Pre-Surgery Chemo, Fewer Mastectomies?
Chemotherapy given before breast cancer surgery--rather than after it, as now is commonly the case--permits more breast-conserving procedures, according to a new study in the August Journal of Clinical Oncology. Dr. Bernard Fisher, scientific director of the National Surgical Adjuvant Breast and Bowel Project, and his colleagues studied 1,532 women with early-stage breast cancer.
Of the patients treated with chemotherapy before surgery, 67.8% underwent lumpectomies rather than mastectomies, but among those treated with surgery first, only 59.8% received lumpectomies. Doctors found that, in many cases, tumors so large that they would have required mastectomy had shrunk enough that lumpectomy could be performed.
The researchers also were better able to evaluate the tumor’s response to drug regimens if the drugs were given before surgery.
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Technique May Reduce Need for Biopsies
A new, noninvasive technique for determining whether suspicious lumps in the breast are benign or malignant can reduce the number of women undergoing biopsies and other invasive procedures by as much as 50%, according to a report in the Aug. 1 Lancet. The Biofield Diagnostic System measures electrical potentials at the breast surface, much like an electrocardiogram measures heartbeats.
Epidemiologist Jack Cuzick and his colleagues at the Imperial Cancer Research Fund in London evaluated 661 women who had undergone biopsies for suspected tumors. They concluded that the test, which analyzes changes in electrical charge distribution associated with breast cancer, could have eliminated the need for a biopsy in 55% of the cases.
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Acetaminophen May Help the Heart, Early Tests Show
Researchers in Texas say they have found preliminary evidence that acetaminophen--a widely used pain reliever, the most popular brands of which are Tylenol, Datril and Pamprin--might help protect against heart disease. They said it might act as an antioxidant, stopping cholesterol from sticking to the walls of arteries and clogging them.
Dr. Addison Taylor and colleagues at the Baylor College of Medicine in Houston said tests of 12 volunteers showed that acetaminophen might act to stop the oxidation of low-density lipoprotein, also known as LDL or “bad” cholesterol. The findings were presented Wednesday at a meeting of the Congress of Pharmacology in Munich.
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Antidiarrheal Drug Shows Promise
Two new studies have found that an antidiarrheal drug called Provir is effective in controlling diarrhea in two populations. In one study, 184 Americans traveling in Jamaica or Mexico were given either Provir or a placebo to control watery diarrhea. Those given the drug improved significantly faster.
In the second study, also released Wednesday, 140 hospitalized Venezuelan nationals were treated with either Provir or a placebo, and again the drug was found to provide significant benefit. “Based upon my 25 years of experience testing antidiarrheal agents, these results indicate Provir may be the most potent . . . agent available to treat diarrhea,” said Dr. Herbert DuPont of the University of Texas Medical Center, who led the study on travelers’ diarrhea. More than 35 million people travel each year to countries that present the risk of diarrhea.
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Weight-Loss Drug May Help Type 2 Diabetics
The weight-loss drug orlistat (trade-named Xenical) can reduce the progression of type 2 diabetes in obese patients and reduce the need for therapy with insulin-stimulating sulfonylurea drugs, according to a report in the August Diabetes Care. Dr. Priscilla Hollander and her colleagues at the Baylor Medical Center in Dallas studied 391 obese, diabetic men and women who were given either orlistat or a placebo.
They found that patients given orlistat lost an average of 6% of their body weight and maintained the loss for one year while having better serum lipid and cholesterol profiles. The team also found that 43.2% of the patients treated with the drug were able to reduce their dosages of sulfonylurea medication, compared to 28.9% of those treated with placebos.
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New Method for Cutting Risk of Multiple Births
A newly developed technique called blastocyst transfer can virtually eliminate the risk of multiple births associated with in vitro fertilization, say researchers at the Center for Advanced Reproductive Care in Redondo Beach. The number of babies born as triplets, quadruplets or higher multiples in the United States doubled between 1990 and 1996, primarily as the result of IVF techniques in which physicians implanted several fertilized eggs to increase the chances of pregnancy.
Physicians typically grow a fertilized egg in the laboratory for only two or three days before implanting it in the mother. The newly developed technique allows them to grow it for five days before implantation. (A 5-day-old embryo is called a blastocyst.) At that age, physicians have a much better idea whether an egg will mature into a fetus, and thus do not have to implant so many. They also can better synchronize the procedure with the woman’s reproductive tract, further increasing the likelihood of success.
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Researchers Say Pregnancy Doesn’t Alter Course of MS
Women with multiple sclerosis who get pregnant are likely to see their disease briefly slow and then speed up, but pregnancy does not change the long-term course of the disease, French researchers have found. Physicians long have known that pregnancy can cause fluctuations in the progression of MS. The disease often flares up and then plateaus, but most studies have been too small to draw firm conclusions.
The latest study was conducted on 254 women in 12 European countries. Doctors looked at how their disease changed over a 33-month period before, during and after pregnancy. Compared with the year before they got pregnant, there was a 70% decrease in the rate of relapse during the women’s third trimester, the team reports in the July 30 New England Journal of Medicine. But during the first three months after delivery, there was a 70% increase in relapse over their pre-pregnancy rate.
--Compiled by THOMAS H. MAUGH II
