remains insignificant.
A study last year by nutrition researcher Walter Willett, MD and colleagues from the Harvard School of Public Health also found no association between coffee or caffeine consumption and an increase in breast cancer risk or between caffeine and ER/PR negative or large tumors. The study did suggest a slight increase in breast cancer risk among postmenopausal women. But Dr. Willett says women should not be overly worried by the subgroup finding. “I wouldn’t pay too much attention to this,” he tells WebMD. “The consistent thing in all the research is that nobody has seen an overall increase in breast cancer risk.”
Dr. Willett noted that after decades of researching caffeine, coffee and health, there is very little to suggest an impact, either positive or negative, on any cancer. “In fact, it is very hard to pin anything on coffee or caffeine at this time,” WebMD quoted him as saying. “It is fair to say that, so far, the overall balance of risks and benefits are on the side of benefits.”
Recent studies have shown that coffee and caffeine may have some significant medical benefits. A study by Harvard University examined 126,000 people over an 18-year period. Their findings indicated that people who drink one to three cups of coffee per day are up to 9 percent less likely to contract diabetes. Men who drank six or more cups of coffee a day slashed their chances by 54 percent and women by 30 percent. Other studies have shown similar results in the development of Parkinson’s disease, colon cancer, cirrhosis and gallstones. It has also been shown to be beneficial in asthma, stopping headaches, boosting mood and even preventing cavities.
But despite the recent findings, most doctors still recommend moderation in regard to caffeine intake. Researchers say women who drink heavy amounts of caffeine tend to have other not-so-healthy lifestyle habits that may be linked to breast cancer risk.
The Zhang study, funded by the National Institutes of Health, was published in the October 13 issue of Archives of Internal Medicine.
Alcohol Intake Increases Risk for Breast Cancer
Ask most women what would put them at high risk for breast cancer and the likely answer would be genetics, a close relative having suffered from the disease. According to a recent U.K. survey, most women are not aware that more likely causes are old age, obesity, late in life childbirth or never having children, not breastfeeding, and alcohol consumption.
According to the U.K. information, 80 percent of women do not know that alcohol can increase the risk of breast cancer. It isn’t clear why the intake of alcohol would increase the possibility of breast cancer, but a 2007 study of laboratory mice showed clearly that mice injected with estrogen-receptive positive adenocarcinoma cells and fed alcohol in their water supply had a much higher growth rate of the cancer cells than mice injected with the same cells and given only water. The amount of alcohol given to the mice over the four week period was listed as equivalent to "moderate" drinking in a human.
Public Health Minister Dawn Primarolo said, “It’s shocking, even for me, to see the potential risks of drinking over recommended guidelines in black and white. One large glass of 12 percent wine takes a woman to her recommended daily limit in just one drink for regular drinking. Knowing the potential health consequences enables women to make choices that can reduce their risk of developing breast cancer.”
The U.K. study entailed 45,000 annual cases of breast cancer in a country where only 5 percent are attributed to family history and more than 80 percent of cancers occur in women over the age of 50. The lifetime risk of developing cancer is one in nine and drinking more than the recommended daily limit of alcohol could significantly increase that risk. Don Shenkar, chief executive of Alcohol Concern, said that wine is the drink of choice for most women who drink and supermarkets are responding to this by selling heavily discounted wine. Alcohol is generally 65 percent more affordable than in 1980 and since affordability of a product leads to increase in consumption supermarkets need to stop selling alcohol at such low prices.
In this country, over the past 20 years, women have increased consumption of alcohol even knowing the elevated risk of breast cancer and other health concerns. Estimates are that one out of every three American women drink, and 10 percent drink more than two drinks daily.
The adage of “a glass of wine a day is good for your heart” may hold true for men, but is not as clearly indicated for women. Men and women metabolize alcohol differently and indications are that there is a higher risk of liver cirrhosis in women who drink compared with men. Women who drink in moderation, one to three drinks per week, have been shown to have a lower rate of deaths from heart disease. Heavier drinking has been associated with a significant increase in risk for death from breast cancer and from cirrhosis. The type of drink does not affect the outcome, only the rate of alcohol consumption.
The age of the woman drinker does seem to have an effect. Heavier drinking earlier in life does not indicate an increase in breast cancer, only if the woman is postmenopausal. Women who are postmenopausal and who are taking hormone replacement therapy seem to be at particular risk. One possible reason for the age related differences may be that alcohol interferes with folate metabolism. Women who drink should take a folate supplement which may help reduce the risk of breast cancer. Most multi vitamins contained the recommended daily amount.
To drink or not to drink, a personal decision each woman must make. The decision should be based on research and fact, not just the decision that “It won’t happen to me.”
According to the U.K. information, 80 percent of women do not know that alcohol can increase the risk of breast cancer. It isn’t clear why the intake of alcohol would increase the possibility of breast cancer, but a 2007 study of laboratory mice showed clearly that mice injected with estrogen-receptive positive adenocarcinoma cells and fed alcohol in their water supply had a much higher growth rate of the cancer cells than mice injected with the same cells and given only water. The amount of alcohol given to the mice over the four week period was listed as equivalent to "moderate" drinking in a human.
Public Health Minister Dawn Primarolo said, “It’s shocking, even for me, to see the potential risks of drinking over recommended guidelines in black and white. One large glass of 12 percent wine takes a woman to her recommended daily limit in just one drink for regular drinking. Knowing the potential health consequences enables women to make choices that can reduce their risk of developing breast cancer.”
The U.K. study entailed 45,000 annual cases of breast cancer in a country where only 5 percent are attributed to family history and more than 80 percent of cancers occur in women over the age of 50. The lifetime risk of developing cancer is one in nine and drinking more than the recommended daily limit of alcohol could significantly increase that risk. Don Shenkar, chief executive of Alcohol Concern, said that wine is the drink of choice for most women who drink and supermarkets are responding to this by selling heavily discounted wine. Alcohol is generally 65 percent more affordable than in 1980 and since affordability of a product leads to increase in consumption supermarkets need to stop selling alcohol at such low prices.
In this country, over the past 20 years, women have increased consumption of alcohol even knowing the elevated risk of breast cancer and other health concerns. Estimates are that one out of every three American women drink, and 10 percent drink more than two drinks daily.
The adage of “a glass of wine a day is good for your heart” may hold true for men, but is not as clearly indicated for women. Men and women metabolize alcohol differently and indications are that there is a higher risk of liver cirrhosis in women who drink compared with men. Women who drink in moderation, one to three drinks per week, have been shown to have a lower rate of deaths from heart disease. Heavier drinking has been associated with a significant increase in risk for death from breast cancer and from cirrhosis. The type of drink does not affect the outcome, only the rate of alcohol consumption.
The age of the woman drinker does seem to have an effect. Heavier drinking earlier in life does not indicate an increase in breast cancer, only if the woman is postmenopausal. Women who are postmenopausal and who are taking hormone replacement therapy seem to be at particular risk. One possible reason for the age related differences may be that alcohol interferes with folate metabolism. Women who drink should take a folate supplement which may help reduce the risk of breast cancer. Most multi vitamins contained the recommended daily amount.
To drink or not to drink, a personal decision each woman must make. The decision should be based on research and fact, not just the decision that “It won’t happen to me.”
Link Between Sedentary Behavior and Uterine Cancer
Women, put down the remote or romance novel and get to exercising! It seems that not only could a little exercise help to reduce weight and other weight-attributing side effects, it may even help to ward off endometrine cancer, also known as uterine cancer, in obese or overweight women. Uterine cancer is the fourth most common cancer in women behind breast cancer, lung cancer and colon cancer.
More than 35,000 women are diagnosed annually in the U.S. with endometrine cancer, the #1 form of gynecologic cancer. The most common subtype is endometrioid adenocarcinoma that usually occurs a few decades after menopause and has been linked to excessive estrogen levels. The most common sign of endometrine cancer is vaginal bleeding between menstrual cycles or after menopause, and the most common treatment is the total removal of the uterus through a surgical procedure known as a hysterectomy.
The American Cancer Society’s Prospective Cancer Prevention Study II Nutrition Cohort found that overweight and obese women, who exercised even lightly or moderately instead of being sedentary, in their spare time, reduced their risks of developing uterine cancer. The study began in 1992 with a questionnaire being mailed to those baseline cohort member’s between 50 and 74 years old, who were chosen for the study and resided in one of the 21 states, with a population based state cancer registries. Detailed information in regards to diet, updated lifestyle factors, and prospective cancer and mortality incidence checks were gathered.
From 1992 to 2001, Dr. Alpha Patel and colleagues with the American Cancer Society gathered research from the participants through completed biannual questionnaires. The questionnaires asked questions in regards to time spent participating in recreational or non-recreational physical activities and questions about their time sitting, not including sitting time at work. They followed nearly 60,000 post menopausal women, according to the American Journal of Epidemiology’s April 15th issue. 314 cases of uterine cancer were reported. The study resulted in the conclusion that women who sat more than three hours a day, not accounting for time sitting at work, increasing their odds of developing uterine cancer by 55 percent.
Get to walking or take part in some form of physical activity, not only to reduce weight and the possible side effects extra weight may cause, but also to ward off cancer. The authors involved in the Prospective Cancer Prevention Study II Nutrition Cohort, released in the most recent issue of the International Journal of Cancer, say that the association between sedimentary behavior and uterine or endometrine cancer may be better defined with discoveries of other studies and that "sedentary behavior has been associated with obesity and with metabolic abnormalities, resulting in increased circulating estrogen, insulin, and other hormones that may promote cell proliferation."
More than 35,000 women are diagnosed annually in the U.S. with endometrine cancer, the #1 form of gynecologic cancer. The most common subtype is endometrioid adenocarcinoma that usually occurs a few decades after menopause and has been linked to excessive estrogen levels. The most common sign of endometrine cancer is vaginal bleeding between menstrual cycles or after menopause, and the most common treatment is the total removal of the uterus through a surgical procedure known as a hysterectomy.
The American Cancer Society’s Prospective Cancer Prevention Study II Nutrition Cohort found that overweight and obese women, who exercised even lightly or moderately instead of being sedentary, in their spare time, reduced their risks of developing uterine cancer. The study began in 1992 with a questionnaire being mailed to those baseline cohort member’s between 50 and 74 years old, who were chosen for the study and resided in one of the 21 states, with a population based state cancer registries. Detailed information in regards to diet, updated lifestyle factors, and prospective cancer and mortality incidence checks were gathered.
From 1992 to 2001, Dr. Alpha Patel and colleagues with the American Cancer Society gathered research from the participants through completed biannual questionnaires. The questionnaires asked questions in regards to time spent participating in recreational or non-recreational physical activities and questions about their time sitting, not including sitting time at work. They followed nearly 60,000 post menopausal women, according to the American Journal of Epidemiology’s April 15th issue. 314 cases of uterine cancer were reported. The study resulted in the conclusion that women who sat more than three hours a day, not accounting for time sitting at work, increasing their odds of developing uterine cancer by 55 percent.
Get to walking or take part in some form of physical activity, not only to reduce weight and the possible side effects extra weight may cause, but also to ward off cancer. The authors involved in the Prospective Cancer Prevention Study II Nutrition Cohort, released in the most recent issue of the International Journal of Cancer, say that the association between sedimentary behavior and uterine or endometrine cancer may be better defined with discoveries of other studies and that "sedentary behavior has been associated with obesity and with metabolic abnormalities, resulting in increased circulating estrogen, insulin, and other hormones that may promote cell proliferation."
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