Breast Cancer Radiation May Increase Risk of Heart Disease
(JAMA)
Among patients with early stages of breast cancer, those whose hearts were more directly irradiated with radiation treatments on the left side in a facing-up position had higher risk of heart disease, according to research letter by David J. Brenner, Ph.D, D.Sc, of Columbia University Medical Center, New York, and colleagues.
Several reports have suggested links between breast cancer radiation and long-term cardiovascular-related deaths, according to the study background.
Researchers examined the radiation treatment plans of 48 patients with stage 0 through IIA breast cancer who were treated after 2005 at the New York University Department of Radiation Oncology. They calculated the association between radiation treatment factors, such as mean cardiac dose, cardiac risk, treatment side, body positioning and coronary events.
According to study results, the highest coronary risks were seen for left-sided treatment in women of high baseline risk treated in the supine (lying down, head facing up) position. The lowest risks were for right-sided treatment in low-baseline risk women. In left-sided radiation, prone (lying down, facing down) position reduces cardiac doses and risks, while body positioning has little effect in right-sided therapy (where the heart is always out of field).
In the brief, researchers did not seem to indicate a high amount of alarm.åÊ
ÛÏBecause the effects of radiation exposure on cardiac disease seem to be multiplicative, the highest absolute radiation risks correspond to the highest baseline cardiac risk,Û the authors conclude. ÛÏConsequently, radiotherapy-induced risks of major coronary events are likely to be reduced in these patients by targeting baseline cardiac risk factors (cholesterol, smoking, hypertension), by lifestyle modification, and/or by pharmacological treatment.Û
In other words keep doing what you are doing in terms of reducing your heart disease risk. Do talk to your doctor. And God forbid you have breast cancer, bring this article up to your oncologist, surgeon and radiation oncologist.
Holiday Visits to Elderly Relatives – Be on the Lookout
The following is reprinted with permission. I urge you to read it and pass it along. As you make your way home for the holidays here is what to look for during visits to elderly relatives. “Home for the Holidays” What to look for during your annual visit to elderly relatives by Mary Twomey, MSW, Co-Director, University of California, Irvine, Center of Excellence on Elder Abuse and Neglect.
- Does an elderly loved one require help with chores or housekeeping, personal care, shopping and meal preparation, money management, transportation, medical checkups, or medications?
- Are they isolated or, do they live with others? If living with another, are they dependent on that person for care? Is that person an appropriate caregiver?
- During your visit, keep an eye out for warning signs of self-neglect, or abuse or neglect by others. If, before you make your trip, you suspect that your loved one needs extra assistance, plan a longer stay so that you can visit local aging service organizations during regular work hours. Allow enough time during your visit to accomplish necessary tasks.
- Make the most of your visits by taking some private time with the elder to discuss future planning. Allow time for them to express anxieties. You can decide together what needs to be done and who can help. Be observant while you are visiting. Realize that you may need to arrange a visit to a doctor for a full evaluation.
Remember that 75-90% of elder abuse is committed by family members. DonÛªt let denial become an obstacle to planning that could prevent future emergencies. This is not the time to hide your head in the sand, setting the stage for future regrets. Some warning signs of elder abuse are: Self-Neglect ÛÒ If the senior lives alone and does not have anyone providing assistance, self-neglect may become an issue. Some things to look for include:
Neglect or Abuse by others ÛÒ If the senior lives with others or ostensibly has people helping with care, neglect or abuse may become an issue. Some things to look for include: åáPresence of “new best friend” who is willing to care for the senior for little or no cost. åáRecent change in banking or spending patterns. åáCaregiver isolates older person from friends and family. åáCaregiver has problems with drugs, alcohol, anger management, and emotional instability. åáCaregiver is financially dependent on the older person. åáFamily pet seems neglected or abused. åáYou find an abundance of mail and/or phone solicitations for money (ÛÏYouÛªre our lucky winner!Û). åáåÊSenior seems afraid of the caregiver. åáSenior has unexplained bruises, cuts, etc. åáSenior has ÛÏbed soresÛ (pressure sores from lying in one place for too long). åáSenior appears dirty, undernourished, dehydrated, over- or under-medicated, or is not receiving needed care for problems with eyesight, hearing, dental issues, continence.
What should you do?
- Center of Excellence in Elder Abuse and Neglect: www.centeronelderabuse.org. A program of the University of California Irvine, the CoE conducts research, training, advocacy, and direct services on the issue of elder abuse and neglect.
- Eldercare Locator: Since 1991, the Eldercare Locator, a nationwide toll-free service provided by U.S. Administration on Aging, has helped older adults and their caregivers find local services for seniors. You may visit the website at www.eldercare.gov or speak to an Information Specialist who has access to a database of more than 4,800 entries. The toll-free Eldercare Locator service operates Monday through Friday, 9:00 a.m. to 8:00 p.m. (Eastern time) and can be reached at 1-800-677-1116.
- AARP: AARP provides caregiving worksheets and tips on ÛÏLong-Distance IssuesÛ http://assets.aarp.org/external_sites/caregiving/planAhead/long_distance_issues.html
BP Drugs May Cut Alzheimer’s Dementia by 50%
(From McKnight’s Long-Term Care News and Assisted Living) Seniors who take certain blood pressure medications might be at a dramatically reduced risk for developing dementia associated with Alzheimer’s disease, according to findings published in the journal Neurology. A team led by a researcher from the Johns Hopkins University School of Medicine analyzed results of the Gingko Evaluation of Memory Study. This was intended to see whether the herb gingko biloba reduces the risk of Alzheimer’s. The herb does not, according to the study, but the researchers took another approach, looking at the blood pressure drugs that some of the 3,000 participants were taking. People older than 75 who had normal cognition and took diuretics, angiotensin-1 receptor blockers (ARBs) and ACE inhibitors demonstrated a 50% reduced risk of Alzheimer’s dementia, the researchers found. Among those with mild cognitive impairment, diuretic use was associated with a 50% reduced risk.åÊ Beta blockers and calcium channel blockers did not have this effect, according to the researchers. Check with your doctor.
Are You Getting a Good Night’s Sleep? Less Sleep, Poor Quality Sleep May Have Alzheimer’s Link
(From JAMA)
Getting less sleep and poor sleep quality are associated with abnormal brain imaging findings suggesting Alzheimer disease (AD) in older adults, according to a report published by JAMA Neurology, a JAMA Network publication.
Deposits of ë_-Amyloid (ëÔë_) plaques are one of the hallmarks of AD. Fluctuations in ëÔë_ levels may be regulated by sleep-wake patterns, the authors write in the study background.
Adam P. Spira, Ph.D., of The Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues used data from 70 adults (average age 76 years) in the Baltimore Longitudinal Study of Aging to examine whether self-reported sleep factors were associated with ëÔë_ deposition, which was measured by imaging of the brain.
Study participants reported sleep that ranged from more than seven hours to no more than 5 hours. Reports of shorter sleep duration and lower sleep quality were both associated with greater ëÔë_ buildup.
The authors acknowledge their study design does not allow them to determine whether sleep disturbance precedes ëÔë_ deposition, so they are unable to say that poor sleep causes AD.
ÛÏIn summary, our findings in a sample of community-dwelling older adults indicate that reports of shorter sleep duration and poorer sleep quality are associated with a greater ëÔë_ burden. As evidence of this association accumulates, intervention trials will be needed to determine whether optimizing sleep can prevent or slow AD progression,Û the study concludes.
Are You Being Over-Diagnosed?
(From JAMA)
Cancer screenings can find treatable disease at an earlier stage but they can also detect cancers that will never progress to cause symptoms. Detection of these early, slow-growing cancers can lead to unnecessary surgery, chemotherapy and radiation. This begs the question: Are You Being Over-Diagnosed?
A survey finds that most patients are not being told about the possibility of over-diagnosis and over-treatment as a result of cancer screenings, according to report in a research letter by Odette Wegwarth, Ph.D., and Gerd Gigerenzer, Ph.D., of the Max Planck Institute for Human Development, Berlin, Germany.
Researchers conducted an online survey of 317 U.S. men and women ages 50 to 69 years to find out how many patients had been informed of over-diagnosis and over-treatment by their physicians and how much over-diagnosis they would tolerate when deciding whether to start or continue screening.
Of the group, 9.5 percent of the study participants (n=30) reported their physicians had told them about the possibility of over-diagnosis and over-treatment. About half (51 percent) of the participants reported that they were unprepared to start a new screening. However, nearly 59 percent reported they would continue the cancer screening they receive regularly even if they learned that the test results in 10 over-treated people per one life saved from cancer death.
ÛÏThe results of the present study indicate that physiciansÛª counseling on screening does not meet patientsÛª standards,Û the study concludes.
DO THIS: Ask your physician about over-treatment and over-diagnosis. Believe me the fact that you’re even asking that question will surprise him/her and beg for an answer.
NOT THAT: Don’t keep your mouth shut. You must continually inquire about your care. There are no dumb questions.
