What if millions of medical diagnoses, procedures, and treatments were based on, at best, questionable scientific evidence, but still performed daily, the world over, in the name of saving patients lives or reducing their suffering? A new JAMA review indicates this may be exactly what is happening. Continue reading
What do we really know about ovarian cancer risk and the ‘gene mutations’ considered largely responsible for increasing it? The answer is quite surprising and opens up the possibility for a radical change in how we diagnosis and treat the most lethal gynecological cancer in existence. Continue reading
Ovarian cancer is one of the most deadly diseases out there. It is the fifth leading cause of cancer death among U.S. women — an astounding 14,000 out of 23,000 diagnosed each year, die. Ovarian cancer tends to be aggressive and generally has very few symptoms until it reaches an advanced stage. Fortunately, several natural remedies have proven to be exceptionally useful in both preventing and curing this silent killer. Ginger, ginkgo biloba, green tea and flaxseed are all remarkably effective Continue reading
In part two of my look at the nutrient lycopene, we take aim at cancer. In fact, six different types of cancer. Found in rich amounts in tomatoes, lycopene may possess powerful cancer-preventative abilities.
Let’s start with a Harvard-based study that reviewed Continue reading
Superfoods are natural foods that have an array of nutrients that synergistically work to together to exponentially expand the individual nutritional components. Many raw, organic vegetables fall into this category. One of the world’s favorite superfoods are cucumbers.
Cucumbers are the 4th most cultivated vegetable in the world. Continue reading
The sobering statistic is that every day approximately seven babies die of Sudden Infant Death Syndrome (SIDS). Recent research suggests the simple act of breastfeeding may significantly reduce the risk of this disease and the reduction may be particularly dramatic if the breastfeeding is exclusive of formula feeding: Health Day reports. The study published in the June 13 issue of Pediatrics found a 45% reduction in SIDS risk in babies who received any amount of breast milk and a whopping 73% reduction in those who were breastfed exclusively.
Aside from lowering SIDS risk, breast feeding provides other advantages. Experts widely regard breast milk as the best type of nourishment, Continue reading
Surgery to remove healthy ovaries gives a triple benefit to high-risk women: It lowers their threat of breast and ovarian cancer, and boosts their chances of living longer, new research suggests.
The study is the largest to date to find advantages for preventive surgery for women who carry BRCA gene mutations. Women with the faulty genes have a dramatically higher cancer risk than other women — five times greater for breast cancer and at least 10 times greater for ovarian cancer.
The study, appearing in Wednesday’s Journal of the American Medical Association, found benefits for women with two different BRCA gene variants whether they had previously had breast cancer or not.
The results offer more tailored evidence for women considering ovary removal, a surgery that ends fertility, fast-forwards them into early menopause and may contribute to osteoporosis or heart problems later in life.
“It’s really critical to have the best information when making such a profound decision,” said senior author Timothy Rebbeck of the University of Pennsylvania School of Medicine.
The researchers followed nearly 2,500 women with BRCA mutations in Austria, England, the Netherlands and the United States. All the women were cancer-free at the start. They were watched for an average of four years. Most of the women were younger than 50 at the start of the study.
They got counseling to help them choose between surgery or increased screening to watch for cancers early.
Ten percent of the women chose mastectomy and 40 percent chose to have their ovaries removed; some had both. More than half the women had neither surgery.
The women who chose ovary removal had impressive results:
_1 percent were later diagnosed with ovarian cancer that showed up in cells missed by surgeons, compared to 6 percent of the women who kept their ovaries.
_11 percent were diagnosed with breast cancer, compared to 19 percent of the women who kept their ovaries.
_3 percent of those who had surgery died, compared to 10 percent of the others.
The study also found preventive mastectomy lowered the risk of breast cancer. No breast cancers were seen in the women who had their breasts removed. That may seem unsurprising, but mastectomy can leave behind breast tissue that can turn cancerous.
The study was observational, meaning it can’t prove one choice was better than another. Other factors could have caused differences in the women’s cancer rates.
But the results will help doctors counsel their patients, said Dr. Virginia Kaklamani of Northwestern University’s Feinberg School of Medicine in Chicago, who wrote an accompanying editorial in the journal.
“I’ll use it mostly in talking to people considering genetic testing,” Kaklamani said. “I can tell them, ‘If we know you test positive, there are things to do that will help you live longer.'”
The increased risk for BRCA carriers is frightening. In the general population, about 12 in 100 women will get breast cancer during their lifetimes, compared to about 60 in 100 women who have faulty BRCA genes, according to the National Cancer Institute. For ovarian cancer, the lifetime risk in the general population is a little more than 1 in 100 compared to 15-to-40 in 100 women with BRCA mutations.
For women with a family history of breast or ovarian cancer, the decision to get tested can be agonizing. The $3,300 blood test, while often covered by insurance, can disrupt families, force decisions on childbearing and leave a woman feeling stigmatized. Surgery costs thousands of dollars, not including lost time at work. Without preventive surgery, a woman faces a regimen of mammograms, MRIs and blood tests to look for cancer.
But several signs point to “the beginning of a new era” for high-risk women, said Joanna Rudnick, a 36-year-old Los Angeles filmmaker. She has known for nine years that she carries a breast cancer gene mutation. Engaged and planning to have children, she’s also planning to have her breasts and ovaries removed when she’s 40. Her documentary “In the Family” tells about her choices and those faced by other “BRCA-positive” women.
With testing more than a decade old, researchers are just beginning to have better data to understand the benefits of risk-reducing surgery. For high-risk women, equally important are the breakthroughs in cosmetic breast reconstruction, laws to prevent genetic discrimination and evolving attitudes toward removing body parts to avoid cancer, Rudnick said. A federal judge recently struck down patents on the two genes held by Myriad Genetics Inc., which may widen research possibilities and testing options.
Rudnick’s glad to hear ovary removal may reduce her risk of breast cancer as well as ovarian cancer.
“This is one of the rare silver linings that has been learned from these prospective studies,” Rudnick said
Women who carry genetic mutations that boost their odds of breast and ovarian cancer can live longer and reduce their cancer risk by having preventive surgery, a new study suggests.
The surgery in question is drastic: removal of the breasts or ovaries before any signs of cancer have arisen.
However, “what our findings show is that women who choose to have these surgeries will reduce their risk of dying of breast or ovarian cancer by about 70 to 80 percent, which is pretty profound,” said study senior author Dr. Timothy Rebbeck, a professor of epidemiology at the University of Pennsylvania School of Medicine.
The findings are published in the Sept. 1 issue of the Journal of the American Medical Association.
The 22-center trial, one of the largest of its kind, studied nearly 2,500 women who were found to have inherited mutations in the BRCA1 or BRCA2 genes.
Women who carry these mutations have a lifetime risk of breast cancer of anywhere between 56 percent to 84 percent, according to the researchers, whereas the risk for ovarian cancer ranges from 36 percent to 63 percent for BRCA1 mutation carriers and 10 percent to 27 percent for BRCA2 mutation carriers. By contrast, the lifetime risk of breast cancer among women generally is about 12 percent, and for ovarian cancer, it’s less than 2 percent.
Roughly half of the women in the study had undergone either mastectomies (surgery to remove their breasts) or salpingo-oophorectomies (surgery to remove the ovaries and fallopian tubes) between 1974 and 2008, in order to proactively lower their risk of cancer. The women were followed for an average of about 3.5 years.
During the follow-up period, no breast cancer events occurred in the women who underwent mastectomies, while 7 percent of the women in the group who didn’t undergo surgery were diagnosed with breast cancer.
In addition, women who had their ovaries removed lowered their risk of ovarian and breast cancer, and also lived longer than women who didn’t have the surgery. For example, over 6 years of follow-up, no ovarian cancer cases were seen among BRCA2 mutation carriers who underwent salpingo-oophorectomy, compared with 3 percent of carriers who did not undergo the procedure, the researchers report.
“One of the main messages of our study is that salpingo-oophorectomy should be part of any management plan for any woman who is found to have these genetic mutations,” said Rebbeck. “There really isn’t anything else that can reduce a woman’s risk by this much.”
“These findings really emphasize how important it is for all women with a family history of early breast or ovarian cancer to undergo genetic testing,” said Dr. Virginia Kaklamani, co-author of an editorial that accompanied the study. “I see women all the time who get the genetic test only after they’re diagnosed with cancer,” said Kaklamani, who is director of translational breast cancer research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, in Chicago.
Kaklamani added that she hoped the findings would encourage more women to ask their primary care physicians whether they are candidates for genetic counseling.
“This is a very important study because it gives us more information in order to counsel women at risk,” said Dr. Daniel Silver, assistant professor of medicine at the Dana Farber Cancer Institute and Harvard Medical School. Silver added that women who are found to carry one of these genetic mutations face “a very complex set of considerations, so the more hard facts you can give them, the better.”
According to Rebbeck, doctors usually recommend that women who test positive for the genes have their ovaries removed at around age 35, but are okay with putting it off until age 40 if they haven’t finished having children. He said the surgery today is often done in an outpatient setting, with the use of laparoscopes, which limits scarring and shortens a patient’s recovery time.