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Health
Cancer Society Casts More Doubt on Prostate Tests PDF Print E-mail
March 11, 2010

BY MIKE STOBBE

AP MEDICAL WRITER

ATLANTA (AP) — The American Cancer Society is warning more explicitly than ever that regular testing for prostate cancer is of questionable value, and can do men more harm than good.

Two big studies last year suggested prostate cancer screening doesn’t necessarily save lives, and any benefits can come at a high price. The widely used PSA test often spots cancers too slow-growing to be deadly. It can yield false-positive readings that result in unnecessary biopsies. And it can lead to treatments that can cause impotence and incontinence.

But some doctors and advocates are troubled by the new guidelines.

“Prostate cancer is still something to be respected if not feared, and we still need to be vigilant,” said Dr. David Roberts, medical director of an Atlanta clinic. “I hope primary care docs or insurance companies don’t use the ‘softening’ of the guidelines as an excuse to not do screening at all.”

Dr. Stephen Freedland, an associate professor of urology at Duke University Medical Center, warned that the medical establishment seems to be moving backward on cancer screening.

“We have seen dramatic drops in mortality from breast, prostate and cervical (cancer) at a time when screening has been increasing, and now we are stepping off the pedal,” he said. “I don’t think that is the right answer.”

The cancer society’s new guidance released March 3 urges doctors to:

• Discuss the pros and cons of testing with patients, offering written information or videos that discuss the likelihood of false test results and the side effects of treatment.

• Stop routinely giving the rectal exam because it has not clearly shown a benefit, though it can remain an option.            

• Use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.

Prostate cancer screening became a medical mantra in the 1990s, thanks to the development of the PSA test.

For American men, prostate cancer is the second-deadliest cancer after lung cancer. An estimated 192,000 new cases and 27,000 deaths from it occurred last year in the United States.

But it is often a slow-growing cancer.

Another problem with the PSA test is that an elevated or fast-rising PSA reading can indicate the presence of cancer, but can also be caused by something minor, such as an infection or an enlarged prostate. A biopsy is needed to confirm cancer, and that can cause unnecessary pain and fear.

The new recommendations could be “game changers” in two respects, said Dr. John Davis, a urologist who directs prostate cancer screening for the University of Texas M.D. Anderson Cancer Center in Houston.

First, it may mean many doctors will stop routinely giving the PSA test, he said. About 41 percent of men 50 and older get annual prostate cancer screenings, he said. Second, the guidelines could have a chilling effect on community screening clinics in which hundreds of men line up and get free, quick exams, Davis said.

That was the intent, said Dr. Andrew Wolf, a University of Virginia physician who led the group that wrote the new guidelines.

Last year, the American Urological Association — a longtime proponent of regular prostate screening — backed off its call for annual tests after age 50.

The group said men should be offered a baseline test at 40, with follow-ups based on each man’s situation. The group also has stood by the rectal exam as a standard part of screening, saying it can find cancer that the blood test does not.

Men at higher risk, including blacks and men with a father or brother who had prostate cancer before age 65, should get the information beginning at 45.

Early prostate cancer has no symptoms.

Advanced disease may interfere with urination or cause blood in the urine. There are few good treatments for very advanced cases, though researchers reported March 3 that an experimental drug extended survival by 10 weeks. They were hopeful that the drug, cabazitaxel, might be more effective in stopping earlier cancers.

Associated Press Writer Stephanie Nano in New York contributed to this report.

 
THE PULSE PDF Print E-mail
March 11, 2010

Community Health, Resource and Book Fair Scheduled

All Peoples Christian Center will host its 13th Annual Community Health, Resource & Book Fair March 27, 10 a.m. to 2 p.m.    

The event is part of All Peoples Christian Center’s efforts to inform and educate the community on ways of adapting healthier behaviors and providing preventive services.

The fair will include free health screenings, college information, and activities for the entire family.

All Peoples Christian Center is at 822 E. 20th St., Los Angeles. Admission and services are free.

Information: (213) 747-6357, ext. 33, sramos@allpeoplescc.org.

 

Obama Pitches Health Plan in Spirited Appearance

GLENSIDE, Pa. (AP) — Stirring memories of his campaign for the White House, President Barack Obama made a spirited, shirt-sleeved appeal for passage of long-stalled health care changes March 8 as Democratic congressional leaders worked behind the scenes on legislation they hope can quickly gain passage.

“Let’s seize reform. It’s within our grasp,” the president implored his audience at Arcadia University, the first outside-the-Beltway appearance since he vowed recently to do everything in his power to push his health care plan into law.

The president’s pitch was part denunciation of insurance companies — “they continue to ration care on the basis of who’s sick and who’s healthy,” he said — and part criticism of his Republican critics.

“You had 10 years. What happened? What were you doing?” he taunted members of a party that held the White House for eight years and control of Congress for a dozen.

The outcome could affect almost every American, changing the ways they receive and pay for health care — and extending coverage to tens of millions more people — if the legislation gains final approval.

 

Board of Supervisors Approve Funding for Mental Health Center

(Mark Ridley-Thomas’ Office) — The Board of Supervisors has approved about $3.5 million in funding for Phase II of the Augustus F. Hawkins Comprehensive Mental Health Center Psychiatric Inpatient Unit Refurbishment Project in the Second District.

The renovations will allow the Mental Health and Health Services departments to consolidate psychiatric inpatient, outpatient and urgent care services, previously provided at both Augustus Hawkins and Ingleside.

On Jan. 18, 2005, the board approved Phase 1 of the project, which addressed inpatient care regulatory compliance and patient safety requirements. Phase II will include the renovations of restrooms to make them ADA compliant and seismic upgrades of wards in the facility.

During the refurbishing, existing psychiatric services at Hawkins will not be adversely impacted.

 

Research: Vitamin D Helps Fight Juvenile Diabetes

(Got Milk?) — Research finds that children who get their daily dose of Vitamin D have a reduced risk of developing Type 1 diabetes — the second most common chronic disease in kids today second to asthma.

The disease could lead to blindness, kidney failure and heart problems.  A recent finding in the journal Diabetologia shows that sun exposure, the number one source of Vitamin D, can reduce the risk of developing Type 1 diabetes.

Additionally, an author of the study, Dr. Cedric Garland of the University of California, San Diego Department of Family and Preventive Medicine, says foods rich in Vitamin D could aid in this effort. 

Garland has highlighted some tips for parents on how to keep their kids healthy with Vitamin D. 

1. Outdoor play. Kids can get Vitamin D from sunlight. Experts suggest children go outside and play for 10 to 15 minutes daily between 11 a.m. to 1 p.m. Limit unprotected sun exposure to that time period and apply sunscreen afterward. 

2. Watch out for supplements. While supplements are readily available in stores, Garland says not all supplements are created equal. Vitamin D3, or cholecalciferol, is the most effective form of Vitamin D supplement.

To read the study and to learn more tips on how to prevent Vitamin D deficiency, visit, www.gotmilk.com

 
A Doctor’s Word: Virus as unpredictable as the weather PDF Print E-mail

February 11, 2010 

Dr. Manoj K. Jain

 My 10-year-old son tracks the weather map each day and enjoys the predictability (colder temperatures in the winter) with the unpredictability (50 percent chance of rain). Such is the case for the flu season this year. We have the usual seasonal flu, which peaks in January and February and then nearly goes away in the summer months. And then there is the unpredictability of the H1N1 or swine flu.

The swine flu first occurred in Mexico this past spring and spread to North America. The World Health Organization soon declared it a pandemic. During June and July, it occurred at summer camps, which my children attended, yet luckily none became ill. But when schools began in the south in late August, a surge of cases began to occur. Hospitals had to set up tents in their parking lots as makeshift emergency rooms to triage sick children. The number of people coming into our clinics with flu-like illness was three to four times the usual for that time of year. Nearly all of the cases were suspected to be H1N1.

The H1N1 flu has been unpredictable. Now, according to the Centers for Disease Control and Prevention, the cases of flu-like illness have been decreasing in all parts of the nation. 

From early findings, it appears to be very contagious and seems to transmit easily from person to person, unlike the bird flu, but much like the seasonal flu virus. 

Additionally, from early findings, it does not appear to be highly virulent among the reported cases in the United States. The virus in most cases causes a mild illness, and most patients recover fully within a week or so, much like the seasonal flu virus and unlike the SARS virus.

It is unclear what will happen when the seasonal flu cases begin to occur in January and February. Will H1N1 cases come back or just go away altogether? Nobody knows, but my son is not worried. Three weeks ago, his school offered the nasal mist vaccine for H1N1. He and all his friends stood in line to be vaccinated. A few weeks earlier, he had his seasonal flu shot.

Studies show that the vaccine for H1N1 is 97 percent effective, and after 22 million doses there are no serious side effects. Also, the rates of flu vaccinations are lower among minority populations. Even though the cases of flu-like illness are decreasing, there is plenty of flu activity to make a non-vaccinated person very sick.

Even as the swine flu epidemic turns into a pandemic, I am reassured for a number of reasons.

First, the pandemic flu preparedness has been unprecedented, with the use of technology and local, state, national and international collaboration. I am on a daily afternoon conference call or webcast at cdc.gov with the Centers for Disease Control and Prevention, and I get routine CDC updates on Twitter. I tell my son, there is a 50 percent chance of rain– so taking an umbrella--the vaccine--is a good idea. Dr. Manoj K.Jain is an infectious-disease specialist in Memphis and an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atlanta. He frequently writes health columns for the Washington Post. Gift of Health is supported by grants from The California Endowment and California Community Foundation.

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Update on H1N1 Virus PDF Print E-mail

Update on H1N1 Virus

“Don’t Let Your Guard Down” Experts Warn

By Ngoc Nguyen 

H1N1 virus has no cure, but there is a way to prevent it … get vaccinated!

That’s the message health experts around the state are telling the public, even though H1N1 flu cases have peaked. 

“It’s much too early to let our guard down,” says Ken August, spokesperson for the California Department of Public Health.  “H1N1 flu cases may be decreasing, but [the virus] is not going away.” 

The first two confirmed H1N1 cases in the country were found in California, and now a majority of counties in the state have reported at least one case of H1N1.

The virus has hospitalized more than 7,546 Californians and caused nearly 397 deaths, according to the latest state data (http://www.cdph.ca.gov/HealthInfo/discond/Pages/H1N1Home.aspx). The state estimates that more than 3 million Californians have become ill from the H1N1 flu. “The vast majority of flu illnesses are of the H1N1 strain.

We’re seeing almost none of the seasonal flu strain right now,” said August, who emphasized the importance of getting vaccinated against the strain that is out there the most. As of early December, California has ordered 7 million doses of H1N1 vaccine.

The number of doses ordered so far is enough to vaccinate about 18 percent of the state’s population against H1N1. Early supply problems hampered mass vaccination efforts, said Jonathan Fielding, M.D., public health officer for Los Angeles County. “That’s really caused a lot of problems, because expectations were heightened, and we didn’t have enough vaccine to fulfill them and that caused anxiety,” he said.

Los Angeles County has received 1.4 million doses, whereas the high-risk group is 5.5 million people, Fielding said. Pregnant women, children, young adults under age 24 and people of all ages with chronic conditions are at increased risk of infection and complications from the flu. 

Health officials emphasized the importance of getting vaccinated against H1N1 flu, especially those in high-risk groups, and they said it is not too late to do so. As it takes up to two weeks after a vaccination for the body to develop immunity, those who want to protect themselves during the holiday season should get immunized in the next two weeks.

The experts say the epidemic has crested for now, but we’re likely to see additional waves. “We’ve already had a second, we could see a third wave,” said Fielding. The first wave of H1N1 infections occurred in the spring (April-June), with cases dropping off, but never disappearing, during the summer.

Infections spiked again in October, after students went back to school. Takashi Wada, M.D., public health officer for the City of Pasadena, said H1N1 cases could rebound again after the New Year, as people tend to congregate indoors more during the winter and travel over the holidays. 

In Santa Clara County, H1N1 hospitalizations and school absenteeism have leveled off, according to Joy Alexiou, spokesperson for the county public health department. But, getting vaccinated is still a good idea, she says, because flu activity is still high. “Flus are notorious for changing and getting unpredictable,” Alexiou said.

“Will there be another wave after the first of this year? We don’t know.” The message: Better to be safe than sorry. Get vaccinated. Gift of Health is supported by grants from The California Endowment and California Community Foundation.                                               

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