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Thursday
Oct282010

New Experimental Drug Shows 'Dramatic' Results in Lung Cancer Patients

Photo Courtesy - Getty Images(NEW YORK) -- Evie Cogan sat in her car, waiting for the light to turn green. She grabbed the X-ray and CT documents she had just picked up from the doctor's office moments before. Scanning the page, she saw the diagnosis: right lung carcinoma.

Months earlier, Cogan, an assistant professor at LaSalle University in Philadelphia, had been trying to fight off a nagging cough that wouldn't let up for months. She dismissed it as bronchitis as she finished the 2005 spring semester in Basel, Switzerland, where she was teaching classes.

"You need to check out that cough," her father told her over the phone.

She finally did. After returning to the United States, she went to the doctor to get her first chest X-ray. Much to her relief, the X-ray came back negative.

Her doctors treated the cough as allergies, and put her on Claritin. But the cough worsened in the following weeks.

After another doctor's visit some time later, she received a voice mail from her physician. His voice sounded urgent and she was told to call him back as soon as possible.

The conversation is now a blur for Cogan, but she remembers the words, "fluid in the lungs."

Cogan had never smoked a cigarette in her life; she eats a healthy diet, and had a grandmother who lived past 100.

"It was surreal," said Cogan. "Everyone has secret fears that never happen, but this actually happened. It was so shocking."

And so Cogan began her journey through chemotherapy, radiation, and more chemotherapy. After all, Cogan said, she was in the battle of her life.

In November 2009, four years after her initial diagnosis, Cogan's friend called her about a medical piece she had seen on the ABC's World News, where Charlie Gibson discussed a new treatment for a specific kind of lung cancer.

Cogan searched the Internet for the video, and watched the story of Bill Schuette, a lung cancer patient who, after exhausting all his treatment options, had qualified for a phase I clinical trial at Massachusetts General Hospital. He joined one other person in the trial after he tested positive for a genetic mutation in his lung tumor, known as EML4/ALK. Within weeks after taking the medicine, Schuette began to feel better and his tumor began to shrink.

I want this drug, Cogan said to herself.

She was hopeful, even though her chance of qualifying was slim. Each year, around 170,000 Americans are diagnosed with non-small-cell lung cancer. About two to seven percent of those patients have the genetic mutation in the tumor.

The experimental drug has now been described as "dramatic" and "exciting." With 82 patients now enrolled on the study, a new study published today in the New England Journal of Medicine shows that the targeted treatment, known as crizotinib, can halt or even reverse the growth of the non-small-cell lung tumors with the genetic mutation.

And Cogan qualified. She entered the clinical trial on January 25.

"It was my miracle," said Cogan. "I have wonderful quality of life now."

"As physicians, it's worth prospectively identifying the genetic abnormalities in tumors to help guide patients to trial that will most like benefit them, even if it's a small number of people," said Dr. Eunice Kwak, lead author of the study and assistant in Medicine at Massachusetts General Hospital.

The study began as a phase one trial to determine the safety profile and tolerated dose of the drug. Because the researchers identified patients who responded positively to the drug, they wanted to find a larger group of patients who tested positive for the gene mutation.

The treatment reduced the tumor size in more than half of the 82 participants, and stopped tumor growth in one third. Historically, chemotherapy only halts tumor growth in 10 percent of non-small-cell cancer patients.

"About 60 percent of people with ALK mutations will have a good response with crizotinib, so for these people, this drug offers a 35 percent better chance for good disease shrinkage," said Dr. Gregory Kalemkerian, professor of Medicine and co-director of Thoracic Oncology at University of Michigan Health System. "That is a big benefit in the oncology world." 

Copyright 2010 ABC News Radio

Thursday
Oct282010

Cold Cap Therapy May Help Women Undergoing Chemotherapy Keep Hair

Photo Courtesy - ABC News(NEW YORK) -- When Shirley Billigmeier was diagnosed with breast cancer this spring, she was grateful for a good prognosis and set about preparing for the life disruption that comes with undergoing a lumpectomy, radiation and chemotherapy.

"I just had a feeling that I was just going to be sick this whole time," said Billigmeier. "And my concern was that it was just gonna absolutely take me out of my life for a while."

When her doctor told her that total hair loss was an inevitable side effect of the chemotherapy, she braced herself and bought a wig, but then a friend told her about another breast cancer patient who managed to preserve her hair using a little-known approach that involves keeping the scalp very cold during chemotherapy treatments.

Billigmeier tracked down the makers of Penguin Cold Caps, designed to help chemotherapy patients keep their hair.

"[He] gives me a list of probably 10 women," said Billigmeier. "I start calling and start having some great conversations with lots of women across the United States. And the women I was talking to, they kept their hair."

Her Minneapolis oncologist, Dr. Paul Zander, was skeptical at first. He knew that early experiments in the United States in the 1980s hadn't been very promising. Still, he gave her the okay to try it. So, each day she received chemotherapy, Billigmeier put on a freshly chilled cap chilled to minus-22 degrees Fahrenheit every 30 minutes for seven hours.

But would it work? After her sixth and final treatment, Billigmeier's locks were intact.

"My hair is all there," she said. "It definitely works."

No one knows how it works. One theory is the caps may decrease blood flow to the scalp, causing the blood vessels in the scalp to shrink. This, in turn, blocks the harsh chemicals in the chemotherapy from reaching the hair follicles. But the fact is no one knows exactly why some women keep their hair after using the caps.

Some doctors are worried by the lack of data on cold caps and fear the treatment may even do more harm than good, for some patients. Still, cold caps are experiencing a groundswell of support from a growing number of women receiving chemotherapy who say it works -- and spread the news.

While early trials with scalp cooling showed it often was ineffective, an analysis of 53 studies showed that since 1995 research suggests the scalp cooling preserves hair in about 70 percent of patients.

But a number of doctors told ABC News they don't support the approach because of another concern.

"I don't know how well this was substantiated, but there has been concern that by blocking chemotherapy from reaching the area of the hair follicles there would be an increase in metastases of the scalp," said Dr. Mary Daly, an oncologist at the Fox Chase Cancer Center in Philadelphia.

Since there are no substantial longitudinal studies measuring such a risk, many doctors strongly discourage using the caps.

Copyright 2010 ABC News Radio

Thursday
Oct282010

Administration Introduces Measures to Reduce Domestic Violence

Photo Courtesy - Getty Images(WASHINGTON) -- The White House on Wednesday introduced a federal program to reduce domestic and sexual violence against women and children.

According to the administration, “the scope and far-reaching effects of violence require a coordinated response across the federal government.”

Statistics suggest the problem is more widespread than previously believed.  As many as one in four women have been the victims of domestic violence at some point in their lives, while 15.5 percent of children are exposed each year to domestic violence.

The new program, introduced by President Obama and Vice President Joe Biden, features a $1.5 billion maternal, infant and early childhood home visiting program for states to try to identify and reduce domestic violence.  Lawyers, judges and law enforcement authorities will also receive government guidance on ways to respond to domestic violence, help victims and punish perpetrators.

Copyright 2010 ABC News Radio

Wednesday
Oct272010

Sugary Drinks Increase Risk of Diabetes

Photo Courtesy - Getty Images(CAMBRIDGE, Mass.) -- Overloading on sugary drinks could increase your risk of developing diabetes, according to findings reported in the journal Diabetes Care by Harvard's Vasanti Malik and colleagues.

People who drink one or two sugar-sweetened beverages a day, like soda or vitamin water, have a 26-percent increased risk of developing type 2 diabetes compared with those who barely drink any, reports MedPage Today

Malik and colleagues said that patients should replace sugary drinks with healthier alternatives like water in order to reduce their risk of obesity and chronic diseases.

"A lot of decisions [to avoid junk food] have been guided by weight," Malik told MedPage. "We now have outcomes data to say that you can actually have a higher risk of diabetes by making these kinds of choices."

Copyright 2010 ABC News Radio

Wednesday
Oct272010

Some Health Info to Move to Front of Food Packages

Photo Courtesy - Getty Images(WASHINGTON) -- It will soon be easier to make informed choices at the grocery store. The food industry Wednesday announced a commitment to put details about calories and “other nutrients” on the front of food and beverage containers.

Consumers should begin to see new labels in grocery stores early next year, according to the Grocery Manufacturers Association and the Food Marketing Institute.

 “It represents the most significant change to food labels in the United States in nearly twenty years,” said David Mackay, president and chief executive officer of Kellogg Company. 

The announcement comes after a report from the Institute of Medicine found that front-of-package food labels would be “most useful to shoppers if they highlighted four nutrients of greatest concern – calories, saturated fat, trans fat, and sodium.”

Food and beverage manufacturers and retailers also have agreed to spend $50 million on a consumer education campaign.

The Obama administration has pushed for new labels as part of the first lady’s fight against childhood obesity.

Copyright 2010 ABC News Radio

Wednesday
Oct272010

Blood Pressure Treatment on Rise in Younger Adults, Says CDC Report

Photo Courtesy - Getty Images(NEW YORK) -- Kristen Pessalano just turned 23, but has been on blood pressure medication for more than two years. Pessalano, a New Yorker who works in public relations, found out she had high blood pressure while getting a physical before heading abroad for an internship.

"[I] got upset when I first found out because I automatically associated it with people who are overweight or old," said Pessalano. "I would have never associated high blood pressure with someone my age, especially when I appeared to be totally healthy."

Pessalano has a lot of company, according to a new report by the Centers for Disease Control and Prevention. The report finds that while the percentage of Americans who have high blood pressure has remained steady over the past decade, the number of younger adults -- ages 18-39 -- who take medication to treat high blood pressure has increased.

Doctors say they're not taken aback because of other health problems that plague younger adults.

"I'm not surprised that more and more young people are being treated for high blood pressure since the incidence of obesity, a contributing cause for high blood pressure, is increasing in this age group," said Dr. Randal Thomas, a cardiologist at the Mayo Clinic in Rochester, Minn.

"With increasing obesity and diabetes in younger populations, clinicians may be more aggressive about recognizing risk factors for cardiovascular disease, like hypertension, and treating it," said Dr. Carol Horowitz, associate professor of medicine at Mount Sinai School of Medicine.

Although the news that she had high blood pressure was unexpected to Pessalano, the CDC report found that overall, people with high blood pressure have become more aware of the condition, which is something physicians say they've noticed in their own practices.

"[I]ndividuals are taking their own health issues more seriously and noticing the increased blood pressure readings," said Dr. R. Scott Wright, also a cardiologist at the Mayo Clinic.

Copyright 2010 ABC News Radio

Wednesday
Oct272010

Flirting While Driving Is Overlooked Danger

Photo Courtesy - Getty Images(LONDON) -- Drivers are constantly warned about the dangers of texting while driving, but a new study indicates that another danger has been overlooked: flirting while driving.

A survey of British drivers found that 41 percent of drivers admitted to trying to flirt with others while on the move, and 15 percent conceded they crashed their car or had a near miss because they were distracted by an attractive passerby.

"Men were by far the worst culprits," said Natalie Grimshare, a spokesperson for the women's car insurance company Diamond, which conducted the nationwide survey of 3,000 drivers, released this week.  Half of all men surveyed admitted to flirting with other motorists on the road, compared to just one-third of the women.

Grimshare said the survey, while conducted in Britain, would have found similar results with American drivers because they share similar vehicle values with Brits.

"We spend a lot of time in our cars," she said.  "Maybe people are seeing their car as an extension of their social life."

Copyright 2010 ABC News Radio

Wednesday
Oct272010

Opera Singer Thrives After Double Lung Transplant

Photo Courtesy - Bill Clark/Roll Call/Getty Images(SAN DIEGO) -- Opera singer Charity Tillemann-Dick, 26, took the stage Tuesday to open this year's TEDMED conference with an exquisitely sung aria.  The conference marks an important anniversary for the singer -- a year ago to the day she awoke from a month-long coma following a difficult double lung transplant.

At age 20, Tillemann-Dick was just starting her singing career in Europe when she was diagnosed with pulmonary hypertension, a condition in which the arteries supplying the lungs have unusually high blood pressure, putting patients at risk for heart failure.

"I saw a specialist and she told me that I had to stop singing, that those high notes were going to kill me," the soprano said at Tuesday's conference.  "She was emphatic: I was singing my own obituary."

But Tillemann-Dick did not give up singing, and even when her condition worsened and she had to carry around a four-pound apparatus that delivered medicine to her continually just to be able to function, she managed to perform all over the globe.

"She just wasn't going to let [her condition] rule her life," the singer's mother, Annette Tillemann-Dick says.

After her father died suddenly however, her condition worsened, as did her voice.  When the singer had right heart failure due to her worsening symptoms, she finally gave in to her doctor's advice and agreed to a double-lung transplant. 

Copyright 2010 ABC News Radio

Tuesday
Oct262010

Fran Crippen Death: Likely Heat Stroke or Heart

Photo Courtesy - Getty Images(NEW YORK) -- Doctors may never know precisely what killed open water swimmer Fran Crippen, the 26-year-old who died during a race in Abu Dhabi over the weekend, but they agree that strenuous exercise in hot water could result in fatal heat stroke.

Had a safety boat been near the elite swimmer when he lost consciousness, he might have been cooled down and been saved, they say.

"It's pretty straightforward -- he died of one of two things," said Dr. Mark Morocco, associate professor of emergency medicine at the UCLA School of Medicine.

"He drowned of a cardiac arrhythmia or he died of drowning because he passed out," said Morocco, who has never treated Crippen. "Both were directly related to over-exertion, which is a terrible garbage-can diagnosis and does not speak to what happened."

"In the age of kayaks, jet skis and outboard motors, this sort of thing should never happen to an elite swimmer," he said. "No one was there to help him up out of the water."

USA Swimming said Monday it would commission a full, independent investigation into Crippen's death.

Some earlier reports indicated that the Olympic-bound athlete died of a heart attack. The findings of an autopsy by local authorities have not been released, and even that may not give definitive answers.

Heat stroke, for example, could only be determined if doctors got an internal body temperature right after Crippen died. His body wasn't found until two hours after the race ended -- about 400 meters from the finish line.

The International Swimming Federation (FINA) said doctors ruled the cause of death as severe fatigue.

Crippen's sister Maddy, herself an Olympic swimmer, told ABC News that her brother had been voicing concerns for months about inadequate safety.

Crippen had told Shoulberg just 12 hours before the race that the outside temperature was 100 degrees and that the water was 87 degrees. Several swimmers complained of dehydration and disorientation and three were taken to the hospital.

"l have heard lot people complaining about the water being too warm," said Bill Volckening, a former editor of Swimmer magazine for U.S. Masters swimming. "There are some dangers of hyperthermia that have not really come to light yet and I hope there is some major reform in the sport of open water swimming with regard to safety."

Those who trained with Crippen said he also used GU energy gel, a replenishing liquid that contains high amounts of caffeine. The swimmer reportedly consumed 10 to 15 packs during a typical two-hour swim.

Doctors say, however, that caffeine is generally "pretty safe."

"It's probably not that likely, but certainly a possible factor in the picture," said Morocco. "Caffeine can cause arrhythmias in sensitive individuals."

The more likely cause of death was hyperthermia, which led to heat stroke.

"During physical exertion as the muscles are working, part of the byproducts is heat, like a power plant," said Dr. Ted Benzer, chief of clinical operations in the emergency department and attending physician at Massachusetts General Hospital.

"The challenge is to get rid of the heat and the body doesn't have that many ways to do that," he said. "The human body underwater is not like a fish or a whale. The primary way it releases heat is through evaporative losses like sweating."

Sweat on the surface of the body creates a cooling effect on blood just under the skin. Unlike a dog, humans can't pant to get rid of the heat.

"It is an intriguing concern that [Crippen] had major exertion submersed under very hot water," said Benzer. "But this is very unusual -- I have never seen this in all the years I have worked in emergency medicine."

When the body's temperature reaches 106 to 107 degrees, it starts to cause death of tissue and organ failure.

One of the first warning signs is confusion and delirium as the brain begins to dysfunction. If not treated by cooling the body down, it can cause death.

"It's hard to say what happened," said Benzer. "Who knows who was watching and how closely. Basically, he may have become confused and his actions might have been unpredictable. Maybe he started getting heat stroke, was delirious and then drowned."

However, doctors say there are other conditions that can cause sudden death in a young athlete -- heart valve problems, an electrolyte imbalance, congenital thickening of the heart muscle, cerebral aneurysms and even undetected arrhythmias like long QT syndrome.

UCLA's Morocco agrees that many of those medical events could have been treated had there been more attention paid to safety.

"A lot of the responsibility is on the folks who put the race together," he said. "When you are 500 feet in the water, you are as far away as being in wilderness 20 miles in Yosemite. If you don't have someone in a rescue boat, you are in trouble. Anything can happen."

"The other problem is elite athletes are not very good patients," said Morocco. "They don't want to get out of the race, even if they feel poorly. They are well-trained, but are also pressured to perform. Oftentimes a great athlete cannot advocate for himself. But those running the race should advocate for him."

Copyright 2010 ABC News Radio

Tuesday
Oct262010

Study Finds Sleepiness Might Be Genetic

Photo Courtesy - Getty Images(PHILADELPHIA) -- No matter how little they sleep, some people can keep a skip in their step while others will yawn and struggle through the day.  A new study from the University of Pennsylvania School of Medicine found that the reason could be in our genes.

Researchers found that healthy people with one particular genetic variant were generally sleepier than those without the gene.  About 25 percent of the general public has the genetic variant, called DQB1 *0602, but only a small percentage of them actually suffer from sleep problems.

For the study, researchers compared 37 healthy adults with the gene variant to 92 healthy adults without it to see if they suffered from any other sleep-related problems.

The research, published in the journal Neurology, found people with the gene variant reported feeling sleepier and more fatigued compared to the people without the variant, whether they slept four hours or 10 hours.  People with the gene variant also spent less time in deep sleep, and woke up more times during their sleep compared to the non-gene participants.

Copyright 2010 ABC News Radio







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