Lung Cancer Survivors Cite a Better Quality of Life
A diagnosis of cancer can evoke a person’s worst fears, but survivors of the disease often say their illness had a positive impact on their lives. And those who battle lung cancer, one of the most deadly malignancies, are no different. Although only about 15% of people with lung cancer live at least five years after diagnosis, the first study of survivors found that about half believe their cancer contributed to a good quality of life.
Despite the persistent physical problems--fatigue, shortness of breath, aches and pains, and changes in appearance--71% of lung cancer survivors described themselves as being very hopeful, and 50% said their illness had made a positive change in their life.
Among the group that reported a poorer quality of life, the most important factor was their emotional state. For those, depression was a bigger issue than their physical limitations. Lung cancer usually requires removal of all or part of a lung, which can cause a loss of up to 30% of lung function. That loss can seriously interfere with daily life. Still, the researchers found those who were cancer-free five years after initial diagnosis had a quality of life as high or higher than survivors of other cancers.
Journal of Clinical Oncology 20
(13): 2920-2929
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Change for the Better ... and Worse
Common wisdom says people don’t change but a new study says those with personality disorders do--but not always for the better. Some neurotic symptoms get better as people age, but in two out of three personality disorders, symptoms get worse. Although psychotherapists are taught that personality disorders are persistent, this is the first study to test this belief and document how the same group of people changed more than a decade after their initial diagnosis.
About 200 people who took a personality test and were treated for depression, anxiety or panic disorders in British psychiatric clinics were tested again 12 years later at the Imperial College School of Medicine in London. Of those, 175 were further evaluated in interviews. Their personalities were categorized as flamboyant (histrionic, antisocial, borderline and narcissistic personalities), fearful and anxious (dependent, obsessive-compulsive and avoidant personalities), and odd and eccentric (paranoid and schizoid personalities).
With the exception of those with borderline personalities, who tend to be quite impulsive, flamboyant types seemed to mellow with age. Characteristics of the other types became more pronounced over time. Flamboyant types tend to be less isolated than the other two types, which may partly explain the difference.
The researchers suggest another round of testing in another 12 or 13 years to see if the personality disorders persist into old age.
The Lancet, June 29, 2002:
359:2253-54
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Training Bladder Can Prevent Need for Surgery
There are at least a dozen treatments for helping women with poor bladder control, but a new study shows that simple bladder training works for many and allows them to avoid surgery, medication and more complicated types of behavioral therapy.
Most of the behavioral methods, such as biofeedback and electrical stimulation, have required lots of time and effort. Such methods often work, reducing the number of incontinent episodes by 50% to 80%.
But a study of less intense therapies, involving patients at Kaiser-Permanente Medical Center in Oakland, found that treatment need not be so complicated. In this study, women came to six weekly group sessions, where they learned a simple technique for gradually increasing the intervals between their usual voiding times. They also learned how the bladder works and were given instructions on pelvic exercises. At completion of the study, they had, on average, 50% fewer incontinent episodes compared to women who didn’t receive the training.
“I hope this study will encourage primary-care practitioners to ask women about incontinence, knowing that with very little time spent on patient education and little intervention they can help women improve,” says Dr. Leslee L. Subak, assistant professor of obstetrics and gynecology at UC San Francisco.
Obstetrics and Gynecology 100 (1): p 72
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Proof of Chromium’s Efficacy Proves Elusive
The mineral supplement chromium is advertised as a dietary aid that is supposed to help burn fat, build muscle, increase the level of “good” cholesterol and keep blood sugar in check.
But a new analysis of 15 randomized clinical trials involving more than 600 people shows that the jury is still out as to whether chromium supplements are even safe, let alone if they affect blood sugar.
The researchers report they found no relationship between chromium and glucose or between chromium and insulin levels in 435 people who were healthy or had impaired glucose tolerance but not diabetes. Studies of people who already have the disease are sparse.
Chromium is found naturally in grains and cereals, but it’s thought that much of it is lost in processing so most people don’t consume the recommended 50 to 200 micrograms a day. Some experts speculate that the deficiency might be linked to diabetes, since chromium is involved in maintaining a normal level of glucose in the blood.
If chromium were a new drug under study by the Food and Drug Administration (mineral supplements sold in the U.S. are not subject to the same rigorous testing as pharmaceuticals), the researchers say they would recommend a clinical study that would test various doses to determine not only what works, but what is safe.
American Journal of Clinical Nutrition 76 (1) 148-155.
