Tuesday, August 27, 2002
Sunburning the Norm Among US Teenagers
This study found that 72% of US youths aged 11 to 18 reported having at least 1 summer sunburn, 30% at least 3, and 12% reported 5 or more sunburns. [ PEDIATRICS Vol. 110 No. 1 July 2002, pp. 27-35 ]
Cigarette Smoking Associated With Ovarian Cancer
This population based case-control study found that smoking was associated with a 90% increased chance of mucinous ovarian cancer. Comment: another reason to decrease smoking rates world-wide. [ EPIDEMIOLOGY 2002;13:467-471 ]
Wednesday, August 21, 2002
Cancer Patients Can be Endangered by Alternative Cures on the Web
Internet websites promoting 'alternative' cures for cancer can seriously harm patients who follow their advice. And some are downright dangerous - according to an editorial published today in the British Journal of Cancer.
A survey of 13 sites relating to alternative or complementary medicine and cancer found that patients were not only discouraged from using conventional cancer therapies but were not informed about alternative remedies that have been shown to be ineffective.
The warning is sounded by scientists at Exeter University's Department of Complementary Medicine*.
Professor Edzard Ernst, who headed research into the subject, says most sites visited recommended a multitude of treatments with little consensus between them.
"Cancer patients get confused in the maze of claims and counter claims and often turn to the Internet for information which can give advice that has led to real harm and even death in some cases. "
The study defined five sites as potentially harmful to patients who followed their advice. And two sites, www.alternativemedicine.com
were described as "dangerous" to cancer patients.
Researcher Katja Schmidt says that www.alternativemedicine.com
downgraded conventional cancer treatments by statements such as 'women with breast cancer are likely to die faster with chemotherapy than without' and that 'of approximately half a million people who die of cancer each year only about two to three per cent actually gain benefit from chemotherapy. '
She says: "The site lists treatments such as herbal remedies and shark cartilage as offering 'promise as cancer treatment.' With a statement like that a patient might abandon orthodox cancer treatment on the basis of the arguments on this website. Also the site has no mention of a govern
ing body nor a reference to frequency of updates. It offers products for sale and is supported by advertising."
The site www.heall.com
provides no details of research efforts for the therapies it promotes nor does it request a patient should also seek conventional advice. "It claims that alternative therapies being used to treat and/or cure cancer are botanicals such as goldenseal, pokeroot, wild indigo, thuja, figwort, red clover, Essiac and astragalus. But there is no evidence that any of these herbal medicines cure cancer," says Schmidt.
When people are diagnosed with cancer they are in shock and feel a real sense of crisis. " They think:' What else can we do?' " says Prof Ernst. "They read pages of information on websites and read that shark cartilage promises a cure for cancer. Patients are overloaded with information and it is very difficult for them to assess the credibility of information they find on random websites.
" As long as statements on the web don't promise a cure but simply offer a chance to improve the quality of a cancer patient's life - that is quite a different matter. If a person feels better after massage or reflexology or aromatherapy that is a good thing - as long as the patient is aware that this is not a cure."
By contrast the researchers praised Cancer Research UK's award-winning website designed specifically for patients by a team of medical experts. Called www.cancerhelp.org.uk
this site "is a very useful source of information regarding conventional cancer treatments," says Schmidt. "Complementary cancer treatments are also discussed. There are details of research given for various therapies and the site provides references to sources of information, links to other cancer websites and is frequently updated. It provides non-profit primary information."
Chief executive of Cancer Research UK Sir Paul Nurse says: " Cancer Research UK works with scientists involved in looking at complementary medicine which, as the name suggests, ca
n complement orthodox treatment and bring benefits to the patient. There is a confusing amount of information about cancer treatment and so called 'alternative' cancer cures available on the Internet. Many of these have no clinical or scientific basis and so it is vitally important that patients seek advice from their doctors before embarking on any alternative therapy. Our Cancer Help website only offers patients information that has been extensively checked by a wide variety of specialists with experience of treating the disease."
* Complementary medicine aims to work in harmony with conventional treatment and as a supplement to it. Alternative medicine tends to substitute orthodox medicine with unconventional and often unproven treatments.
[ British Journal of Cancer (2002) 87, 479-480
Saturday, August 17, 2002
Aspirin Use Linked to Decreased Risk of Pancreatic Cancer
This prospective study of 28 283 postmenopausal women found that self-reported aspirin use was associated with a decreased risk of pancreatic cancer. [ Journal of the National Cancer Institute, Vol. 94, No. 15, 1168-1171, August 7, 2002
Wednesday, August 14, 2002
68% of Californians Favor Legalization
According to Mendocino County (California) Sheriff Tony Craver, who favors legalization of marijuana, 68% of Californians now favor legalization. According to Sheriff Carver, "Let me say I'm not in favor of smoking marijuana, but the people that consume it could care less what I think, and that's never stopped anybody. But I do believe that if you took the profit out of growing you're not going to see the major violence with it, the shootings and robbery, when today it's worth $5,000 a pound. People would still steal other people's marijuana, but it would be like stealing someone's tomatoes." [ article
Tuesday, August 13, 2002
Marijuana Initiative Makes Ariz. Ballot
NewsMax Wires, Tuesday, Aug. 13, 2002, PHOENIX -- An initiative that would decriminalize possession of small amounts of marijuana will appear on Arizona's general-election ballot this fall, state officials said Monday. Proposition 203, also known as the "Drug Medicalization, Prevention, and Control Act of 2002," would make possession of 2 ounces or less of marijuana a civil violation punishable by a fine of no more than $250. The fine could be waived by taking a drug education class, the initiative said. A sampling of submitted voter signatures indicated that Prop. 203 supporters included 164,264 signatures, or 161.5 percent of the minimum needed, the Secretary of State's office said. Besides reducing penalties for marijuana possession from a low-level felony, the law would allow doctors to recommend, rather than prescribe marijuana for qualifying patients. Currently under Arizona's 1996 law, doctors who want to prescribe marijuana to their patients have been discouraged by threats of federal criminal charges. The 1996 initiative was approved by 65.4 percent of registered voters in Arizona. The proposition would also require the state Department of Public Safety to distribute confiscated marijuana for free to those who receive doctors' recommendations. However, patients who qualify for medical use will not be able to sell or otherwise distribute the marijuana provided to them by the state. Proposition 203 reads that all qualified patients must be Arizona residents. The law would also acknowledge that there is a legitimate medical use for marijuana. Copyright 2002 by United Press International. All rights reserved. Reprinted with permission from NewsMax.com
. [ article
Monday, August 12, 2002
Cops Unanimously Back Nevada Pot Liberalization Proposal
August 8, 2002 - Carson City, NV, USA - A state initiative that would remove the threat of arrest for pot possession was endorsed this week by the state's largest police organization.
Eldon "Andy" Anderson, president of the Nevada Conference of Police and Sheriffs, said Tuesday that the organization unanimously backed the initiative because it would free police to spend more time dealing with more significant crimes.
"We feel that our priorities should be changing," Anderson explained on MSNBC. "[Police] shouldn't be spending a lot of time making simple marijuana arrests. We should be out there using our time to address more serious incidents. We should free up a little more of our time."
The Nevada Conference of Police and Sheriffs endorsed the proposal by a 9-0 vote. The 3,000-member organization represents 65 percent of the state's street patrol officers.
Nevada's marijuana initiative seeks to amend the state constitution so that possession of up to three ounces of marijuana by individuals 21 years of age or older would no longer carry any criminal or civil penalty. Public use of marijuana or driving under the influence of pot would continue to be penalized under the proposal.
Additional drug-law reform initiatives will likely be voted on this fall in Arizona, Ohio, Michigan, South Dakota, San Francisco, Seattle and Washington, DC. [ article ]
Strategic marketing in the UK tobacco industry
This review article discusses the strategic marketing tactics used by the tobacco industry. [ The Lancet Oncology Volume 3, Number 8 01 August 2002
Friday, August 09, 2002
Targeted Screening For Prostate Cancer In High Risk Families
This study of 442 first degree relatives of prostate cancer victims found that 27 had a serum prostate specific antigen level of greater than 4 ng/ml. Of these 27, 10 were shown to have biopsy proven prostate cancer. Comment: there still are no official recommendations on whether or not to screen for prostate cancer by testing serum PSA levels. This study adds little to the controversy. [ THE JOURNAL OF UROLOGY 2002;168:483-487 ]
Wednesday, August 07, 2002
Aspirin Use Linked to Decreased Pancreatic Cancer Rates
This study of 28 283 postmenopausal women found that those who took aspirin versus those who didn't had approximately 40% less risk for pancreatic cancer. Furthermore, there was a significant trend showing decreasing risk of pancreatic cancer with increasing frequency of aspirin use per week. Other nonsteroidal anti-inflammatory drug use was not associated with benefit or risk of pancreatic cancer. Comment: this is a powerful study in that it not only found a significant association, but also a significant trend. This makes it much more likely that aspirin truly is associated with decreased pancreatic cancer rates, and that the authors findings are not just a statistical oddity. [ article ]
Tuesday, August 06, 2002
Alaskan Eskimos More Likely to Get Lethal, Fast Growing Cancers
According to a recent study led by Dr. Anne Lanier, Alaskan Eskimos are being hard hit by difficult to detect, lethal, fast growing cancers. The most likely reason is that 43% of Alaskan Eskimos smoke, compared to approximately 20% of Americans as a whole. article
Friday, August 02, 2002
Chemoprevention of breast cancer: a summary of the evidence for the U.S. Preventive Services Task Force.
This review of the literature found that both tamoxifen and raloxifene effectively decrease the risk of breast cancer in women. The relative risk for tamoxifen was estimated to be 0.51 (a risk reduction of 49%) in a group of women whose risk of breast cancer was at least 1.66%. Raloxifene lead to a 76% risk reduction, a relative risk of 0.24 for invasive breast cancer. Both medications had side-effects. Both increased the risk for venous thromboembolic disease. Tamoxifen increased the risk for endometrial cancer and stroke. The authors conclude that raloxifene and tamoxifen may be indicated to reduce the risk of breast cancer in women, however, this reduced risk must be balanced against the potential harms of treatment. Comment: raloxifene is showing promise as an alternative to estrogen with or without provera for post-menopausal women. I anticipate that its use will steadily increase as we find out more about the severe side-effects of estrogen/provera therapy. [ Ann Intern Med. 2002 Jul 2;137(1):I62. ]
Thursday, August 01, 2002
US Preventive Services Task Force Releases Recommendations for Colon Cancer Screening
The USPSTF has released updated recommendations in screening for colon cancer. Their summary states:
"The USPSTF found fair to good evidence that several screening methods are effective in reducing mortality from colorectal cancer. The USPSTF concluded that the benefits from screening substantially outweigh potential harms, but the quality of evidence, magnitude of benefit, and potential harms vary with each method.
The USPSTF found good evidence that periodic fecal occult blood testing (FOBT) reduces mortality from colorectal cancer and fair evidence that sigmoidoscopy alone or in combination with FOBT reduces mortality. The USPSTF did not find direct evidence that screening colonoscopy is effective in reducing colorectal cancer mortality; efficacy of colonoscopy is supported by its integral role in trials of FOBT, extrapolation from sigmoidoscopy studies, limited case-control evidence, and the ability of colonoscopy to inspect the proximal colon. Double-contrast barium enema offers an alternative means of whole-bowel examination, but it is less sensitive than colonoscopy, and there is no direct evidence that it is effective in reducing mortality rates. The USPSTF found insufficient evidence that newer screening technologies (for example, computed tomographic colography) are effective in improving health outcomes. Comment: most organizations support at a minimum that fecal occult blood tests be obtained yearly starting at age 50. Beyond that, the recommendations vary. [ article ]