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Role Medical, Seattle, WA (2025)

03/29/2012

The way lung cancer patients feel around the time they`re diagnosed may be related to how long they survive -- even after taking into account objective measures of the disease, a new study suggests.

Researchers found that newly-diagnosed lung cancer patients who rated their quality of life higher generally lived longer with the disease: typically surviving nearly six years, versus less than two years among patients who`d reported a poor quality of life.

And objective measures -- like age, the stage and aggressiveness of the cancer and other health conditions -- did not fully explain the connection.

Quality of life is a "complex construct" that includes a person`s feelings of physical, mental and emotional well-being, said Jeff A. Sloan, a professor of oncology and biostatistics at the Mayo Clinic in Rochester, Minnesota, who led the new study.

But doctors can begin to get at the issue by basically asking, "How are you doing?" Sloan said in an interview.

"That can start a conversation," he said.

Blood work and other lab tests are one way of seeing how a patient is doing, according to Sloan. But, he said, doctors have long been aware that two patients can look the same as far as objective cancer-related measures go, yet fare differently.

A number of studies have now shown that quality of life seems to affect the long-term picture for cancer patients, Sloan said.

So doctors at Mayo have begun routinely assessing cancer patients` quality of life, and some other cancer centres are starting to do the same, he added.

The current study, published in the Journal of Clinical Oncology, included 2,442 patients treated for lung cancer at Mayo over 11 years.

Around the time of their diagnoses, patients rated their overall quality of life on a standard scale of zero to 100. The researchers found that 21 percent had a "deficit" in quality of life -- or a score of 50 or lower.

Those patients survived for substantially less time: 1.6 years, on average, versus 5.6 years in the group with a higher quality of life around the time of diagnosis.

There were other differences between the two groups, too. Patients with a poorer quality of life were more likely to be men, current smokers and have more-advanced cancer, for example.

But even when Sloan`s team factored in those differences, quality of life was still a predictor of survival time. Overall, the death rate during the study period was 55 percent higher among patients who gave low ratings to their quality of life.

03/29/2012

For a long time the city gynaecologists and cancer surgeons have been claiming that cervical cancer is becoming the leading cancer in women. This was confirmed in the study, led by the centre for global health research, in close collaboration with Tata Memorial Hospital, published in Lancet on Wednesday. It revealed that 17% of the total cancer deaths in women are because of cervical cancer.

In women, cervical cancer was the leading fatal cancer in both rural and urban areas, with somewhat higher rates in rural areas. The cervical cancer death rate of 16 per 1 lakh population suggests that a 30-year-old Indian woman has about 0.7% risk of dying from cervical cancer before 70 years of age, in the absence of other diseases. By contrast, the risk of deaths during pregnancy for Indian women aged 15- 49 years is about 0.6%.

The study pointed out strategies to reduce cervical cancer deaths. This included vaccination against human papillomavirus before marriage, and for married women a once-only-testing or screening followed by visual inspection with acetic acid and further referral for treatment.

According to experts, simple precautions like better hygiene, use of copper-T (birth control measure for women) and regular screening can help bring down this cancer considerably.Dr Rajendra Badwe, director of Tata Memorial Hospital said, “The incidence of cervical cancer is coming down every year by 15- 20%. Early detection is one of the key factors to bring down the cervical cancer mortality rate.”

The study also shows mortality deaths were higher in Hindu women than in Muslim women and experts feel this is because of circumcision among Muslim men, which reduces the sexual transmission of human papillomavirus. “Studies have proved that circumcision reduces the risk of transfer of HIV virus,” said Badwe.

Ashwini Bhalerao Gandhi, consulting gynecologist, PD Hinduja Hospital said, “I ensure that women coming to me are made aware of what is cervical cancer and the how it can be prevented. If they have daughters, we persuade them to go for vaccination. I have kept a pamplet with all the information on cervical cancer and I make the patient read it.”

03/29/2012

Cancer death rates for men, women and children steadily decreased from 2004 to 2008, according to a new report from four major national cancer tracking groups. The declines in death and new cases of cancer reflect progress against the disease in terms of prevention, diagnosis and treatment, but experts say rising obesity may present a new challenge in the fight against cancer.

From 1999 to 2008, cancer death rates declined by an average of 1.7 percent per year for men, 1.3 percent per year for women and 1.5 percent annually for children, according to the report from the U.S. Centers for Disease Control and Prevention, the American Cancer Society, the National Cancer Institute and the North American Association of Central Cancer Registries. The report was published online today in the journal Cancer.

The declining death rates applied to all types of cancer, including the four most common: lung, colorectal, breast and prostate cancers.

The numbers of new cases of many cancers have also been on the decline. Cancer of all types among men dropped by 0.6 percent each year from 2004 to 2008, the report said. Among women, the rate of new cases declined by 0.5 percent each year from 1998 to 2006, then leveled off until 2008.

New cases of many specific cancers went down, including prostate, colorectal, lung and breast cancers. But certain kinds of cancer actually increased, such as those of the pancreas, kidney, thyroid, liver and melanoma.

03/29/2012

Losing weight and exercising may help people with type 2 diabetes hold on to their mobility as they age, a new study shows.

The good news is that neither lifestyle change requires drastic measures.

The study, published in the New England Journal of Medicine, shows that losing just a little bit of weight and adding 25 minutes of physical activity a day can help prevent worsening of mobility-related disabilities among people with type 2 diabetes.

Experts who weren’t involved in the research praised the study for showing, once again, how critical lifestyle changes can be.

“I think this is an important study which comes to state what’s been said again and again: that you have to lose weight and be fit. The more fit you are, the fewer problems you’re going to have,” says Spyros Mezitis, MD, an endocrinologist at Lenox Hill Hospital in New York. He was not involved in the new study.

12 Tips to Avoid Diabetes Complications
Mobility-Related Disability and Diabetes

Problems with mobility become more common with age. Studies have shown that about 30% of adults over age 50 face some kind of difficulty with everyday activities.

“When you look at people with diabetes, that basically doubles. Over 60% of people who have diabetes report some difficulty in their daily activities,” says study researcher W. Jack Rejeski, PhD, a professor of health and exercise science at Wake Forest University in Winston-Salem, N.C.

Activity limitations include problems like struggling to climb stairs or push a vacuum cleaner, or having trouble bending over to pick up something off the floor.

“The loss of independence, the loss of being able to do valued activities, is what really is important to people as they age, so it’s fairly catastrophic from a personal standpoint,” Rejeski says.
Weight Loss and Exercise to Prevent Mobility Problems

For the study, researchers randomly assigned adults aged 45 to 74 with type 2 diabetes to a program of diet and exercise or to regular diabetes education and support classes.

The goal of the lifestyle intervention program was to help people lose at least 7% of their body weight by reducing calories and boosting physical activity by 175 minutes a week -- or 25 minutes a day -- of moderately paced exercise, like walking.

After four years, people in the diet and exercise group had lost, on average, about 6% of their body weight. For a person who weighs 250 pounds, that’s about a 15-pound loss.

The scale hadn’t moved much for the group that got diabetes education. They lost, on average, less than 1% of their total body weight, or just over 2 pounds for a person who weighs 250.

People in the lifestyle intervention group were also more active. They burned about 881 calories per week, compared to 99 calories a week in the education group.

03/29/2012

Losing weight and improving fitness may ward off some of the mobility problems that older overweight people with type 2 diabetes often face, according to a new study.

The lifestyle changes helped mobile people stay that way and eased severe mobility problems in others, at least over the short term.

Lead author W. Jack Rejeski from Wake Forest University in Winston-Salem, North Carolina, said the trends show the importance of encouraging people to get their weight down and exercise sooner, rather than waiting until they develop problems getting around.

In the new study, published in the New England Journal of Medicine, the researchers calculated that a one-percent drop in weight cut the risk of mobility problems by more than seven percent, and the same increase in fitness level lowered mobility risks by between one and two percent.

"If you can change people`s lifestyles sufficiently, they`re going to get more mobile and, over time, this will have a tremendous impact on their lives," said Dr. Vivian Fonseca, president of medicine and science for the American Diabetes Association, who wasn`t involved in the research.

"There has yet to be really a large study like this that says, `This really does make a difference,`" Rejeski said, adding that he hopes the results find a way into typical conversations between doctors and their diabetic patients.

The ADA estimates that nearly 26 million Americans have diabetes -- most of them with type 2, the form of the disease often associated with being overweight -- and 79 million more are at risk for developing the condition. Those numbers are expected to increase dramatically as the US population ages.

Diabetics are twice as likely to have mobility problems as other people their age.

Rejeski and his colleagues tested a program in which volunteers were encouraged -- through diet plans, eat-smart strategies, meal replacements and other techniques -- to lose more than seven percent of their body weight. They were also encouraged to exercise at least three hours per week, primarily by walking.

Volunteers in a comparison group were asked to attend group meetings -- focusing on nutrition, physical activity and support -- three times a year.

The study involved more than 5,000 volunteers age 45 to 74, all overweight or obese. They reported their own mobility on health surveys given over four years and took fitness tests at different points during the study period.

After a year, participants in the intervention group had lost an average of six percent of their body weight, compared to less than one percent in the "control" group.

Fifteen percent of people in the no-intervention group had severe mobility problems at the start of the study. That rate increased to nineteen percent after a year, and continued to rise over the next three years.

In the diet and exercise group, thirteen percent started off with severe mobility problems. After a year that fell slightly to twelve percent -- but after that, the likelihood of severe problems began to increase again.

"It`s difficult to drag yourself out of that hole," said Rejeski.

For example, some people may regain the weight they lost, "but they also get older, and other things catch up with them," Fonseca, who is also an endocrinologist at the Tulane University School of Medicine in New Orleans, said.

The researchers found that 33 percent of the control group started out with good mobility, a fraction that didn`t change much over the next few years.

On the other hand, 37 percent of volunteers in the intervention group started out with good mobility. With diet and exercise, that ratio rose to 41 percent at the one-year mark and, although it declined after that, never fell below the starting point.

Rejeski`s team calculated that all in all, the lifestyle changes led to a 48-percent drop in the chance of diabetic patients losing their mobility.

"You don`t need extreme amounts of weight loss or extreme lifestyle change to improve your outlook," said Fonseca.

"It is achievable by many people who put their mind to it and who are given the right kind of tools to do that. The problem is, how do we translate this to people outside the study?"

03/29/2012

Diabetes has become an epidemic in the United States, with the number of cases tripling over the last three decades. Most of those cases are Type 2 diabetes, which is linked to obesity and can lead to serious medical issues that range from heart disease to renal failure, blindness, and more. People living with obesity and Type 2 diabetes have tried all kinds of approaches to losing the weight and living healthier lives, but often with little success. Diet, exercise, and even medication have in many cases failed to produce substantial results. Many people with Type 2 diabetes take 10 to 12 medications on a daily basis, but for many that regimen seems to hardly put a dent in their condition. This is not just a matter of self-esteem, or even quality of life; Type 2 diabetes kills, and it is this grim reality that looms over so many people struggling with diabetes in this country. There is hope, however. Bariatric surgery can not only provide dramatic weight loss, but also reduce or even completely eliminate the need for diabetes medication. At Dr. Feiz & Associates, a reputable surgery center in Beverly Hills, Dr. Michael Feiz has seen this amazing development with his own eyes.

Dr. Feiz brings to the table a wealth of knowledge and experience in the field of bariatric surgery, and has a proven track record with patients suffering from Type 2 diabetes. He has earned a great deal of trust within the community at large, so it is with considerable authority that he is able to assert the following claim: his patients have not only succeeded in losing weight, but have also seen dramatic reversals in their Type 2 diabetes. Indeed, within a year of undergoing laparoscopic gastric bypass or sleeve gastrectomy surgery, a large portion of Dr. Feiz's patients find that their Type 2 diabetes has gone into complete remission.

Recent studies published in the New England Journal of Medicine support what Dr. Feiz has been observing in his own patients for years now. In fact, these studies conclude that weight loss surgery can actually be more effective than the standard diabetes treatments. It is no surprise, then, that so many people still struggling with Type 2 diabetes are inquiring about Dr. Feiz's surgical techniques.

Role Medical

03/29/2012

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