More women choosing double mastectomy
Researchers have found a 150 percent increase between 1998 and 2003 in American women who choose to have both breasts removed when cancer has been found in one breast.
I reported not long ago on Oklahoma’s rank in the number of women who choose to have a prophylactic mastectomy or choose to have a mastectomy rather than lumpectomy despite general agreement among doctors and researchers that survival chances are equal for both procedures.
To read the story, click here.
The recent study, published in the Oct. 22 edition of the Journal of Clinical Oncology, was the first to examine the trend on a national level. The study’s authors caution that aggressively removing both breasts may not be necessary since most patients will never develop cancer in the second breast, and the risk of cancer spreading to other parts of the body is a greater threat that development of cancer in the second breast.
“Although breast cancer is now often diagnosed at earlier stages, we’re seeing more women having contralateral prophylactic mastectomy, even though there are very little data showing that this irreversible procedure improves overall survival,” study author Dr. Todd M. Tuttle said in a press release. Tuttle is chief of surgical oncology and associate professor of surgery at the University of Minnesota. “We need to determine why this is occurring and use this information to help counsel women about the potential for less invasive options.”
Among 152,755 women diagnosed with state I, II or III breast cancer during the period studied, 59,460 underwent single mastectomy; 4,969 other women who were candidates for single mastectomy chose to have the other breast removed as well.
Tuttle suggested reasons women choose to remove the second breast is an increase in public awareness of the role of genetics in breast cancer and more frequent testing for certain gene mutations, which increase the risk of cancer in the second breast. He also attributed the increase to less invasive mastectomy techniques and improved breast reconstruction.
This subject particularly interests me because I can’t imagine how difficult the decision must be for women who are vulnerable and reeling from being told they have cancer.
Jeff Raymond, Medical Writer
Disability risk higher in states with rich-poor gap
Canadian researchers have found Americans who live in states with high rates of income inequality are much more likely to have a disability that limits their ability to complete daily tasks such as dressing, bathing and getting around at home.
“We have always known personal income and education can affect one’s health outcomes,” study author and University of Toronto assistant professor Esme Fuller-Thomson said in a press release. “What we didn’t know until now was the substantial strength of the relationship between state-level income inequality and disability. This research shows that individuals have a higher likelihood of physical disability when they live in states where wealth is distributed very unevenly.”
Researchers looked at information collected from 645,000 Americans through the 2003 American Community Survey. Their study findings are published in the British journal Public Health.
Other findings include:
- In states with a greater income gap, the wealthy were also at a health disadvantage and more likely to have “high-level” disabilities.
- Living in a state with unequal wealth distribution is nearly as much of a risk factor as gender in predicting certain disabilities. Americans living in states with high income inequality were 11 per cent more likely to have a disability than those living in states where wealth is more widely distributed.
- New York, Arizona and the District of Columbia were the three regions with the highest levels of income inequality.
Wanna talk about this? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
More on being sad….
An interesting question for depression sufferers and their doctors is why antidepressants work for some people and not for others.
If someone is diagnosed with depression, and his or her doctor prescribes a Selective Serotonin Reuptake Inhibitor (SSRI) such as Prozac or Zoloft, only about 2/3 of people respond to a given drug.
The doctor typically will then try another, and another, until the right one is found. Meanwhile, the patient has endured additional weeks of depression and expenses.
Findings from the University of Iowa shed a little light on why these drugs work for some people and not for others.
“The study focused on a gene associated with the availability of serotonin, a chemical that at low levels can affect mood and sleep. The researchers found that among people with a variation in this gene, women were more likely than men to have altered processes related to serotonin,” according to a press release on the study.
The results were based on genetic analysis and depression assessments for 192 individuals and appeared online Wednesday the American Journal of Medical Genetics.
“While the finding is exciting, the researchers caution that they have not found a ‘depression gene,’ as genes alone cannot cause behaviors,” the release continued.
Researchers investigated the function of SLC6A4, a serotonin transporter gene. They found that chemically turning off the gene’s function occurred more often in women with the variant than men with the variant.
“This means that in some women less gene expression resulted in less mRNA, which is the genetic material that helps a gene make a protein,” according to the release.
Genes don’t code for behavior. They allow production of proteins, which may or may not influence behavior, depending on their function.
“The gene variant we studied may make some people more prone to develop depression if they experience more stress or abuse — similar to how, if two people have a genetic risk for osteoporosis, the one who runs may be more likely than the one who swims to actually develop osteoporosis,” one researcher said.
Jeff Raymond, Medical Writer
Depression by job
As I looked through the 1,200 e-mail messages I accumulated during my vacation, I ran across this.
According to data from the National Survey on Drug Use and Health released last month, full-time workers ages 18 to 64 in the “personal care” and “service occupations” had the highest rates of depression, followed closely by food service. The survey used 2004-06 data to determine depression rates by occupation.
During this time, an annual average of 7 percent of full-time workers ages 18-64 experienced a “major depressive episode” in the past year.
For women, the highest rates of depression were in food preparation and service occupations — 14.8 percent. For men, the highest rates were in arts, design, entertainment, sports and media — 6.7 percent.
The unemployed had higher rates of depression than did those employed full time and part time.
U.S. companies lost an estimated $30 to $44 billion a year because of depression-related lost productivity, absenteeism and low morale, according to a press release on the study.
And, of course, depression rates vary by occupation and industry. Seems obvious, but it’s interesting to see research bear it out.
Occupations with the lowest rates of depression were engineering, architecture and surveying; life, physical and social sciences; and installation, maintenance and repair.
As this is a health care blog, 9.6 percent of health care practitioners and technical personnel reported being seriously depressed.
I have one observation to make on the men’s end: Many people wind up in arts-entertainment-media jobs straight out of college, with stars in their eyes. When they find out how little money they’ll make, and realize how incredibly competitive the job markets are, they get down.
Take, for example, a dream job as a trainer with a professional sports team. Now imagine having to deal with the debt of a master’s degree, frequent travel, little respect and a paltry salary. That’s just one example I’m personally familiar with.
Wanna talk? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
Nobel prizes not too far from home
Below are some excerpts from an Associated Press story on this year’s winners of the Nobel Prize in medicine. This is particularly pertinent because Oklahoma researchers are using some of the same techniques on tiny roundworms.
Mario R. Capecchi, Oliver Smithies and Sir Martin J. Evans won for their groundbreaking discoveries that led to “gene targeting.”
“The process has helped scientists develop models on mice of human disorders including cardiovascular and neurodegenerative ailments, diabetes and cancer. … Gene targeting is often used to inactivate single genes. Such gene “knockout” experiments have elucidated the roles of numerous genes in embryonic development, adult physiology, aging and disease. To date, more than 10,000 mouse genes (approximately half of the genes in the mammalian genome) have been knocked out. … With gene targeting it is now possible to produce almost any type of DNA modification in the mouse genome, allowing scientists to establish the roles of individual genes in health and disease,” according to the prize citation.
Research on C. elegans, the worm used in The C. elegans Knockout Consortium at the Oklahoma Medical Research Foundation, has won several Nobel Prizes, but this year’s is the first for gene targeting. The OMRF knockout project creates genetically modified worms on a production-line scale and is a crucial link between scientists’ curiosities and ability to test their ideas on a “model organism.” This year’s Nobel Prize for medicine went to scientists who pioneered the method in mice.
Mice are more complicated — both good and bad, from a research perspective — but that doesn’t detract from the importance of the technology this year’s winners developed and its diffusion to Oklahoma and elsewhere.
Any time my eyes glaze over when I hear about/read about research, I think about what it is scientists are able to do in the lab and how global research powerhouses no longer have a monopoly on talent and technology.
Jeff Raymond, Medical Writer
Mental health burden
Mental disorders cause 1.3 billion annual days of lost performance, a new Harvard University/National Institute of Mental Health study shows.
Depression is associated with the largest number of lost days. The number of days lost to mental disorders is roughly half that lost to all chronic physical conditions combined, according to a Harvard press release.
More than half of U.S. adults have a mental or physical condition that influences their “role functioning,” according to the release.
The findings are published in this month’s issue of the “Archives of General Psychiatry.” They are based on the National Comorbidity Survey-Replication, a nationwide survey of 9,282 Americans ages 18 and older. Respondents were asked how many days they were completely unable to work or carry out their usual activities because of problems with their physical or mental health.
“Previous research has found that, on the whole, the least amount of health resources are spent on research and treatment of musculoskeletal conditions,” author Kathleen Merikangas of the NIMH said in the release. “These results illuminate the discrepancy between how we allocate our health care resources, and which illnesses have the most impact.”
Jeff Raymond, Medical Writer
Roaches: geniuses, dummies or both?
A Vanderbuilt University study shows cockroaches go from moron to genius in the same day.
Studies like this make my job easy. Everybody loves to read about cockroach research. I’m no different.
Researchers discovered “dramatic daily variations” in the cockroach’s learning ability, according to a Vandy press release. The study was published online this week in the Proceedings of the National Academy of Sciences.
“This is the first example of an insect whose ability to learn is controlled by its biological clock,” Terry L. Page, the professor of biological sciences who directed the project, said in the release.
A handful of studies suggest mammals’ learning ability varies with the time of day.
“The Vanderbuilt researchers taught cockroaches to associate peppermint — a scent that they normally find slightly distasteful — with sugar water, causing them to favor it over vanilla, a scent they find universally appealing,” according to the release.
Here’s the good part.
The researchers trained cockroaches at different times in the 24-hour cycle and then tested them to see how long they remembered the association. They found that roaches trained during the evening retained the memory for days while those trained in the morning were “totally incapable” of forming new memories, although they could recall memories from other times.
Page suggested circadian rhythm could be influencing a number of senses beyond vision.
Jeff Raymond, Medical Writer
Raise your hands for hand washing
For all of you who obsessively spray alcohol and water at the gym or clean your hands with sanitizers, Canadian researchers have found what medical professionals already knew — old-fashioned soap and water works better than anything to clean your hands.
Hospital-acquired infections — called nosocomial infections — are a huge problem worldwide. One of the most difficult bugs to combat is Clostridium difficile. Michael Libman, director of the Division of Infectious Diseases at the McGill University Health Centre in Montreal studied the most effective ways to eliminate C. difficile from the hands of health care workers.
Researchers tested five hand-washing protocols that emulated hospital conditions as closely as possible, according to a McGill press release. After the hands of 10 volunteers were contaminated with the bacterium, they washed with regular soap and warm or cold water, antiseptic soap and warm water, an alcohol-based solution and a disinfectant towel.
“The results were striking: the protocols that involved washing with water eliminated more than 98 percent of the bacteria, while washing with an alcohol-based solution eliminated almost none! The protocol involving a disinfectant towel eliminated around 95 percent of bacteria,” according to the release.
Part of the challenge in controlling the bacterium is eliminating the resistant spores it produces. Alcohol eliminates “living” bacteria but not spores, the researchers postulated. The chemical action of soap and mechanical action of hand washing eliminates both. Alcohol rubs remain effective in killing bacteria but not spores.
And, by the way, soap is all antibacterial. So unless you get your soap from a hospital supply closet, washing your hands is more mechanical than chemical. And don’t rush it!
Jeff Raymond, Medical Writer
Can’t take my eyes off you
A Florida State University study shows what we all thought was true but didn’t want to believe — good-looking people catch and keep our attention.
To quote a press release on the study:
“Whether we are seeking a mate or sizing up a potential rival, good-looking people capture our attention nearly instantaneously and render us temporarily helpless to turn our eyes away from them.”
Psychology professor Jon Maner compared the attraction to “magnetism” at the visual level. In technical terms, he calls it “attention adhesion.” He showed study participants pictures and then precisely judged reaction time for them to concentrate on something else.
Maner’s findings are published in the September issue of the Journal of Personality and Social Psychology.
In three experiments, Maner and colleagues found that heterosexual men and women “fixated on highly attractive people within the first half of a second of seeing them.”
“Single folks ogled the opposite sex, of course, but those in committed relationships also checked people out, with one major difference: They were more interested in beautiful people of the same sex,” according to the release. “If we’re interested in finding a mate, our attention gets quickly and automatically stuck on attractive members of the opposite sex,” Maner said. “If we’re jealous and worried about our partner cheating on us, attention gets quickly and automatically stuck on attractive people of our own sex because they are our competitors.”
The first study had 120 participants, while the second and third had 160 and 162, respectively.
Now men have an excuse when a pretty girl walks by — we couldn’t help but look.
