Better Care for Cancer Survivors
Though the degree to which cancer is better controlled today than it was a decade or two ago remains a matter of some controversy, National Cancer Institute researchers estimate there are 5 million Americans who have been diagnosed as having cancer and are still alive.
The report, in the New England Journal of Medicine, was an estimate derived from figures maintained by the Connecticut Tumor Registry. In 1982, 1,789 of every 100,000 men and 2,222 of 100,000 women had at one time been diagnosed as having cancer. The highest rates--not surprisingly--were among the old, with 12% of men and 11% of women over 70 having received a cancer diagnosis sometime in their lives.
Breast cancer for women and prostate cancer for men are the most common varieties. The analysis could not determine how many of the 5 million people had been successfully treated and how many were destined to die of their cancers.
The report sounded an increasingly familiar note, however, emphasizing that, as more people survive cancer, more will need to be done with their sometimes special physical and psychological needs.
With the fitness revolution making almost a status symbol of knee surgery, researchers have been increasingly puzzled by how to deal with the inevitable atrophy of the muscles of the thigh that occurs during recovery from knee operations.
Writing in the journal Orthopedics, researchers in Stockholm have concluded that electronic nerve stimulation machines--which have enjoyed a surge of popularity in the last few years--can be used for do-it-yourself treatment in concert with an exercise program and yield significantly better muscle restoration--for women, at least--than exercise alone or no rehabilitation.
Surprisingly, though, the Swedish team concluded that female knee surgery patients both are more susceptible to this variety of quadriceps wasting and more prone to making progress with the combination treatment. In a study of 18 men (average age: 27) and 20 women (average age: 24), the Swedish team concluded that men’s improvement in the combination stimulation-exercise treatment was statistically insignificant but that women showed surprisingly large gains.
Involved are small battery-powered machines that pass a small electric current through the skin, stimulating muscle tissue. All of the study subjects had undergone surgery to repair their anterior cruciate ligaments--site of many of the most common knee injuries.
There are more boys born than girls in the United States (1,052 boys for every 1,000 girls, to be precise), but the American population retains its slight--51.4% to 48.6%--female majority. The difference is accounted for by the continuing longevity advantage women have historically enjoyed.
There are slight signs now, though, that men may be narrowing--albeit not by much--the longevity gap, according to new figures compiled by the Metropolitan Life Insurance Co. In the years 1979 through 1981, the expectation for years of life at birth among women increased to 77.6 years nationwide and men reached 70.1. But compared to a similar period a decade before, the average anticipated life span at birth for men increased 3.1 years while women’s rose by 3.0 years.
The figures also show there continue to be marked differences in longevity between states, with boys and girls born in Hawaii having the greatest anticipated life span (74.1 years for boys and 80.3 for girls) and children in the District of Columbia faring the worst (64.5 years for boys and 73.7 years for girls.)
California boys can expect to live 71.1 years and girls, 78.0 years. Other states with high life expectancies were Minnesota, Utah, North Dakota and Iowa. Low rates were also recorded in Mississippi, Georgia, South Carolina and Louisiana.
Just what accounts for the range of difference remains open to speculation, with racially imposed socioeconomic factors apparently playing a role, along with life-style factors like tobacco use. The Metropolitan Life Statistical Bulletin speculates that with better maternal health programs, more public health education, medical advances and greater uniformity among health care services, the regional differences might eventually disappear.
MISCELLANEA MEDICA--Transplant recipients and others taking drugs to suppress their immune systems should be carefully monitored, a study in the Archives of Dermatology advises, because they may have an increased risk of contracting a variety of cancers--particularly skin cancer . . . Two University of Pennsylvania researchers have concluded that, just as owning a dog or cat can be comforting to humans, so can having a bird. “Almost any sound made by the bird is sufficient to stimulate dialogue from owners,” they say . . . A Chicago firm is selling a special dart board, called “A Second Opinion,” to be hung in doctors’ waiting rooms. Diagnosis or treatment is determined by where the dart lands, with the bull’s eye being “take a cruise” and other possibilities including “put ice on it” and “bypass the bypass.”
DOCTOR’S LEXICON--If you’ve ever heard doctors talk about one another and wondered what the difference is between interns and internists, you are not alone. Since the two words sound so much alike, there is a natural tendency to confuse them.
An intern is a physician who has just finished medical school and is undergoing the first year of what is called postgraduate training--the period of one to seven years when a young physician hones his or her skills. In recent years, a trend has developed away from use of intern as hospitals have gravitated to calling such doctors first-year residents , according them the same nomenclature that is applied to doctors in training after internship.
An internist , on the other hand, is a fully trained physician who specializes in internal medicine , or the general field of disease that can be treated without surgery--generally anywhere in the body.
