(HealthDay News) -- Nurses, printers and woodworkers are more likely than the average population to develop work-related asthma, according to a European research team that is calling for more monitoring of workers' exposure to chemicals that could cause the illness.
Workplace conditions may be responsible for one out of four new asthma cases in industrialized countries, the team found. They analyzed health information and workplace exposure details from more than 6,800 people who participated in the European Community Respiratory Health Survey between 1990 and 1995.
None of the participants had asthma at the beginning of the nine-year study. Exposure to possible asthma-causing substances was calculated using an "asthma-specific job exposure matrix" with additional insight from asthma experts.
Writing in the July 27 issue of The Lancet, the researchers reported that exposure to substances known to cause occupational asthma increased the risk of asthma by an average of 60 percent. The occupations with the greatest excess risk were printing (137 percent), nursing (122 percent), woodworking (122 percent), agriculture/forestry (85 percent), and cleaning (71 percent).
The risk of asthma tripled after certain incidents, such as fires, mixed cleaning products or chemical spills, leading the researchers to highlight the importance of following up with workers after similar events.
The increased risk for nurses was of particular interest to the researchers, who theorized that the high rate of asthma in that profession could be attributed to sensitizing substances, respiratory allergens, and irritants including sterilizers and disinfectants such as glutaraldehyde or bleach, as well as latex in the early 1990s.
More information
To learn more about asthma, visit the Asthma and Allergy Foundation of America.
Saturday, July 28, 2007
Tuesday, July 24, 2007
More Hospital Nurses Mean Fewer Infections
(HealthDay News) -- Fewer nurses at a hospital may mean more infections and life-threatening pneumonia for patients, research shows.
Ventilator-associated pneumonia (VAP) is a serious infection caused by bacteria entering the lungs whenever ventilator tubing is used. It's one of the most common preventable problems affecting people who are critically ill in the hospital and can extend a patient's stay at the hospital by an average of 10 days and cost $10,000 to $40,000 to treat.
For a new study published in the open access journal Critical Care, researchers examined the number of patients who were admitted to the intensive care unit at the University of Geneva Hospitals in Switzerland.
More than a fifth of the 936 patients who received mechanical ventilation during the study developed VAP.
The researchers noted that when there were fewer nurses on duty, patients were more likely to develop VAP six days or more after being placed on a ventilator. The nurses' training level had no effect on infection rates.
VAP most likely develops when bacteria are transferred between patients or from one site to another in the same patient.
The authors concluded that this study supports their previous findings on ICU infection risks. They proposed that employing more than two nurses per patient per day would prevent a large proportion of infections. In this study, there was an average ratio of two nurses per patient per day.
"This study shows that a low nurse-to-patient ratio increases the risk of late-onset VAP," researcher Stephane Hugonnet said in a prepared statement. "It adds also to the growing body of evidence demonstrating that adequate staffing is a key determinant and a prerequisite for adequate care and patient safety."
More information
There's more on pneumonia at the American Lung Association.
Ventilator-associated pneumonia (VAP) is a serious infection caused by bacteria entering the lungs whenever ventilator tubing is used. It's one of the most common preventable problems affecting people who are critically ill in the hospital and can extend a patient's stay at the hospital by an average of 10 days and cost $10,000 to $40,000 to treat.
For a new study published in the open access journal Critical Care, researchers examined the number of patients who were admitted to the intensive care unit at the University of Geneva Hospitals in Switzerland.
More than a fifth of the 936 patients who received mechanical ventilation during the study developed VAP.
The researchers noted that when there were fewer nurses on duty, patients were more likely to develop VAP six days or more after being placed on a ventilator. The nurses' training level had no effect on infection rates.
VAP most likely develops when bacteria are transferred between patients or from one site to another in the same patient.
The authors concluded that this study supports their previous findings on ICU infection risks. They proposed that employing more than two nurses per patient per day would prevent a large proportion of infections. In this study, there was an average ratio of two nurses per patient per day.
"This study shows that a low nurse-to-patient ratio increases the risk of late-onset VAP," researcher Stephane Hugonnet said in a prepared statement. "It adds also to the growing body of evidence demonstrating that adequate staffing is a key determinant and a prerequisite for adequate care and patient safety."
More information
There's more on pneumonia at the American Lung Association.
Friday, July 20, 2007
Combo HIV Drug Therapy May Restore Healthy Immune System
(HealthDay News) -- People with HIV may be able to achieve normal CD4 counts -- a marker of immune system strength -- by taking combination antiretroviral drug therapy, says a new study.
In a study published early online July 19 and in an upcoming edition of The Lancet, researchers found that people with HIV who remain on combination drug treatment for long enough and have their HIV viral load suppressed to below 50 copies per milliliter could see their CD4 count rise to concentrations equal to those of people uninfected by HIV.
In the study, a British team at the Royal Free and University College London Medical Schools, studied 1,835 people with HIV who had not previously taken antiretroviral therapy. The participants had a mean CD4 count of 200 cells per microliter of blood and then started combination antiretroviral therapy. They were selected to participate in the study because they responded well to this treatment, and their HIV viral loads were suppressed to below 50 copies per milliliter for extended periods of time.
The greatest average yearly increase in CD4 count -- 100 cells per microliter -- was seen in the first year after starting combination drug therapy. In the years following, significant, but lower (50 cells per microliter), increases were seen.
The participants who started combo therapy with low CD4 cell counts (of less than 200 cells per microliter) had substantial rises in CD4 counts even after five years. The only groups without substantial increases in CD4 counts were those who had taken the therapy for more than five years with high current CD4 counts (more than 500 cells per microliter).
The authors concluded that people with HIV can normalize their CD4 counts with combinations of antiretroviral drugs if they can maintain their viral load at less than 50 copies per milliliter.
But, in an accompanying comment, Gary Maartens and Andrew Boulle from the University of Cape Town, South Africa, cautioned that the findings are only applicable to patients with ideal responses to combination antiretroviral drug therapy, possibly limiting their application in patients in poorer countries.
More information
The World Health Organization has more about antiretroviral therapy.
In a study published early online July 19 and in an upcoming edition of The Lancet, researchers found that people with HIV who remain on combination drug treatment for long enough and have their HIV viral load suppressed to below 50 copies per milliliter could see their CD4 count rise to concentrations equal to those of people uninfected by HIV.
In the study, a British team at the Royal Free and University College London Medical Schools, studied 1,835 people with HIV who had not previously taken antiretroviral therapy. The participants had a mean CD4 count of 200 cells per microliter of blood and then started combination antiretroviral therapy. They were selected to participate in the study because they responded well to this treatment, and their HIV viral loads were suppressed to below 50 copies per milliliter for extended periods of time.
The greatest average yearly increase in CD4 count -- 100 cells per microliter -- was seen in the first year after starting combination drug therapy. In the years following, significant, but lower (50 cells per microliter), increases were seen.
The participants who started combo therapy with low CD4 cell counts (of less than 200 cells per microliter) had substantial rises in CD4 counts even after five years. The only groups without substantial increases in CD4 counts were those who had taken the therapy for more than five years with high current CD4 counts (more than 500 cells per microliter).
The authors concluded that people with HIV can normalize their CD4 counts with combinations of antiretroviral drugs if they can maintain their viral load at less than 50 copies per milliliter.
But, in an accompanying comment, Gary Maartens and Andrew Boulle from the University of Cape Town, South Africa, cautioned that the findings are only applicable to patients with ideal responses to combination antiretroviral drug therapy, possibly limiting their application in patients in poorer countries.
More information
The World Health Organization has more about antiretroviral therapy.
Tuesday, July 17, 2007
Chemical 'Paint' Helps Surgeons See Cancer's Borders
(HealthDay News) -- Researchers say they've developed a tumor "paint" that illuminates cancerous cells and help surgeons spot the borders of tumors.
A team at Seattle Children's Hospital Research Institute and the Fred Hutchinson Cancer Research Center found that the paint -- a protein derived from scorpions called chlorotoxin -- helped surgeons distinguish between brain tumor cells and normal brain tissue during surgery.
"My greatest hope is that tumor paint will fundamentally improve cancer therapy. By allowing surgeons to see cancer that would be undetectable by other means, we can give our patients better outcomes," study senior author Dr. James M. Olson said in a prepared statement.
The findings are in the July 15 issue of the journal Cancer Research.
Chlorotoxin is linked to a molecular "beacon" called Cy5.5. The use of chlorotoxin:Cy5.5 improves the likelihood that surgeons will be able to remove all cancerous cells during surgery without damaging surrounding healthy tissue, the researchers said. This is especially important for brain cancer patients. About 80 percent of malignant cancers recur at the edges of sites where tumors have been surgically removed.
Until now, there has been no way to allow surgeons to "see" tumors during surgery.
The researchers also noted that current technology, such as MRI, can distinguish tumors from healthy tissue only if more than one million cancer cells are present. Chlorotoxin:Cy5.5 is able to identify tumors with as few as 200 cancer cells, which means that it's 500 times more sensitive than MRI.
The tumor paint has been successfully tested in mice, and pilot safety trials have been completed. The researchers are preparing required toxicity studies before they apply to the U.S. Food and Drug Administration for permission to begin human clinical trials with the tumor paint.
More information
The American Cancer Society has more about cancer surgery.
A team at Seattle Children's Hospital Research Institute and the Fred Hutchinson Cancer Research Center found that the paint -- a protein derived from scorpions called chlorotoxin -- helped surgeons distinguish between brain tumor cells and normal brain tissue during surgery.
"My greatest hope is that tumor paint will fundamentally improve cancer therapy. By allowing surgeons to see cancer that would be undetectable by other means, we can give our patients better outcomes," study senior author Dr. James M. Olson said in a prepared statement.
The findings are in the July 15 issue of the journal Cancer Research.
Chlorotoxin is linked to a molecular "beacon" called Cy5.5. The use of chlorotoxin:Cy5.5 improves the likelihood that surgeons will be able to remove all cancerous cells during surgery without damaging surrounding healthy tissue, the researchers said. This is especially important for brain cancer patients. About 80 percent of malignant cancers recur at the edges of sites where tumors have been surgically removed.
Until now, there has been no way to allow surgeons to "see" tumors during surgery.
The researchers also noted that current technology, such as MRI, can distinguish tumors from healthy tissue only if more than one million cancer cells are present. Chlorotoxin:Cy5.5 is able to identify tumors with as few as 200 cancer cells, which means that it's 500 times more sensitive than MRI.
The tumor paint has been successfully tested in mice, and pilot safety trials have been completed. The researchers are preparing required toxicity studies before they apply to the U.S. Food and Drug Administration for permission to begin human clinical trials with the tumor paint.
More information
The American Cancer Society has more about cancer surgery.
Friday, July 13, 2007
Straight Talk From Docs on Grim Prognoses Works Best
(HealthDay News) -- Perhaps the only phrase tougher to hear than, "It's cancer" are the words, "There is no cure."
And those to whom the words are spoken might not even hear or understand them, new research reveals.
But if the terminal patient is a child, a second study shows, parents would feel better when doctors offer the full truth on what lies ahead.
Successfully imparting bad news about survival isn't always easy, as these research papers from the recent American Society of Clinical Oncology annual meeting in Chicago prove.
In audiotaped interviews involving individuals newly diagnosed with terminal lung or gastrointestinal cancers, 74 percent of doctors at Boston's Brigham & Women's Hospital let patients know that their illness had no cure.
However, only 32 percent of those patients later told researchers that they had heard and understood this important fact in their meeting with the doctor.
"Clearly, what's happening is that patients aren't understanding it, and the interesting question is why?" said lead researcher Dr. Lisa Lehmann, director of the hospital's Center for Bioethics.
In the study, Lehmann's group audiotaped conversations between 90 newly diagnosed patients with terminal cancer and their doctors.
They found that "[most] doctors are actually being very honest and open about patients' prognoses, at least with respect to the curability of these diseases," she said.
But almost a third of patients failed, in follow-up interviews with the researchers, to recall that the doctor had explicitly told them their illness had no cure.
Lehmann said the tapes showed that the words doctors used were simple and straightforward, so language wasn't the problem. "Whether they are traumatized by the information that's being communicated in terms of a very poor life expectancy, we just don't know," she added.
The study did uncover one possible clue: Patients who told the researchers that prognostic information was "very important" to them were more likely to remember being told bad news.
To Lehmann, that suggests that those patients understood how vital this information is for the tough health-care decisions that lie ahead. They are therefore better able to "latch onto" prognostic data when they hear it, she said.
She did call the findings troubling, however, because they suggest that many cancer patients are making treatment choices without fully understanding their prognosis.
"Patients have to realize that, despite the shock and trauma of this kind of information, it is really important information to hear," Lehmann said.
Just how important was underscored by the second research paper.
Dr. Jennifer Mack, a pediatric oncologist at the Dana Farber Cancer Institute in Boston, and her team surveyed 194 parents of children with cancer. All of the children were within a year of their diagnosis and still undergoing treatment.
The questionnaires asked parents about the type of information they hoped to receive from their child's doctors, and the extent to which they had gained hope from the information they had already received. Patients were also asked about their personal belief about their child's chance of a cure.
Mack's team found that, "even if the child's prognosis was poor, parents were more likely to derive hope if they also receive more extensive prognostic information," compared to when doctors purposely withheld information to keep hope alive.
That finding held true even when the prognostic outlook was grim and pointed to little or no likelihood of a cure.
"It really shows the power of information to be helpful to people in this kind of situation," said Mack.
According to Mack, the days when cancer doctors would hide the worst news from patients are gone -- but not quite forgotten.
"There's still that tendency to withhold information or give overly optimistic information about prognosis," according to Mack, who is also a pediatrics instructor at Harvard Medical School.
"I think that comes out of compassion," she added. "I think it may be the wrong instinct, though.
Because, ultimately, it's not good for the patients. Still, I've felt that instinct myself, because it feels like such a terrible thing to give somebody really bad news."
Why is more knowledge almost always better in these kinds of cases?
"I think that often people fear the worst, and when they think they are not getting direct information, those fears just continue," Mack said. "But if we can provide information that is realistic for them, then they have a way to frame their expectations in a way that's more reasonable."
Frank, sensitive and fully articulated exchanges between doctor and patient also build trust, she added.
"They know then that they have a relationship with the physician that's going to be worthy of their trust," Mack said. "Hopefully, that physician will remain with them and continue to provide realistic information along the way."
Lehmann believes the same.
Knowing whether or not you might survive, or for how long, is crucial to the choices you must make -- for example, choosing aggressive chemotherapy vs. palliative care, she said.
"However, patients can only make those decisions if they have some information on life expectancy," she added.
For patients facing what could be bad news, she advises bringing a family member or friend to the doctor.
"They can really listen in a way that the patient themselves may not be able to," she said.
And she suggested that doctors also need to "check in" with patients periodically, to make sure they have a full grasp of their illness and its prognosis.
"We also have to find some way of communicating it so that people are willing to hear it," Lehmann said.
More information
There's more on cancer patient support at the American Cancer Society.
And those to whom the words are spoken might not even hear or understand them, new research reveals.
But if the terminal patient is a child, a second study shows, parents would feel better when doctors offer the full truth on what lies ahead.
Successfully imparting bad news about survival isn't always easy, as these research papers from the recent American Society of Clinical Oncology annual meeting in Chicago prove.
In audiotaped interviews involving individuals newly diagnosed with terminal lung or gastrointestinal cancers, 74 percent of doctors at Boston's Brigham & Women's Hospital let patients know that their illness had no cure.
However, only 32 percent of those patients later told researchers that they had heard and understood this important fact in their meeting with the doctor.
"Clearly, what's happening is that patients aren't understanding it, and the interesting question is why?" said lead researcher Dr. Lisa Lehmann, director of the hospital's Center for Bioethics.
In the study, Lehmann's group audiotaped conversations between 90 newly diagnosed patients with terminal cancer and their doctors.
They found that "[most] doctors are actually being very honest and open about patients' prognoses, at least with respect to the curability of these diseases," she said.
But almost a third of patients failed, in follow-up interviews with the researchers, to recall that the doctor had explicitly told them their illness had no cure.
Lehmann said the tapes showed that the words doctors used were simple and straightforward, so language wasn't the problem. "Whether they are traumatized by the information that's being communicated in terms of a very poor life expectancy, we just don't know," she added.
The study did uncover one possible clue: Patients who told the researchers that prognostic information was "very important" to them were more likely to remember being told bad news.
To Lehmann, that suggests that those patients understood how vital this information is for the tough health-care decisions that lie ahead. They are therefore better able to "latch onto" prognostic data when they hear it, she said.
She did call the findings troubling, however, because they suggest that many cancer patients are making treatment choices without fully understanding their prognosis.
"Patients have to realize that, despite the shock and trauma of this kind of information, it is really important information to hear," Lehmann said.
Just how important was underscored by the second research paper.
Dr. Jennifer Mack, a pediatric oncologist at the Dana Farber Cancer Institute in Boston, and her team surveyed 194 parents of children with cancer. All of the children were within a year of their diagnosis and still undergoing treatment.
The questionnaires asked parents about the type of information they hoped to receive from their child's doctors, and the extent to which they had gained hope from the information they had already received. Patients were also asked about their personal belief about their child's chance of a cure.
Mack's team found that, "even if the child's prognosis was poor, parents were more likely to derive hope if they also receive more extensive prognostic information," compared to when doctors purposely withheld information to keep hope alive.
That finding held true even when the prognostic outlook was grim and pointed to little or no likelihood of a cure.
"It really shows the power of information to be helpful to people in this kind of situation," said Mack.
According to Mack, the days when cancer doctors would hide the worst news from patients are gone -- but not quite forgotten.
"There's still that tendency to withhold information or give overly optimistic information about prognosis," according to Mack, who is also a pediatrics instructor at Harvard Medical School.
"I think that comes out of compassion," she added. "I think it may be the wrong instinct, though.
Because, ultimately, it's not good for the patients. Still, I've felt that instinct myself, because it feels like such a terrible thing to give somebody really bad news."
Why is more knowledge almost always better in these kinds of cases?
"I think that often people fear the worst, and when they think they are not getting direct information, those fears just continue," Mack said. "But if we can provide information that is realistic for them, then they have a way to frame their expectations in a way that's more reasonable."
Frank, sensitive and fully articulated exchanges between doctor and patient also build trust, she added.
"They know then that they have a relationship with the physician that's going to be worthy of their trust," Mack said. "Hopefully, that physician will remain with them and continue to provide realistic information along the way."
Lehmann believes the same.
Knowing whether or not you might survive, or for how long, is crucial to the choices you must make -- for example, choosing aggressive chemotherapy vs. palliative care, she said.
"However, patients can only make those decisions if they have some information on life expectancy," she added.
For patients facing what could be bad news, she advises bringing a family member or friend to the doctor.
"They can really listen in a way that the patient themselves may not be able to," she said.
And she suggested that doctors also need to "check in" with patients periodically, to make sure they have a full grasp of their illness and its prognosis.
"We also have to find some way of communicating it so that people are willing to hear it," Lehmann said.
More information
There's more on cancer patient support at the American Cancer Society.
Wednesday, July 11, 2007
Nursing Home Residents Don't Get Routine Eye Exams
(HealthDay News) -- Two out of three nursing home residents do not receive eye exams despite nearly half being visually impaired, a new study says.
Nursing home residents have rates of visual impairment between three and 15 times higher than non-resident adults of the same age, according to previous studies.
Cynthia Owsley and colleagues at the University of Alabama at Birmingham analyzed vision and health data from 380 adults age 55 or older living in 17 nursing homes in the Birmingham area. Each resident and a family member were interviewed about the use of eyeglasses and eye care.
More than half -- 57 percent -- of the residents were visually impaired, which the researchers defined as having worse than 20/40 vision in the better eye. The researchers compared this to national data showing visual impairment in approximately 10 percent to 20 percent of adults 60 or over living outside of nursing homes. The researchers said that older people who are visually impaired may be more likely to be admitted to a nursing home, accounting for the higher rate among residents, and that people in nursing homes may be less likely to either have access to an eye doctor or use prescription eyeglasses. There may also be a lack of eye care professionals serving nursing home residents, according to the researchers.
Three out of four participants in the study had abnormal binocular contrast sensitivity, which is an inability to clearly detect boundaries between objects and changes in brightness. This condition makes it difficult to read or move around safely.
Even though the majority (90 percent) of the residents had health insurance, the researchers noted that two-thirds of them had no reference to eye exams in their medical records. When asked, almost one out of three (28 percent) said their last exam was during the previous year, and one out of five (20 percent) said it was more than two years ago. One-third did not know when their last exam was.
The researchers said their data did not indicate whether eye exams would have helped to prevent the visual impairment. However, they cited previous studies that suggested 37 percent of visual impairment and 20 percent of blindness could be corrected with eyeglasses, contacts or surgery.
The findings were published in the July issue of the journal Archives of Ophthalmology.
More information
To learn more about age-related low vision conditions, visit the American Foundation for the Blind.
Nursing home residents have rates of visual impairment between three and 15 times higher than non-resident adults of the same age, according to previous studies.
Cynthia Owsley and colleagues at the University of Alabama at Birmingham analyzed vision and health data from 380 adults age 55 or older living in 17 nursing homes in the Birmingham area. Each resident and a family member were interviewed about the use of eyeglasses and eye care.
More than half -- 57 percent -- of the residents were visually impaired, which the researchers defined as having worse than 20/40 vision in the better eye. The researchers compared this to national data showing visual impairment in approximately 10 percent to 20 percent of adults 60 or over living outside of nursing homes. The researchers said that older people who are visually impaired may be more likely to be admitted to a nursing home, accounting for the higher rate among residents, and that people in nursing homes may be less likely to either have access to an eye doctor or use prescription eyeglasses. There may also be a lack of eye care professionals serving nursing home residents, according to the researchers.
Three out of four participants in the study had abnormal binocular contrast sensitivity, which is an inability to clearly detect boundaries between objects and changes in brightness. This condition makes it difficult to read or move around safely.
Even though the majority (90 percent) of the residents had health insurance, the researchers noted that two-thirds of them had no reference to eye exams in their medical records. When asked, almost one out of three (28 percent) said their last exam was during the previous year, and one out of five (20 percent) said it was more than two years ago. One-third did not know when their last exam was.
The researchers said their data did not indicate whether eye exams would have helped to prevent the visual impairment. However, they cited previous studies that suggested 37 percent of visual impairment and 20 percent of blindness could be corrected with eyeglasses, contacts or surgery.
The findings were published in the July issue of the journal Archives of Ophthalmology.
More information
To learn more about age-related low vision conditions, visit the American Foundation for the Blind.
Thursday, July 05, 2007
Most Sunscreens Aren't Up to the Task
(HealthDay News) -- Beachgoers lulled into the breezy, bronzed glow of summer take note: Most sunscreens don't live up to their promise of protecting against harmful ultraviolet rays, a new study contends.
"Sunscreens just aren't as good as people think they are," said Dr. James Spencer, a dermatologist in St. Petersburg, Fla. "They aren't perfect, but they are the best tool we have."
"There's no such thing as a safe tan," added Dr. Darrell Rigel, a clinical professor of dermatology at New York University who does laboratory research on melanoma and other skin cancers.
The culprits in sunshine are the ultraviolet rays, particularly UVA and UVB.
Rigel said that sunscreens were designed initially to block out UVBs, because scientists thought these rays were to blame for sunburns and skin cancer. More recent studies suggest that UVA rays are also dangerous. But most current sunscreen labels don't offer a measure of UVA protection, he said.
While there's agreement on how to measure UVB rays, the U.S. Food and Drug Administration has spent almost three decades trying to determine how best to measure UVA rays. There are at least six different ways to do it, and the health agency hasn't settled on the best one. The agency said it would have a final answer in the coming months.
Spencer is working with the American Academy of Dermatology (AAD) to create a seal of approval for sunscreens, much like the American Dental Association has done. Companies wanting to carry the AAD seal would have to submit independent measures of their product to show that it offers adequate SPF protection and provides "broad-spectrum" protection against ultraviolet rays, as well as evidence of durability.
Meanwhile, unless you're a chemist or a dermatologist, it's tough to make sense of labeling on sunscreen lotions.
For one thing, many products claim "broad-spectrum" protection, meaning they block both UVA and UVB rays, and that means absolutely nothing, Riger said. He added that consumers should look for chemicals like oxybenzone, avobenzone and parsol 1789 that block both UVA and UVB rays. European manufacturers use another powerful UV blocker called mexoryl. L'Oreal just introduced a product, called Anthelios SX, with this newly approved ultraviolet ray blocker.
One of the biggest problems with sunscreens is the stability of the chemicals used -- some break down faster than others when exposed to sunlight and lose their potency to block UVA and UVB rays. Riger said that Neutrogena's Helioplex is one product that maintains stability over time.
More than a million new skin cancers are diagnosed each year in the United States, and rates are climbing. The most aggressive and deadly is melanoma, diagnosed in 60,000 people a year.
Unchecked, melanoma thickens and spreads and is responsible for about 8,000 deaths a year, according to federal statistics. The two other types of skin cancer -- basal cell and squamous cell -- are slow-growing and can generally be caught in time for successful treatment. Still, squamous cell carcinoma claims about 2,200 lives a year.
"The development of cancer is not a single event," Spencer explained. Unlike some other cancers, "the cause of skin cancer is not confusing," he added. "One thing causes it -- overexposure to the ultraviolet rays of the sun. Period. It's a short-term cosmetic benefit with long- term damage."
The Environmental Working Group, a consumer advocacy organization, recently set out to analyze hundreds of scientific studies on sunscreens to develop a list of the best and the worst sun products.
The group analyzed 400 scientific studies (on 780 name-brand sunscreens) to see how many are actually safe and effective. One in every eight did not protect against UVA rays, the study found. And only 16 percent of the products studied were both safe and effective. This can include anything from harmful chemicals used in the products to false labeling that states that it can offer all-day protection.
"No one had ever looked at the safety or efficacy of sunscreens," said Richard Wiles, executive director of the Environmental Working Group. The FDA has approved 17 chemicals for use in sunscreens, and only four of them provide UVA protection, he said.
The working group found that 84 percent of the sunscreens studied did not offer adequate protection from the harmful effects of the sun. They did identify 128 products that passed the rigors of testing.
The best on the list, Wiles said, include products with zinc oxide or titanium oxide that provide broad-spectrum effectiveness. What's more, they don't easily break down in the sun, which means they remain active longer. The group only studied products with SPF 15 or higher.
While dermatologists agree that sunscreens should be used to protect against harmful ultraviolet rays, there are other things people can do short of staying in the shade. Wear protective clothing and stay out of the sun between the hours of 11 a.m. and 3 p.m., when the UV rays are the strongest and most damaging. And, Rigel said, sunscreens should be reapplied every two hours in the sun.
Many dermatologists promote sensible sun exposure. After all, sun is a powerful source of vitamin D, and a few minutes a day several times a week is all the body needs to maintain its store of the vitamin. Vitamin D promotes bone formation and mineralization, and there is growing evidence that it powers the immune system's ability to fight cancer cells.
More information
For more on the sunscreen study, visit the Environmental Working Group.
"Sunscreens just aren't as good as people think they are," said Dr. James Spencer, a dermatologist in St. Petersburg, Fla. "They aren't perfect, but they are the best tool we have."
"There's no such thing as a safe tan," added Dr. Darrell Rigel, a clinical professor of dermatology at New York University who does laboratory research on melanoma and other skin cancers.
The culprits in sunshine are the ultraviolet rays, particularly UVA and UVB.
Rigel said that sunscreens were designed initially to block out UVBs, because scientists thought these rays were to blame for sunburns and skin cancer. More recent studies suggest that UVA rays are also dangerous. But most current sunscreen labels don't offer a measure of UVA protection, he said.
While there's agreement on how to measure UVB rays, the U.S. Food and Drug Administration has spent almost three decades trying to determine how best to measure UVA rays. There are at least six different ways to do it, and the health agency hasn't settled on the best one. The agency said it would have a final answer in the coming months.
Spencer is working with the American Academy of Dermatology (AAD) to create a seal of approval for sunscreens, much like the American Dental Association has done. Companies wanting to carry the AAD seal would have to submit independent measures of their product to show that it offers adequate SPF protection and provides "broad-spectrum" protection against ultraviolet rays, as well as evidence of durability.
Meanwhile, unless you're a chemist or a dermatologist, it's tough to make sense of labeling on sunscreen lotions.
For one thing, many products claim "broad-spectrum" protection, meaning they block both UVA and UVB rays, and that means absolutely nothing, Riger said. He added that consumers should look for chemicals like oxybenzone, avobenzone and parsol 1789 that block both UVA and UVB rays. European manufacturers use another powerful UV blocker called mexoryl. L'Oreal just introduced a product, called Anthelios SX, with this newly approved ultraviolet ray blocker.
One of the biggest problems with sunscreens is the stability of the chemicals used -- some break down faster than others when exposed to sunlight and lose their potency to block UVA and UVB rays. Riger said that Neutrogena's Helioplex is one product that maintains stability over time.
More than a million new skin cancers are diagnosed each year in the United States, and rates are climbing. The most aggressive and deadly is melanoma, diagnosed in 60,000 people a year.
Unchecked, melanoma thickens and spreads and is responsible for about 8,000 deaths a year, according to federal statistics. The two other types of skin cancer -- basal cell and squamous cell -- are slow-growing and can generally be caught in time for successful treatment. Still, squamous cell carcinoma claims about 2,200 lives a year.
"The development of cancer is not a single event," Spencer explained. Unlike some other cancers, "the cause of skin cancer is not confusing," he added. "One thing causes it -- overexposure to the ultraviolet rays of the sun. Period. It's a short-term cosmetic benefit with long- term damage."
The Environmental Working Group, a consumer advocacy organization, recently set out to analyze hundreds of scientific studies on sunscreens to develop a list of the best and the worst sun products.
The group analyzed 400 scientific studies (on 780 name-brand sunscreens) to see how many are actually safe and effective. One in every eight did not protect against UVA rays, the study found. And only 16 percent of the products studied were both safe and effective. This can include anything from harmful chemicals used in the products to false labeling that states that it can offer all-day protection.
"No one had ever looked at the safety or efficacy of sunscreens," said Richard Wiles, executive director of the Environmental Working Group. The FDA has approved 17 chemicals for use in sunscreens, and only four of them provide UVA protection, he said.
The working group found that 84 percent of the sunscreens studied did not offer adequate protection from the harmful effects of the sun. They did identify 128 products that passed the rigors of testing.
The best on the list, Wiles said, include products with zinc oxide or titanium oxide that provide broad-spectrum effectiveness. What's more, they don't easily break down in the sun, which means they remain active longer. The group only studied products with SPF 15 or higher.
While dermatologists agree that sunscreens should be used to protect against harmful ultraviolet rays, there are other things people can do short of staying in the shade. Wear protective clothing and stay out of the sun between the hours of 11 a.m. and 3 p.m., when the UV rays are the strongest and most damaging. And, Rigel said, sunscreens should be reapplied every two hours in the sun.
Many dermatologists promote sensible sun exposure. After all, sun is a powerful source of vitamin D, and a few minutes a day several times a week is all the body needs to maintain its store of the vitamin. Vitamin D promotes bone formation and mineralization, and there is growing evidence that it powers the immune system's ability to fight cancer cells.
More information
For more on the sunscreen study, visit the Environmental Working Group.
Sunday, July 01, 2007
Surgeons Push for Less Invasive Lung Cancer Procedures
(HealthDay News) - Less invasive lung surgery should become the first option for cancer patients, U.S. experts say.
The procedure, called thoracoscopic lobectomy, "should be considered the standard of care for patients with early-stage lung cancers," Dr. Michael Reed, an assistant professor of surgery at the University of Cincinnati (UC) and a minimally invasive thoracic surgeon at University Hospital, said in a prepared statement. "But few surgeons offer the procedure because it's difficult and requires a lot of additional training."
Only an estimated 10 percent of all lung cancer operations nationwide are minimally invasive procedures. However, these procedures result in faster recovery time and less pain for patients, Reed said.
Thoracoscopic lobectomy is a minimally invasive lung surgery that uses several small incisions instead of a major chest incision that requires rib-spreading. Only a handful of academic medical centers, including UC, are actively training surgeons to perform the procedure.
"The key to implementing this program into our practice was having a dedicated team of extensively trained thoracic surgeons with expertise in both open and minimally invasive, video-guided techniques," Dr. Sandra Starnes said in a prepared statement. "This isn't a procedure you can perform confidently after just a few cases -- mentorship and expertise are key."
The Cincinnati team has trained two cardiothoracic surgery fellows and more than a dozen community thoracic surgeons to perform minimally invasive lung surgery.
To assess how the training program affected the rate of minimally invasive lobectomies at UC, Reed and Starnes conducted a four-year review of surgical cases at University Hospital and the Cincinnati Department of Veterans Affairs Medical Center.
They found that the number of minimally invasive lobectomies performed by UC surgeons has increased by about 57 percent over four years.
Prior to the implementation of the training program, only about 18 percent of lobectomies were performed with minimally invasive procedures. Now, Reed estimated, 75 percent of lobectomies at University Hospital employ minimally invasive techniques.
"We've shown that with a predetermined, step-by-step plan -- guided by a highly experienced minimally invasive thoracic surgeon -- thoracoscopic lobectomy can be integrated safely into thoracic surgical training programs," Reed said.
These findings were to be presented June 29 at the Western Thoracic Surgical Association's annual meeting in Santa Ana Pueblo, N.M.
More information
The National Cancer Institute has more about lung cancer treatment.
The procedure, called thoracoscopic lobectomy, "should be considered the standard of care for patients with early-stage lung cancers," Dr. Michael Reed, an assistant professor of surgery at the University of Cincinnati (UC) and a minimally invasive thoracic surgeon at University Hospital, said in a prepared statement. "But few surgeons offer the procedure because it's difficult and requires a lot of additional training."
Only an estimated 10 percent of all lung cancer operations nationwide are minimally invasive procedures. However, these procedures result in faster recovery time and less pain for patients, Reed said.
Thoracoscopic lobectomy is a minimally invasive lung surgery that uses several small incisions instead of a major chest incision that requires rib-spreading. Only a handful of academic medical centers, including UC, are actively training surgeons to perform the procedure.
"The key to implementing this program into our practice was having a dedicated team of extensively trained thoracic surgeons with expertise in both open and minimally invasive, video-guided techniques," Dr. Sandra Starnes said in a prepared statement. "This isn't a procedure you can perform confidently after just a few cases -- mentorship and expertise are key."
The Cincinnati team has trained two cardiothoracic surgery fellows and more than a dozen community thoracic surgeons to perform minimally invasive lung surgery.
To assess how the training program affected the rate of minimally invasive lobectomies at UC, Reed and Starnes conducted a four-year review of surgical cases at University Hospital and the Cincinnati Department of Veterans Affairs Medical Center.
They found that the number of minimally invasive lobectomies performed by UC surgeons has increased by about 57 percent over four years.
Prior to the implementation of the training program, only about 18 percent of lobectomies were performed with minimally invasive procedures. Now, Reed estimated, 75 percent of lobectomies at University Hospital employ minimally invasive techniques.
"We've shown that with a predetermined, step-by-step plan -- guided by a highly experienced minimally invasive thoracic surgeon -- thoracoscopic lobectomy can be integrated safely into thoracic surgical training programs," Reed said.
These findings were to be presented June 29 at the Western Thoracic Surgical Association's annual meeting in Santa Ana Pueblo, N.M.
More information
The National Cancer Institute has more about lung cancer treatment.
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