Testing It Up

Less than a week after Angelina Jolie’s preventive double mastectomy disclosure, a London-based businessman had his prostate removed after being diagnosed with a mutated gene.

The DailyMail reports that one of the participants of a clinical trial by the Institute of Cancer Research in London decided to undergo the removal procedure for cancer prevention, which is pretty much the same reason as Jolie’s procedure. The businessman was told that he possessed BRCA2, which is a gene mutation similar to Jolie’s diagnosed condition.

BRCA2 or breast cancer type 2 susceptibility protein is known to increase the risk of breast cancer and ovarian cancer, and has recently been discovered as a probable cause of prostate cancer as well.

Doctors of the institute led by Roger Kirby were initially hesitant to do the procedure, since the MRI scans and a series of tests showed that the businessman’s prostate appeared to be in a healthy state. The procedure was only finalized when the medical team observed malignant changes in the prostate gland, which might develop into full-blown cancer.

This event serves as a giant step for men diagnosed with BRCA2 to undergo the preventive surgical procedure and raise awareness on the negative effects of the mutant gene. Kirby also hopes that it also emphasizes the importance of prostate cancer prevention in the country.

The businessman, whose identity has been kept under wraps, is now declared by Kirby to be 100 percent clear of BRCA2. He is currently residing in London with his wife and kids.

In perhaps one of the most startling pieces of news to come out of Hollywood in recent times, Angelina Jolie publicly disclosed last Tuesday that she recently underwent a double mastectomy.

Her decision to go under the knife came from the diagnosis that she was carrying a BRCA1 gene mutation, which Genetics Home Reference describes as a precursor of breast cancer through abnormal cell growth and eventual tumor formation.

Jolie’s declaration appears as a double-edged sword. While public disclosure of her mastectomy operation sends a strong message for women to make an empowered choice to remove both breasts for cancer prevention, it can also fuel the trend for unnecessary breast removal procedures. In fact, several doctors in recent years have reported an increasing number of women who choose preventive mastectomies of both breasts even if one of the breasts is still healthy.

Nevertheless, this bold decision is most welcome in some circles, especially for women who are hesitant to undergo surgery or even subject themselves to genetic tests. Barron H. Lerner, author of “The Breast Cancer Wars”, applauds Jolie for the decision to go out in public about her condition, saying that her stature as a world-famous actress will definitely influence women in profound ways.

Jolie wrote a column in the New York Times to share her experience. She said she had her double mastectomy done at the Pink Lotus Breast Center in Beverly Hills. The whole procedure included reconstructive surgery, and lasted for three months until its completion on April 27. She was especially thankful to partner Brad Pitt, who was with her through every minute of the process.

A small town in Pennsylvania has recently been given a medical equipment upgrade.

In their press release, Easton Hospital Health and Wellness Center reported that it is now home to the latest technology in breast cancer detection: 3D mammography. This breakthrough technology allows for a three-dimensional examination of the breast tissue for a closer scrutiny. The procedure improves the assessment of the breast structure by distinct separation of overlapping tissues.

Also called breast tomosynthesis, this novel technique reduces the physical pain during scanning. Unlike conventional mammography wherein the breast tissue is subjected to pressure, this technique uses no pressure. This development alone has sparked interest in women who are hesitant to undergo mammography because of the pain. The 3D mammography system used in Easton is called Selenia Dimensions breast tomosynthesis, which is ergonomically designed for better patient comfort.

But more than the benefits of a pain-free procedure, the greatest advantage of 3D imaging is the clarity of the images. Easton’s 3D Mammography system generates crisp imaging details, thereby giving radiologists a higher confidence level in diagnosis. Results from a 3D mammography system are expected to be far better than the conventional method.

The procedure involves scanning the breast in several angles. The machine then takes 1-mm scans of the tissue, and then reconstructs the images to form a three-dimensional image of the breast. From the digital image, radiologists can then examine the breast for abnormalities or signs of breast cancer.

Easton Hospital Health and Wellness Center is located in Forks Township, Northampton County, PA.

Tobacco smoking has long been established as the primary risk factor of lung cancer. But it appears that the same danger cannot be said for those who smoke marijuana, whether occasionally or habitually.

In a study presented at the annual meeting of the American Association of Cancer Research, a group of researchers reported that regular cannabis smoking has no significant association with lung cancer risk.

Dr. Li Rita Zhang of the University of California, Los Angeles, and colleagues examined the role of cannabis smoking in lung cancer risk using data from six case-control studies in the United States, Canada, the United Kingdom and New Zealand. All of the studies were part of the International Lung Cancer Consortium (ILCCO), according to The Oncology Report.

The risk of lung cancer was assessed between the frequency, intensity, and duration of use, while adjusting for age, sex, sociodemographic factors and tobacco packyears. In the end, the researchers found that regular pot smokers had no significant increase in lung cancer risk when compared with marijuana smokers who also used tobacco.

“The conventional wisdom is that cannabis smoking is not as dangerous as cigarette smoking,” said pulmonologist Dr. Michael Alberts, chief medical officer of the Moffitt Cancer Center, Tampa, who wasn’t part of the study. Still, he cautioned that smoking anything can have some negative effects to the respiratory system.

Dr. Zhang, on the other hand, did not comment on the study but she noted that their findings “cannot preclude the possibility that cannabis may exhibit an association with lung cancer risk at extremely high dosage over long periods of continued exposure.”

The American College of Chest Physicians (ACCP) has released updated lung cancer guidelines, which recommend offering low-dose computed tomography (LDCT) scanning to people who are at higher risk of developing lung cancer.

“Our new lung cancer guidelines take into account the many advances and new information in the field by providing comprehensive and nuanced recommendations related to prevention, screening, diagnosis, staging, and medical and surgical treatments,” Guideline Panel Chair, W. Michael Alberts, MD, MBA, FCCP, Moffitt Cancer Center, Tampa, FL., said in a news release.

According to ACCP’s guidelines, smokers and former smokers age 55-74 with more than 30 pack-years of smoking should be offered low-dose CT screening. This is a clear change from the 2007 version of the guidelines, in which evidence that showed the importance of CT screening in reducing lung cancer deaths was not yet available.

The guidelines clearly indicated that CT screening should not be given to individuals with less than 30 pack-years of smoking; younger than 55 or older than 74; and those suffering from severe diseases in addition to a primary disease or disorder.

“Lung cancer screening offers a potential benefit for select individuals, but it is not a substitute for stopping smoking,” explained Frank Detterbeck, MD, FCCP, Yale University, New Haven, CT, and Vice-Chair of the Guidelines Panel.

Detterbeck added that the guidelines are also meant to educate both the patient and the physician about the screening in order to overcome misconceptions and misguided fears.

In addition to CT scanning, the guidelines underscore advances in treatment, including the benefits of minimally invasive surgery and treatment at specialized centers.

The Maryland-headquartered association for urology professionals announced this week the latest guidelines on prostate cancer screening.

According to the American Urological Association, men ages 55 to 69 who want to undergo PSA test should talk with their doctors about the benefits and harms of testing, and proceed based on their personal values and preferences. The new guidelines do not address detection of prostate cancer in symptomatic men, but they are specifically meant to reduce prostate cancer mortality through early detection of the disease.

“There is general agreement that early detection, including prostate-specific antigen screening, has played a part in decreasing mortality from prostate cancer,” Dr. H. Ballentine Carter, who chaired the panel that developed the guideline, said in a news release. “The randomized controlled trials are more mature at this point and there is more data available today than there was in 2009. It’s time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms.”

AUA’s new prostate cancer screening guidelines indicate that PSA screening is not recommended in men under 40 years old. They also do not recommend routine screening in men between the ages of 40 and 54. Additionally, routine PSA screening is not recommended in men over the age of 70 or any man with less than a 10 to 15-year life expectancy.

However, 55 to 69-year-old men who are considering PSA test are advised to discuss the matter with their physician in order to understand the benefits and potential harm of the procedure. Patients should proceed based on their personal values and preferences, the AUA guidelines add.

To reduce the harms of screening, a routine screening interval of 2 years or more may be preferred over annual screening.

Prostate cancer is one of the leading causes of cancer death among men of all races. It is the most common cancer among American men aside from non-melanoma skin cancer. The National Cancer Institute estimated that 238,590 men will be diagnosed with prostate cancer and 29,720 men will die of the disease in 2013.

A group of researchers has linked air pollution exposure to some cardiovascular problems, such as heart attack and stroke.

The study examined more than 5,300 individuals, ages 45-84, from six U.S. metropolitan areas to determine whether there is an association between long-term exposure to fine particulate air pollution and thickening of the inner two layers of the common carotid artery — an important blood vessel that supplies blood to the head, neck and brain.

After considering other factors, such as smoking, it was found that long-term exposure to air pollution speeds up the hardening of the arteries, even among people who did not have symptoms of heart disease.

“Our findings help us to understand how it is that exposures to air pollution may cause the increases in heart attacks and strokes observed by other studies,” Sara Adar, one of the study’s lead authors and John Searle Assistant Professor of Epidemiology at the University of Michigan School of Public Health, said in a news release.

Fine particulate air pollution is mainly produced by motor vehicles, power plants, and other combustion sources.

“Linking these findings with other results from the same population suggests that persons living in a more polluted part of town may have a 2 percent higher risk of stroke as compared to people in a less polluted part of the same metropolitan area,” Adar explained.

The group’s findings were published on April 23 in the online edition of PLOS Medicine.

The Federal Bureau of Investigation confirmed on Thursday that intercepted letters addressed to Republican Senator Roger Wicker and President Barack Obama contained traces of ricin. But even though the agency also noted there was no reported illness as a result of exposure to the letters, many people are curious about this substance and exactly how dangerous it is.

To begin with, ricin is a highly toxic protein naturally found in the castor oil plant. According to the Centers for Disease Control and Prevention fact sheet, ricin can be in the  form of a powder, a mist, or a pellet, or it can be dissolved in water or weak acid. It has been used experimentally in medicine to kill cancer cells.

Exposing someone to ricin is a matter of deliberate efforts. You’d have to turn ricin into a partially purified material or have it refined into a terrorist or warfare agent to poison a target. An example of intentional ricin poisoning would be the 1978 attack against Georgi Markov, a Bulgarian writer and journalist.

Markov died three days after he was attacked by a man with an umbrella that had been rigged to inject a poison ricin pellet under his skin.

Ricin can be inhaled, ingested or injected. Once inside the cells of the person’s body, it will prevent the cells from making the proteins they need, which will cause the cells to deteriorate and die. Eventually this is harmful to the whole body, and death may occur within 36 to 72 hours following exposure.

The symptoms of ricin poisoning depend on the route of exposure. If inhaled, symptoms may include difficulty breathing, fever, cough, nausea, and tightness in the chest. If ingested, the person would likely develop vomiting and diarrhea that may become bloody. Other symptoms that could occur include severe dehydration, low blood pressure, seizures, and blood in the urine.

Avoiding ricin exposure is the best way to prevent ricin poisoning. If someone is exposed, though, it’s important to seek medical help as soon as possible to get it off or out of the person’s system. The type of supportive medical care would also depend on the route of exposure. Care could include helping the victim breathe, giving intravenous fluids, and giving medications to treat conditions such as seizure and low blood pressure.

Breathalyzer tests are commonly used by police officers in drunk-driving situations, as well as by some employers in the transportation industry. But in the future, it may serve as an effective diagnostic tool for detecting stress in a non-invasive way.

Researchers from the Loughborough University and Imperial College London studied breath samples taken from 22 young adults, in both relaxed and stressful conditions. They found six compounds in the breath that increase and decrease with stress exposure.

“If we can measure stress objectively in a non-invasive way, then it may benefit patients and vulnerable people in long-term care who find it difficult to disclose stress responses to their carers, such as those suffering from Alzheimer’s,” lead author Professor Paul Thomas said.

But Thomas said more extensive research and trials would be required to come up with breath tests that can accurately detect stress. It’s also unclear for now how to best manage external factors which can affect a person’s breath sample.

“It is possible that stress markers in the breath could mask or confound other key compounds that are used to diagnose a certain disease or condition, so it is important that these are accounted for,” Thomas said. “What is clear from this study is that we were not able to discount stress. It seems sensible and prudent to test this work with more people over a range of ages in more normal settings.”

A new study presented this week at an American Heart Association conference in New Orleans linked consumption of sugary drinks to about 180,000 deaths around the world, including 25,000 deaths in the U.S., in 2010.

The research, led by Gitanjali M. Singh, Ph.D., a postdoctoral research fellow at the Harvard School of Public Health in Boston, found that sugar-sweetened beverages increase the risk of developing diabetes, cardiovascular diseases and some cancers.

Using data collected as part of the Global Burden of Disease Study 2010, the researchers tied intake of soft drinks and other sugary beverages to 133,000 diabetes deaths, 44,000 deaths from cardiovascular diseases and 6,000 cancer deaths.

Singh told HealthDay that their findings point to a need for policies that curb people’s sugary drink intake. But banning the sale of large sodas like the proposed measure in New York is not the only solution to the problem. She said other effective strategies may include taxing sugar-added drinks or limiting advertising of the beverages to children.

“Because we were focused on deaths due to chronic diseases, our study focused on adults,” Singh said in a news release. “Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health.”

In response to the study, the American Beverage Association (ABA) issued a statement on Tuesday, saying the study “is more about sensationalism than science.”

“In no way does it show that consuming sugar-sweetened beverages causes chronic diseases such as diabetes, cardiovascular disease or cancer — the real causes of death among the studied subjects,” the ABA added. “The researchers make a huge leap when they illogically and wrongly take beverage intake calculations from around the globe and allege that those beverages are the cause of deaths which the authors themselves acknowledge are due to chronic disease.”

But while Singh agrees that there are several factors that could increase people’s risk of developing heart disease, cancer or other chronic conditions, it is still possible to estimate the number of deaths attributable to consumption of sugar-sweetened beverages, particularly in large amount.