plus 4, SABCS: Risk of Vaginal Estrogens Not Known in Breast Cancer Patients - MedPage Today |
- SABCS: Risk of Vaginal Estrogens Not Known in Breast Cancer Patients - MedPage Today
- Agenda full for Wednesday Board of Health meeting - Chillico Gazette
- Genetic tests for all Jewish women urged - canada.com
- Gaps found in young people's sex knowledge - CNN
- Notes on cause-marketing, breast cancer, and HIV/AIDS - DAILY KOS
| SABCS: Risk of Vaginal Estrogens Not Known in Breast Cancer Patients - MedPage Today Posted: 15 Dec 2009 12:13 PM PST SAN ANTONIO -- Postmenopausal breast cancer patients face an uncertain risk from use of vaginal estrogen preparations that raise systemic estradiol levels, data from a small clinical study suggested. Both a vaginal estradiol ring and vaginal estradiol tablets significantly increased serum estradiol levels, researchers reported here. Estradiol levels remained elevated throughout the three months of the ring's therapeutic life, while tablets caused spikes in estradiol levels that persisted for 12 to 24 hours after twice-weekly insertion. "We know that there is absorption with both the tablet and the ring," Shannon Wills, PhD, of William Beaumont Hospital in Royal Oak, Mich., said in an interview at the San Antonio Breast Cancer Symposium. "We do not know if there is any clinical significance. We do not know if that increases their chances of breast cancer or regeneration of the tumor. We just know that there is absorption." Atrophic vaginitis is a common consequence of menopause and can have a substantial adverse impact on quality of life. Many postmenopausal women use vaginal estrogens to alleviate associated symptoms, including vaginal dryness, pain, dyspareunia, and urinary and sexual dysfunction. Systemic absorption of estradiol by postmenopausal breast cancer patients receiving adjuvant endocrine therapy had not been studied extensively, said Wills. To that end, she and colleagues in Michigan and London conducted a prospective, case-control study. The study included 24 postmenopausal breast cancer patients who had been treated with an aromatase inhibitor or selective estrogen receptor modifier (SERM) and were using vaginal estrogens to treat symptoms of atrophic vaginitis. Ten patients used a vaginal ring that was replaced every 90 days, and 14 patients used estradiol tablets inserted twice weekly. For comparison, the investigators recruited 24 postmenopausal breast cancer patients who were being treated with an aromatase inhibitor or SERM but were not using vaginal estrogens. Serum estradiol levels were measured prior to ring insertion and 30 and 60 days afterward, or the morning prior to tablet insertion and 12 hours after insertion. Serum samples also were obtained from the control patients, all of whom had taken an aromatase inhibitor or SERM for more than 14 days. The mean age of the patients in the vaginal preparation group was 60 (compared with 68 in the control group), and they had used vaginal estrogens for an average of 20 months prior to enrollment. Among the patients using estradiol tablets, preinsertion serum estradiol levels were an average of 4.7 pmol/L greater than those of the control group, a nonsignificant difference. However, 12 hours after tablet insertion, the patients' mean estradiol levels were 76 pmol/L greater than baseline levels (P<0.0001). One patient using the tablets had estradiol assessments preinsertion and at 12 and 24 hours. Her serum estradiol level had returned to the baseline level by 24 hours. Women using vaginal rings had significantly higher preinsertion serum levels of estradiol compared with the control group (+14.2 pmol/L, P=0.0001). Eight weeks postinsertion, mean serum estradiol level had increased by more than 30 pmol/L compared with baseline levels (P<0.001). Two patients had no increase in serum estradiol levels 60 days after ring insertion. Wills had no disclosures. fivefilters.org featured article: Normalising the crime of the century by John Pilger. Available tools: PDF Newspaper, Full Text RSS, Term Extraction. |
| Agenda full for Wednesday Board of Health meeting - Chillico Gazette Posted: 15 Dec 2009 12:20 PM PST The Ross County Board of Health will consider several items when it meets at 4:30 p.m. Wednesday, including terms of the contract for Dr. Donald Berling, medical director for the Ross County Health District. Among other items on the agenda include approval of a revised 2010 budget, acceptance of $26,080 as the state's portion of the Breast and Cervical Cancer Project grant for which the federal portion was approved in July, and declaring a sewage nuisance situation at 2893 Simmons Road. The meeting will take place in the health district's administrative conference room in the Ross County Service Center, 475 Western Ave. fivefilters.org featured article: Normalising the crime of the century by John Pilger. Available tools: PDF Newspaper, Full Text RSS, Term Extraction. |
| Genetic tests for all Jewish women urged - canada.com Posted: 15 Dec 2009 12:34 PM PST When a relative convinced Rena Bramson last year to get tested for genetic mutations that can dramatically increase the risk of certain cancers among Ashkenazi Jewish women like her, she worried little about the results. After all, there was no apparent history of the disease in the Toronto resident's family. Then came the call from Women's College Hospital a few months later: the 39-year-old had a BRCA-2 mutation, meaning she had a one in two lifetime chance of getting breast cancer, and one in four of ovarian cancer. "It literally felt like my blood ran cold," she recalled. "I was thinking 'This can't be, I don't have this in my family.' ... Here was this bullet coming straight at me and I had no idea." Within months, Ms. Bramson had undergone operations to remove her uterus and ovaries, followed by a double mastectomy and breast reconstruction, a preventive surgical ordeal that now all but shields her from the two cancers. Yet the mother of an 11-year-old son and eight-year-old daughter would never have been screened for the mutation had she not enrolled in a special study at the hospital. Only Jewish women who have had cancer themselves or cancer in their close family are eligible for genetic testing under the rules followed by most provinces. In fact, the Toronto study of 2,000 Jewish women found that more than half of those who tested positive for one of three cancer gene mutations would normally -- like Ms. Bramson -- not have qualified for screening. Taken aback by that finding, the doctors leading the study are now suggesting that all Jewish women be given government-funded genetic testing, which can trigger preventive measures or early detection of cancer. "We were shocked," said Dr. Kelly Metcalfe, a scientist at Women's College. It has long been known that Ashkenazi Jews -- those originating from Germany and eastern Europe -- are much more likely than most women to have genetic abnormalities that increase their risk of breast and ovarian cancer. Dr. Metcalfe, Dr. Steven Narod and others at Women's College set out to try to accurately pinpoint the prevalence of the mutations, inviting women to come forward through a newspaper article. They found that 23 -- just over one in 100 -- had one of the abnormalities. What surprised everyone is the lack of family history of cancer among many of those who tested positive. One geneticist not involved in the research, though, urged caution before reading too much into the findings. While many women with no family history of cancer may have one of the BRCA mutations, it is possible they are still at much less risk of disease than women with both the mutation and the family history, said Dr. Ab Chudley, a University of Manitoba professor. "To offer it to everybody, the jury is still out on that, particularly with limited resources," he said. "There are a lot of things we could be testing for. This is just the tip of the iceberg." Other types of cancer screening have triggered controversy lately, with some experts suggesting technology like mammograms and prostate PSA exams can lead to unnecessary treatment if offered too indiscriminately. The genetic testing of Jewish women, however, is a different matter, argued Dr. Metcalfe. One of the mutations gives women as much as an 80% chance of getting breast cancer and 50% of ovarian cancer. And yet, a positive test can lead to potentially life-saving preventive action, she said. Women have the choice of taking the drug Tamoxifen, having surgery to remove breasts and ovaries, or undergoing intensive cancer screening designed to catch the disease early, making treatment more likely to succeed. Given the costs of therapy for cancer patients, making the genetic testing more widely available among Jews would likely save money, said Dr. Metcalfe. The Women's College lab can do the test for the three mutations for $25. Dr. Chudley, however, notes that the costs of providing preventive treatment to women who have the mutation can be steep, so the economics should be carefully considered. In the meantime, the Toronto hospital is expanding the study so another 5,000 can be screened. There are about 170,000 Jewish girls and women in Canada. Ms. Bramson said she was "beyond grateful" for the opportunity to get her test, especially after receiving some chilling news from a surgeon. Examination of the excised tissue indicated she would likely have had breast cancer within five years. Ms. Bramson also pressured others in her family to get screened. Her aunt, Judy Kowal, tested positive for one of the mutations, and subsequent examination revealed she already had stage-two ovarian cancer. Doctors figured Ms. Kowal would have been dead within a couple of months if they had not caught the cancer then, said the niece. After surgery and chemotherapy, she is now cancer free. tblackwell@nationalpost.com fivefilters.org featured article: Normalising the crime of the century by John Pilger. Available tools: PDF Newspaper, Full Text RSS, Term Extraction. |
| Gaps found in young people's sex knowledge - CNN Posted: 15 Dec 2009 12:55 PM PST (CNN) -- Most sexually active unmarried young adults believe pregnancy should be planned, but about half do not use contraception regularly, according to a study published Tuesday. The survey of 1,800 people age 18 to 29 was conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy. "What is surprising is just how wide the gap is between single young adults' intentions and behavior on this very important issue," said Bill Albert, chief program officer at the organization. Also, 29 percent of women and 42 percent of men said it is at least slightly likely they will have unprotected sex in the next three months -- and it's quite likely or extremely likely for 17 percent of women and 19 percent of men. The discrepancy between both wanting to plan pregnancy and having unprotected sex may have something to do with a focus in recent years on abstinence-only education, said Laura Lindberg, senior research associate at the nonprofit Guttmacher Institute. "Abstinence-only curriculums have gone explicitly out of their way to teach misconceptions about contraception," she said. "This generation of 20-somethings have missed many opportunities to get medically accurate and correct information." But for abstinence education advocates, the problems stem from not enough focus on refraining from sex until marriage. "I don't think we'll be able to overcome this problem unless we restore the social norm of not having sex and not getting pregnant before marriage," said Peter Sprigg, senior fellow for policy studies at the Family Research Council. "Even when people are informed, they just don't choose to consistently practice contraception." Many of the people surveyed said they did not know much about contraception to begin with -- 63 percent said they knew little or nothing about birth control pills, and 30 percent said they had scant knowledge about condoms. The numbers may reflect that while most people have heard of the pill and condoms, they have never been taught how to use the pill or where to get it, or how to put on a condom, said Dr. Yolanda Wimberly, assistant professor of clinical pediatrics at the Morehouse School of Medicine and an adolescent medicine specialist with Grady Health Systems in Atlanta, Georgia. Myths about pregnancy and sexual activity continue to permeate circles of young people. For instance, 28 percent of men incorrectly believe they will get extra protection from wearing two condoms at once, a practice that actually leads to condom breakage. At the same time, 18 percent of men wrongly believe that having sex standing up reduces the chance that they will get a female partner pregnant. These are the kinds of myths often heard in Wimberly's office. Wimberly, who sees young people from age 12 to 30 about sexual health issues, commonly hears rumors like these that have spread among friends. Anecdotal evidence that a behavior is safe is sometimes more convincing for young adults than the recommendations of health professionals. "If other people have been doing it, and nothing bad has happened, then they'll do it," she said. "We have definitely got to do a better job of dispelling myths." Albert said it was shocking that about four in 10 respondents said it doesn't matter whether people use birth control, believing that people get pregnant when it's their "time." But this was not surprising for Wimberly. She pointed out that some people are not opposed to having children in their 20s and are at a point in their lives at which they would be relatively comfortable going through with an unplanned pregnancy. There are also exaggerated doubts and fears about birth control pills, the study said. Twenty-seven percent of women and 34 percent of men in the survey said serious health problems such as cancer are likely to result from using the pill or other hormonal contraceptives. Experts say hormonal contraceptives are relatively safe, but there is some mixed scientific research on the topic. According to the National Cancer Institute, oral contraceptives have been shown to increase the risk of cervical cancer, although human papillomavirus is the major risk factor for the disease. Some studies have found an increased risk of breast cancer, but others found no connection. There is also evidence that oral contraceptives decrease the risk of ovarian and endometrial cancer, but that they increase the risk of liver cancer in women who are otherwise considered at low risk for the disease. But the known evidence does not suggest it is "highly likely" that cancer will result from the pill, the National Campaign to Prevent Teen and Unplanned Pregnancy said. The survey cites a recent Mayo Clinic study that suggested an additional 2 to 3 percent increase of developing breast cancer as a result of being on the pill. Wimberly always goes through all the pros and cons of using the pill with her patients, including the noncontraceptive benefits. Each individual should discuss all the positives and negatives of the pill with a health care provider before deciding to use it, she said. Nearly half the adults surveyed said they agreed that "drug companies don't care if birth control is safe; they just want people to use it so they can make money." Thirty-two percent said they agreed that "the government is trying to limit blacks and other minority populations by encouraging the use of birth control." Still, according to a 2002 study from the Centers for Disease Control and Prevention, the leading contraceptive method among women ages 15 to 29 is the pill. While the actual rate of infertility among people 18 to 29 years old is 8 percent, a great deal more think they may fall into that category -- 59 percent of women and 49 percent of men said it is at least slightly likely they are infertile, and 75 percent of people who had concerns about fertility did not worry about it because of information from a doctor. About half of all pregnancies in the United States are unplanned, according to the American Congress of Obstetricians and Gynecologists. The survey calls for more sex education for adults, given that about one in five participants said they had never had sex education in school. Colleges -- both two-year and four-year -- should educate students about pregnancy and contraception, and such programs should also be available in workplaces, job training sites and the military, the survey said. Health care providers also have a role to play in ensuring that young people know all their options for family planning, and in providing patients with these methods, the report said. Wimberly added that other community-based venues such as churches, community centers, hospitals and after-school programs could all disseminate information about contraception and family planning. Parents can also play a big role in helping educate their children about these issues, Albert said. Groups such as the Family Research Council continue to advocate for abstinence-only education at the K-12 level, but the organization does not have an official stance on what sex education should happen beyond that, Sprigg said. "But as far as investing taxpayer dollars and making a strong public policy effort, we think the principle focus should be on encouraging abstinence," he said. The survey also touches on a distrust of the health care system more generally, Lindberg said. The challenge is to "create more positive attitudes and make health care providers and the health care system feel like a safe and trusting place," she said. fivefilters.org featured article: Normalising the crime of the century by John Pilger. Available tools: PDF Newspaper, Full Text RSS, Term Extraction. |
| Notes on cause-marketing, breast cancer, and HIV/AIDS - DAILY KOS Posted: 15 Dec 2009 12:48 PM PST Cause-marketing in the United States has a long history, originating in both the government and private sector. From Donald Duck telling us paying taxes will defeat the Axis to Lance Armstrong's ubiquitous yellow bracelets, cause-marketing pairs behaviors surrounding money, finance, and consumption to morality. This is especially true of those campaigns paring a cause like eliminating a disease with a product. HIV/AIDS Product(Red) launched in 2006 and may be the best example of capitalist culture's ability to co opt something as destructive as HIV/AIDS. In the case of a scourge like HIV/AIDS, while the money generated for the Global Fund through Product(Red) is useful, the funds are obtained through a brisk trade in commodity signaling, effectively sanitizing the nature of HIV/AIDS. (Red) states openly that the goal is not charity. (Red) is licensed by various companies such as Gap, Motorola, American Express, Apple, and Armani. Gap's statement about its (Red) clothing line is particularly diagnostic of capitalist culture's ability to sanitize and mask the means of production, as though goods manifest for consumption without human agency or consequence.
Gap's (Red) line products are made out of African cotton in Lesotho, a country with one of the highest percentage of population affected by HIV/AIDS in the world. Presumably the products are manufactured under poor working conditions given Gap's history. Yet, the clothing generates money to fight HIV/AIDS and revitalizes a corporation's image, while whatever percentage of the charitable donation end up in the hands of pharmaceutical companies who actively worked to suppress generic HIV/AIDS treatments. Access to drugs would be no problem for those countries wealthy enough to compete in the pharmaceutical market, but those regions of the world that remain unstable will continue to be ravaged by HIV/AIDS. American Express offers a (Red)Card, featuring a kickback of 1% of each purchase to the Global Fund. Membership can provide exciting experiences like VIP treatment at Aspen's Food and Wine Classic. American Express asks, has their ever been a better reason to shop? In capitalist culture, it's a compelling question and one American Express has asked before.
American Express' board remains staffed by people with vested interests in drug companies including Richard Levn, president of Yale University. As of late 2007, Yale University held the key use patent for Zerit, a drug that helps maintain an HIV carrier's immune system, although on 15 March 2001, Bristol-Myers Squibb—Zerit's manufacturers—said it would no longer try to suppress the distribution of low cost generics in Africa. Unstable treatment helps foster mutations and more robust strains of the virus and it's no coincidence the most difficult strains of HIV/AIDS to combat come from areas of the world where treatment is not consistent. Pharmaceutical companies fought generics, arguing the cost of researching a drug like Zerit is astronomical. Maybe they could divert funds from lobbying? In the case of the Gap, cause-marketing has been incredibly effective, going from bad press over an enormous class action lawsuit in 2003 to being lauded as one of the world's most ethical companies in 2007. While initially coming under fire for the relatively low figure generated to combat HIV/AIDS in Africa, (Red) is now successful and responsible for the largest donation to the Global Fund in history. The caveat that accompanies this looms large: Gap's marketing implies that wearing African cotton makes you CULTU(Red). Does it really? Capitalist culture says so and Gap repackages African culture for western consumers as though any of their products were authentically African beyond the physical location of production. Bizarrely, one of the current (Red) products features the phrase UNCENSO(Red), but this is exactly what cause-marketing does, because it relieves the consumer of the burden of thought. (Red) portrays Africans exactly the way white Western consumers want them to look: vibrant, happy, safe, and healthy, when the reality of AIDS decimated Africa is far from any of these things. The success of (Red), while helpful in the fight against HIV/AIDS, should not come at the expense of knowledge. Cancer LiveStrong perpetuates a similar, equally dangerous 'cleansed' presentation of cancer. Doctors like David Ryan, interviewed in a PBS documentary called The Truth About Cancer had this to say about Armstrong:
[For clarity, when Armstrong was diagnosed his cancer had spread to other parts of his body, so he was not treated exclusively for testicular cancer, but Dr. Ryan's "lottery" comment remains accurate.] Certainly cause-marketing is useful to the organizations it sponsors, but how helpful is it to misrepresent those causes? Ryan's invocation of the peculiarly American insistence that beating disease requires more personal fortitude than genetic luck speaks to this power. Linguist and cognitive scientist Steven Pinker observes in obituaries, nobody dies from cancer. Instead we succumb to a "lengthy illness" or "lose a battle", as though we might outwit metastatic cells. Barbara Ehenreich's newest work, Bright-Sided discusses this aspect of the cancer/survivor community in greater detail. The power of assertive thinking in the face of adversity is well documented, but the demand for perpetual cheeriness is snake oil which permeates the cancer/survivor community and is ultimately linked to cause-marketing. Susan G. Komen, the subject of several discussions here, helps maintain a similar image of women with cancer. The women of Race for the Cure and Komen are heroic, often beautiful fighters with permanent smiles, triumphantly defeating their cancer with the full support of family, friends, early screening, competent doctors, and presumably a great insurance plan. If diarists here wish to engage Susan G. Komen, they'll have better luck attacking the practices of the foundation itself and not those in positions of power within the organization. It would seem more productive to criticize the foundation's stock options in companies manufacturing mammogram technology, its ties to AstraZeneca, or its relationship with cancer-causing petrochemicals.
The moral imperative should be to reduce the suffering of others through direct action, not compassionate consumption. Consumption ends when the cards are swiped, when the Gap shirt falls apart, when you're finished with your Starbuck's coffee drink on the single day of the year it devotes to HIV/AIDS cause-marketing. We should fight to end illness, disease, environmental destruction, poverty and illiteracy because we care as humans, because all these problems exist in the same system, and not because such causes are marketed to us by our culture as 'sexy'. I realize this ending is somewhat abrupt but this diary is becoming a bit unwieldy. Questions and criticism are welcome. I hope this diary and its sources will help answer some questions I've seen in other comments. Sources: Dr. Ryan on Lance Armstrong, PBS: The Truth About Cancer The Marketing of Breast Cancer Mary Ann Swissler, AlterNet. The Foundation Center FAQ on Cause-Related Marketing Gap(Red), and other Product (Red) sites. Buy(Less) - one response to (Red) Barbara Ehenreich, Bright-Sided Steven Pinker, The Stuff of Thought fivefilters.org featured article: Normalising the crime of the century by John Pilger. Available tools: PDF Newspaper, Full Text RSS, Term Extraction. |
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