Salute Press :: Archives :: November 2006 Issue


	HEADLINES ARCHIVES MEDIA CENTER

November 2006 Issue

• New View on African-American Breast Cancer
• The Price of Life: An Italian View
• Health Briefs: Alcohol

New View on African-American Breast Cancer

By Ilene Raymond Rush
Editor-in-Chief
November 1, 2006

African-American women with breast cancer have lower survival rates compared with white or Hispanic women, and new research suggests that a difference in tumor biology may explain this difference, according to a paper to be published in December now available online in the journal Cancer.

Poorer outcomes for African-American women have long been attributed to poverty, disparities in care or late diagnoses.

The study of more than 2,000 women found that African-American women had a more aggressive and harder-to-treat form of breast cancer. Estrogen-receptor negative, or ER-negative, tumors, which are not fed by the hormone estrogen, are immune to the most successful breast cancer drugs such as tamoxifen and the aromatase inhibitors, although some can be fought with the targeted cancer drug Herceptin.

Dr. Wendy Woodward of the M.D. Anderson Cancer Center in Houston and colleagues compared cases of black, Hispanic and white breast cancer patients. After statistically adjusting for differences in tumor size and ER-negative tumors at the time of diagnosis, the study found that 10-year survival rates among women who received chemotherapy before mastectomy was 50% for whites and 40% for blacks. Among women who received chemotherapy after surgery, 10-year survival rates were 52% for blacks and 62% for both whites and Hispanics. The study also found that the survival rate among women who underwent chemotherapy after mastectomy and whose cancer had not spread to other organs was lower among blacks compared with whites and Hispanics.

Researchers did not suggest a potential mechanism to explain the findings and the study did not control for chemotherapy doses or socioeconomic status.

"This doesn't mean every African-American woman is going to have a bad outcome," Woodward said, in an interview in the Houston Chronicle. "But is does suggest commonality that puts some at higher risk, and that should prompt us to develop better therapies for those women."

Breast cancer is the second most common cause of cancer death in U.S. women after lung cancer, and the No. 1 killer of women aged 45 to 55. Each year, 211,000 American women are diagnosed with breast cancer, and 40,000 die from it, according to the American Cancer Society, which publishes Cancer.

See: "African-American race is associated with a poorer overall survival rate for breast cancer patients treated with mastectomy and doxorubicin-based Chemotherapy"
DOI: 10.1002/cncr.22281
US: www3.interscience.wiley.com

Print Article E-Mail Article

November 2006 Issue

The Price of Life: An Italian View

By Ilene Raymond Rush
Editor-in-Chief
November 1, 2006

The high cost of new anti-cancer drugs - up to $4,500 per month -- that extend life for an average of four or five months, have created financial and ethical dilemmas for patients and doctors. In August, for example, the National Institute for Clinical Excellence (NICE) recommended that the National Health Service in the United Kingdom refuse coverage for the colon cancer drugs Avastin and Erbitux, arguing that the money might be better spent.

In an e-mail interview, Dr. Giovanni Abbadessa and Dr. Lorenza Rimassa, both of the Dipartimento di Oncologia ed Ematologia Clinica Istituto Clinico Humanitas in Rozzano - Milano discussed the costs of these new drugs for patients and society. Dr. Abbadessa is also a researcher at the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia.

How are drugs like Avastin and Erbitux covered in Italy? In public hospitals, they are paid for by the state; at the moment there are no limitations on treating patients with these drugs if they fall into the inclusion criteria approved by the National Committee on Drugs.

Is it ever acceptable to deny access to very high cost anti-cancer drugs? It should not be acceptable from an ethical point of view; nevertheless, not many countries can afford to give these treatments to every patient who needs them, if the related benefit is not clear. Also, in Italy, the health system is divided on the basis of the administrative region and some of the regions are in an economic deficit that does not allow them to offer the most expensive treatment options available.

Should a cost-benefit analysis be applied to drugs that offer a few months of extra life? In the cancer field, even a few months of life can be extremely valuable for the patients and their families. One should always offer the best therapeutic option if it can be economically supported. Perhaps we should set a parameter, deciding how many months of survival are necessary to justify giving a patient an expensive therapy. Of course, some of the newest drugs approved by the FDA offer only two months of extra life.

Is a two-tiered health care system for the rich and poor inevitable? The utopian path may lead to political and legal action against the main pharmaceutical companies, to oblige them to sensibly reduce the price of end-of-life drugs. Otherwise, countries that produce these drugs for diseases like cancer and AIDS will gain the profit of the drug sales, while countries which only import drugs, will have to carry the entire burden.

Would the funds for these drugs be better allocated for prenatal, diabetes or preventive health care measures? That would mean to surrender completely to one of the main causes of death in our society.

Print Article E-Mail Article

November 2006 Issue

Health Briefs: Alcohol

By Ilene Raymond Rush
Editor-in-Chief
November 1, 2006

Alcohol Protects Healthy Hearts.

Even for men with perfectly healthy lifestyle habits, moderate alcohol consumption may be associated with a lower risk of heart attack than drinking heavily or not drinking at all, researchers report in the Archives of Internal Medicine.

Studies have long recommended moderate drinking to reduce the risk of myocardial infarction (heart attack), but until now it has been unknown what role alcohol plays in individuals who exercise, abstain from smoking, maintain optimal weight and adhere to an appropriate diet.

Investigators at Beth Israel Deaconess Medical Center, Boston, studied 8,867 healthy men who were part of the Health Professionals Follow-Up Study, which began in 1986 and included 51,529 dentists, pharmacists, veterinarians and other health care professionals aged 40 to 75. Analysis showed that those who drank 15 to 29 grams of alcohol had the lowest risk for heart attack, while those who did not drink at all had the highest risk.

Alcohol Improves Memory?

A drink or two a day can be good for the brain, according to a new study presented at the Society for Neuroscience in Atlanta.

Researchers found that amounts of alcohol equivalent to a couple of drinks a day for a human improved the memories of laboratory rats.

"There is some evidence suggesting that mild to moderate alcohol consumption can protect against diseases like Alzheimer's," said Matthew During, professor of molecular virology, immunology and cancer genetics at Ohio State University.

A neuronal mechanism - NR1 -- may help to explain the link between alcohol and improved memory. Researchers found that low levels of alcohol increased the expression of NR1 on the surface of neurons in the hippocampus, a region of the brain that plays a role in memory.

Print Article E-Mail Article

TOP	CONTACT OUR POLICY SHRO CREDITS