Category: Health Written by Associated Press
CANCER RISK RISING--In this July 20, 2006 file photo, a woman smokes a cigarette during a break from work in downtown Chicago. (AP Photo/Julio Cortez, File)
by Marilyn Marchione
AP Chief Medical Writer
Smoke like a man, die like a man.
U.S. women who smoke today have a much greater risk of dying from lung cancer than they did decades ago, partly because they are starting younger and smoking more — that is, they are lighting up like men, new research shows.
Women also have caught up with men in their risk of dying from smoking-related illnesses. Lung cancer risk leveled off in the 1980s for men but is still rising for women.
"It's a massive failure in prevention," said one study leader, Dr. Michael Thun of the American Cancer Society. And it's likely to repeat itself in places like China and Indonesia where smoking is growing, he said. About 1.3 billion people worldwide smoke.
The research is in Thursday's New England Journal of Medicine. It is one of the most comprehensive looks ever at long-term trends in the effects of smoking and includes the first generation of U.S. women who started early in life and continued for decades, long enough for health effects to show up.
The U.S. has more than 35 million smokers — about 20 percent of men and 18 percent of women. The percentage of people who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women.
Researchers wanted to know if smoking is still as deadly as it was in the 1980s, given that cigarettes have changed (less tar), many smokers have quit, and treatments for many smoking-related diseases have improved.
They also wanted to know more about smoking and women. The famous surgeon general's report in 1964 said smoking could cause lung cancer in men, but evidence was lacking in women at the time since relatively few of them had smoked long enough.
One study, led by Dr. Prabhat Jha of the Center for Global Health Research in Toronto, looked at about 217,000 Americans in federal health surveys between 1997 and 2004.
A second study, led by Thun, tracked smoking-related deaths through three periods — 1959-65, 1982-88 and 2000-10 — using seven large population health surveys covering more than 2.2 million people.
Among the findings:
— The risk of dying of lung cancer was more than 25 times higher for female smokers in recent years than for women who never smoked. In the 1960s, it was only three times higher. One reason: After World War II, women started taking up the habit at a younger age and began smoking more.
—A person who never smoked was about twice as likely as a current smoker to live to age 80. For women, the chances of surviving that long were 70 percent for those who never smoked and 38 percent for smokers. In men, the numbers were 61 percent and 26 percent.
—Smokers in the U.S. are three times more likely to die between ages 25 and 79 than non-smokers are. About 60 percent of those deaths are attributable to smoking.
—Women are far less likely to quit smoking than men are. Among people 65 to 69, the ratio of former to current smokers is 4-to-1 for men and 2-to-1 for women.
—Smoking shaves more than 10 years off the average life span, but quitting at any age buys time. Quitting by age 40 avoids nearly all the excess risk of death from smoking. Men and women who quit when they were 25 to 34 years old gained 10 years; stopping at ages 35 to 44 gained 9 years; at ages 45 to 54, six years; at ages 55 to 64, four years.
—The risk of dying from other lung diseases such as emphysema and chronic bronchitis is rising in men and women, and the rise in men is a surprise because their lung cancer risk leveled off in 1980s.
Changes in cigarettes since the 1960s are a "plausible explanation" for the rise in non-cancer lung deaths, researchers write. Most smokers switched to cigarettes that were lower in tar and nicotine as measured by tests with machines, "but smokers inhaled more deeply to get the nicotine they were used to," Thun said. Deeper inhalation is consistent with the kind of lung damage seen in the illnesses that are rising, he said.
Scientists have made scant progress against lung cancer compared with other forms of the disease, and it remains the leading cause of cancer deaths worldwide. More than 160,000 people die of it in the U.S. each year.
The federal government, the Canadian Institutes of Health Research, the Bill and Melinda Gates Foundation, the cancer society and several universities paid for the new studies. Thun testified against tobacco companies in class-action lawsuits challenging the supposed benefits of cigarettes with reduced tar and nicotine, but he donated his payment to the cancer society.
Smoking needs more attention as a health hazard, Dr. Steven A. Schroeder of the University of California, San Francisco, wrote in a commentary in the journal.
"More women die of lung cancer than of breast cancer. But there is no 'race for the cure' for lung cancer, no brown ribbon" or high-profile advocacy groups for lung cancer, he wrote.
Kathy DeJoseph, 62, of suburban Atlanta, finally quit smoking after 40 years — to qualify for lung cancer surgery last year.
"I tried everything that came along, I just never could do it," even while having chemotherapy, she said.
It's a powerful addiction, she said: "I still every day have to resist wanting to go buy a pack."
American Cancer Society: http://www.cancer.org
National Cancer Institute: http://www.cancer.gov/cancertopics/tobacco/smoking and http://www.cancer.gov/cancertopics/types/lung
Medical journal: http://www.nejm.org
Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP
Last Updated on Friday, 25 January 2013 09:52
Category: Health Written by Debbie Vargus
LINE DANCING IN BRADDOCK
Cardiovascular disease (CVD) is the most common cause of death in the U.S. Fortunately, the earlier people find out they have CVD, and with the many ways it can be treated, people can live healthier, longer lives. The UPMC Heart and Vascular Institute developed the Community Outreach and Cardiovascular Health (COACH) program to provide education about heart health, screening and treatment for CVD.
COACH has three components. The first is Check Your Heart, a community program that checks people for CVD. The next is FreeCare, a program to provide cardiovascular care to underserved patients who lack medical insurance. The last is the Childhood Health and Nutritional Goals and Education (CHANGE) program, dedicated to helping children be healthy.
Members of the COACH team provide free CVD screenings to adults in the community. Screenings include measures of height, weight, blood pressure, body mass index (BMI), cholesterol levels and blood sugar. Additionally, counseling is available from dietitians and cardiologists.
The FreeCare program runs a free cardiovascular clinic as part of the Birmingham Free Clinic (412-431-4280), located at 44 South 9th Street on Pittsburgh’s South Side. This clinic serves patients who have little to no health care coverage. The free cardiovascular clinic is sponsored by the University of Pittsburgh’s Program for Health Care for Underserved Populations. Cardiovascular services provided include heart-health tests, standard treatments and follow-up visits with doctors.
The CHANGE program was created to reach children. According to the Centers for Disease Control and Prevention, childhood obesity has more than tripled in the past 30 years. The goals of CHANGE are to help provide educational services to address the cardiovascular health and physical activity needs of local children. CHANGE emphasizes physical activity, healthy eating and overall wellness.
The CHANGE program works with schools, communities and health care providers to promote heart health. The Urban League of Greater Pittsburgh Charter School has partnered with the CHANGE program to help their students reduce BMI and childhood obesity as important risk factors influencing heart health.
For more information about the COACH program and the UPMC Heart and Vascular Institute, visit UPMC.com/COACH or call toll-free at 1-855-UPMC-HVI (876-2484).
Last Updated on Friday, 18 January 2013 10:24
Category: Health Written by Courier Newsroom
Several research studies (called clinical trials) involving diseased heart valves are currently looking for research participants. These studies involve the use of investigational devices. This means that research studies are required to determine whether these devices are safe and are beneficial to patients. In some cases, these devices might allow patients to undergo less invasive procedures than traditional open-heart surgery (“less invasive procedures” mean not as much cutting into or entering the body with surgical instruments). If you are interested in enrolling in this type of study, you might undergo physical examinations, blood and other tests to make sure that you are eligible. After you complete these tests, results will be reviewed by a committee of doctors to determine whether you are eligible.
Participating in this type of research may benefit others in the future by improving treatment of diseased heart valves. Like all research studies, your participation is completely voluntary. You may withdraw from a study at any time. The study doctor might also end your participation if he or she determines that it is not in the best interest of your health.
If you are interested in learning more about this type of research, please call the HVI Valve Center at 1-877-412-8258.
Last Updated on Friday, 18 January 2013 10:20
Category: Health Written by Courier Newsroom
Sudden cardiac arrest occurs when the heart suddenly, and without warning, stops beating. This event causes hundreds of thousands of deaths in the U.S. every year. Without immediate help, people who have sudden cardiac arrest can die within minutes. According to Clifton W. Callaway, MD, PhD, professor of emergency medicine at the University of Pittsburgh, it affects one person a day in Pittsburgh on average.
Cardiopulmonary resuscitation (CPR) is the first step in saving the life of someone who has sudden cardiac arrest. From 2000-2005, people in Pittsburgh were taught to give 15 chest compressions and two breaths (15:2). But Dr. Callaway’s research, and that of others, found that every time chest compressions are stopped to give breaths, the blood pressure created by the compressions drops off. Dr. Callaway and his group began preliminary testing and started training local first responders to do 30 compressions and two breaths (30:2). Researchers tracked patient outcomes before and after this change and found that they were more successful at getting pulses back by doing 30:2. Dr. Callaway and his group weren’t the only ones doing research on this, but they had helped Pittsburgh first responders switch to 30:2 well before the CPR guidelines were changed. Now, 30:2 is part of the international CPR guidelines.
One of the questions researchers are studying now is, if 30:2 is better than 15:2, would it be even better not to pause chest compressions at all and just blow some oxygen into the patient every 10 seconds or so? In Pittsburgh, first responders are now being trained to do either 30:2 (pausing to give two breaths) or continuous chest compressions while blowing oxygen. Some ambulances are doing one and some are doing the other. Dr. Callaway and his group are tracking all the outcomes in the region to answer that question.
Because patients can’t give consent to participate in research if they are having an emergency, resuscitation researchers like Dr. Callaway have to follow particular rules. Regulations allow for exceptions from informed consent for research in emergency situations. Researchers are permitted to try things if the study meets certain guidelines set by the Food and Drug Administration, the national Office for Human Research Protections and local institutional review boards. Anyone looking for information about studies going on in the region can go to http://acutecareresearch.org/ or call 412-647-3078.
It’s also important to remember that this is emergency research. It’s taking place in a life-threatening situation. Researchers aren’t studying procedures to see if they would be cheaper or easier. They are only doing things that have a real chance of helping someone stay alive.
According to Dr. Callaway, the best way of preparing for a sudden cardiac event is to learn CPR. People don’t have to go to a class or get certified. They can learn the basics online, at a public event or even from a health care provider. Don’t be afraid to help someone. Know how to activate the emergency system, which begins by calling 911. It’s what stands between you and a bad outcome some rough day.
Last Updated on Friday, 18 January 2013 10:22
Category: Health Written by Courier Newsroom
The SYMPLICITY trial is a type of research study called a clinical trial. A clinical trial is designed to test the safety or effectiveness of a new drug or device in humans. This clinical trial tests a new medical device meant for people whose high blood pressure cannot be controlled by different medications. The device has not yet been approved for the general public. The SYMPLICITY trial will include more than 500 people in more than 90 hospitals nationwide. To participate, people must be between 18 and 80 and on at least three doses of antihypertensive medication, one of which must be a diuretic (medicine that helps the body get rid of water and salt through urine).
If you want to enroll in the SYMPLICITY trial, you will be screened for the medications that you are currently taking. If you meet the study’s requirements, you will be asked to come in for a visit. Study visits take place in Oakland. Participants will be involved in three screening visits within 30 days and several follow-up visits for up to three years. If you participate in this trial, you may receive more frequent clinic visits and more information about your blood pressure. It may also decrease the amount and numbers of medications that you take.
If you’d like more information about high blood pressure or the SYMPLICITY trial, please call Lisa at 412-802-8672.
Last Updated on Friday, 18 January 2013 10:19
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