LOCAL HEALTH NEWS: Jefferson Offers Free Screenings For Prostate Cancer

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

09/17/2008

Philadelphia - Philadelphia area residents can get free prostate cancer screenings today at the Bodine Center for Cancer Treatment at 111 South 11th Street at Thomas Jefferson University Hospital. The service will be provided between 9 a.m. and 3 p.m. to all men who come and request it.

The free screenings are part of a research program and include a rectal exam as well as a blood test for levels of prostate specific antigen (PSA), testosterone and cholesterol.

"The blood test right now should be done once a year over the age of 50," recommended Dr. Leonard Gomella, chairman of the department of urology at Thomas Jefferson University's Kimmel Cancer Center.

Prostate cancer is the most common non-skin cancer in the United States, affecting one in six American men. It is the second-leading cancer killer, after lung tumors, among men.

Screening is generally recommended for men aged 40 to 75, and beginning at age 35 if there is family history of prostate cancer or you are of African American or Hispanic background.

The benefits of screening for older men above age 75 has been questioned in recent studies, but discussing your options and risks with your doctor is still best, said Dr. Gomella. "More men die with prostate cancer than of prostate cancer."

Although the government does not endorse PSA screenings and there is currently no cure for the disease, discovering the cancer earlier allows for possible treatment of symptoms and monitoring for continued progression.

The American Cancer Society notes that the year 2007 saw 218,890 men diagnosed in the U.S. and about 27,050 deaths. Worldwide, approximately 780,000 men are diagnosed with it each year, 250,000 of whom die.

The event is in its 19th year and is sponsored by Jefferson's Kimmel Cancer Center and the Foundation for Breast and Prostate Health. The month of September is the country's newly designated Prostate Cancer Awareness Month.


Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

HEALTH NEWS: Returning Veterans At Higher Risk For Alcoholism And Stress Disorder

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/15/2008

New research supports ongoing observations that military deployment into combat zones puts young men and women at greater risk of developing mental health issues, including post-traumatic-stress-disorder (PTSD) and heavy drinking.

The two studies were presented in a themed issue on violence and human rights by the Journal of the American Medical Association, as was a study that found suicide rates for returning combat veterans were no higher than rates for the general U.S. population.

In the study on alcohol abuse, returning service members who had seen combat were 63 percent more likely to experience new-onset heavy and binge drinking than those who were in non-combat areas.

The rates for new-onset heavy weekly drinking was 8.8 percent, with it being 25.6 percent for binge drinking, and 7.1 percent for other alcohol-related problems.

Binge drinking rates were 31 percent higher for combat veterans than for those not exposed to the same level of violence.

The results also showed a higher risk for younger service members compared to older personnel, and a higher incidence rate for Reserve or National Guard members compared to members in other military branches.

Surveys were taken of 48,400 military personnel before and after assumed deployment (between 2001-2003 and again in 2004-2006), setting a pre-deployment precedent for drinking levels and alcohol-related issues. Only 5,500 were actually deployed into combat zones, with 5,661 deployed into non-combat areas. The rest remained on active duty in the Reserve or National Guard.

The researchers suggested in their report that alcohol use likely serves as a coping mechanism for returning soldiers, as it does for individuals in the general populace. To combat this unhealthy response, the building and provision of familiar and stable support networks of trusted family, friends or fellow veterans is best - anywhere that doesn't involve meeting at a bar.

A separate study on excess alcohol intake lists additional dangers as including a greater chance of developing metabolic syndrome, which includes obesity, high blood pressure and diabetes.

This study by the CDC's National Center for Chronic Disease Prevention and Health Promotion defines excess drinking as more than two drinks daily for men and one drink a day for women, as well as binge drinking.

In the U.S., 58 percent of drinkers fall into this "excess" category and a majority had engaged in at least one instance of binge drinking, according to a recent survey cited by the researchers in their report.

Researchers suggest that public health messages emphasize the cardiometabolic risk of excess drinking. This study will be published in the Journal of Clinical Endocrinology & Metabolism.


Heather J. Chin can be reached at hchin@thebulletin.us.

©The Evening Bulletin 2008

HEALTH: Study: Americans Drinking Less Alcohol, More Wine

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/12/2008

Americans may drink more in one sitting than some Europeans (who drink steadily in small amounts), but their average overall alcohol intake has decreased across age and gender differences, according to a study published last week in the American Journal of Medicine.

The results from a 55-year study (1948-2003) on 8,600 white adults in Framingham, Mass., found Americans drink less as they get older, and they tend to gravitate away from beer and toward wine in the process. Each successive generation also showed a trend from heavier drinking toward moderate drinking.

All participants were initially at least 28 years old and were born between 1900 and 1959.
The average amount of alcohol intake was highest between ages 30 and 50 for most cohorts, regardless of gender.

Up to their mid-30s, young men relied on beer for at least half of their alcohol consumption. After that, beer consumption dropped to around one-quarter of the average male in his mid-70s.

While both men and women in each generation drank less with age and each generation drank less than the generation before it, the overall incidence rate of an alcohol use disorder among those aged 40 to 79 years was about three times higher among men (12.8 percent) than women (3.8 percent).

Female participants also showed a move from beer to wine over time, although the report's authors noted that they were less partial to beer to begin with. No significant alcohol-related problems were linked with women here, but a report by University of Washington researchers in the May issue of Alcoholism: Clinical and Experimental Research found that women born after 1953 had rising rates of alcoholism.

Lead author Yuqing Zhang, D.Sc., of the Boston University School of Medicine, told WebMD he doesn't know why the rates of alcohol use dropped over generations and this study "did not try to answer these questions."

The long-term health study collected data by asking participants to answer questions about their lifestyle and health, including alcohol consumption over time. Researchers hoped that the data would help determine patterns of alcohol use and disorders according to sex, age and birth cohorts.

The study, supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (part of the National Institutes of Health), is not clearly representative of all U.S. adults, but researchers said the data supports the efficacy of efforts to reduce alcohol use disorders.

Researchers also hope the data may be useful for policy-making groups responsible for drinking and alcohol recommendations, continuing "to support potentially beneficial effects of moderate drinking on cardiovascular disease and other diseases of aging, as well as adverse health and social effects of heavy alcohol use."

Heather J. Chin can be reached at hchin@thebulletin.us

©The Evening Bulletin 2008

HEALTH: Report: Prostate Cancer Screenings Pose Greater Risk Than Benefit For Older Men

(previously published here at www.thebulletin.us)

By: Heather J. Chin, The Bulletin

08/07/2008

Recommendations by a federal task force are challenging routine preventive care practices for prostate cancer for the country's population of older men.

The guidelines, issued Monday by the U.S. Preventative Services Task Force and updated from its inconclusive stance in 2002, advise that such cancer screenings should not be performed on men aged 75 years and older. Reasons cited include a lack of strong evidence of overall benefit compared to the potential risks of screening.

In younger men, the efficacy of prostate-specific antigen (PSA) screenings remains unclear. Here, the task force advises early counseling about the risks and few benefits so men may elect not to be tested.

The study's results were published in the Aug. 5 issue of Annals of Internal Medicine. This is the first time a specific recommendation has been made on the issue.

According to Dr. Ned Calonge, chair of the 16-member task force, "the benefit of screening at this time is uncertain ... You have a chance that screening will help you live longer or better, and ... the chance that screening detection and treatment will harm you. At age 75, the chances are great that you'll have negative impacts from the screening."

Negative effects listed by the panel include psychological harm, impotency and incontinence, "additional medical visits, adverse effects of prostate biopsies, anxiety and overdiagnosis" - detection when treatment won't affect life expectancy. Some studies suggest that overdiagnosis alone can occur between 29 to 44 percent of the time.

Prostate cancer is the most common non-skin cancer in the United States and affects one out of every six men. Risk factors include family history of cancer or an African-American background.

According to the American Cancer Society, last year saw 218,890 men diagnosed with prostate cancer and about 27,050 deaths. It is the second-leading cancer killer, after lung tumors, among men. The overall mortality rate from the disease has dropped since it peaked in 1991.

Currently, one third of American men receive either PSA screenings, which test for protein blood levels, or a digital rectal exam, which identifies abnormal growth of the prostate gland. Detection enables doctors to monitor a patient whose condition is slow-growing, or to provide treatment. Some men die before their cancer even becomes an issue.

Still, the panel says their findings do not support definitive advice, and the new guidelines will not prevent a man from seeking screening and treatment for prostate cancer symptoms, such as frequent or painful urination or blood in the urine or semen.

"Larger, longer-term [clinical] studies are urgently needed," Dr. Calonge, who is also the chief medical officer for the Colorado Department of Public Health and Environment said. "We recommend that men concerned about prostate cancer talk with their health care providers to make a decision based on their individual risk factors and personal preference."

While the age limitation may be welcome for some, many doctors find the lack of strong new evidence against screening as not enough to discourage preventative care.

"The spirit of the recommendations is good, but the problem is they really do send the wrong message to older men who could have prostate cancer," said Dr. Leonard Gomella, chairman of the department of urology at Thomas Jefferson University's Kimmel Cancer Center. "This study falls short of the fact that there are older men over 75 who do need treatment."

Falling mortality rates and longer life spans around the world where PSA testing have been made available may support continued preventative care, as well.

"Men are living a lot longer these days. I play golf with 84-year-old guys who beat me all the time," Dr. E. David Crawford, a professor of surgery and radiation at the University of Colorado at Denver said to the Washington Post. "You have to individualize treatment."

"If it turns out that PSA screening and aggressive treatment saves lives, maybe all the harm that it has caused is worth it," Dr. Otis W. Brawley, chief medical officer at the American Cancer Society added. "We just don't know yet."

The PSA test was approved by the Food and Drug Administration in 1986 and has been utilized increasingly since the mid-1990s as stigmas faded, awareness grew, and screenings for other cancers such as breast and ovarian became more popular.

Heather J. Chin can be reached at hchin@thebulletin.us.

©The Evening Bulletin 2008