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Nearly 12 Million Cancer Survivors In The U.S.

The number of cancer survivors in the United States increased to 11.7 million in 2007, according to a report released by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). Women survive more often, and survive longer, according to the report.

There were 3 million cancer survivors in 1971 and 9.8 million in 2001. Researchers attributed longer survival to a growing aging population, early detection, improved diagnostic methods, more effective treatment and improved clinical follow-up after treatment.

The study, “Cancer Survivors in the United States, 2007,” is published today in the CDC’s Morbidity and Mortality Weekly Report.

To determine the number of survivors, the authors analyzed the number of new cases and follow-up data from NCI’s Surveillance, Epidemiology and End Results Program between 1971 and 2007. Population data from the 2006 and 2007 Census were also included. The researchers estimated the number of persons ever diagnosed with cancer (other than non-melanoma skin cancer) who were alive on Jan. 1, 2007. Read more »

*This blog post was originally published at ACP Internist*

New Study Links HPV To Head And Neck Cancers In Men

A new study finds that half of men in America are infected with the HPV virus. Dr. Jon LaPook reports on the growing concern that the virus in men could be responsible for an increase in head and neck cancers.

HPV Affects Half Of U.S. Men

A study out [yesterday] in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital infection with human papillomavirus (HPV).  HPV is the virus that causes cervical cancer in women. It also causes warts and cancer of the genitals and anus in both men and women. Over the past several years, researchers have realized that the virus can also cause cancer of the head and neck.

Aimee R. Kreimer, Ph.D., of the National Cancer Institute, estimates that about 65 percent of the approximately 8,000 cancers of the tonsils and base of the tongue (oropharynx) seen in the U.S. in 2010 were from HPV infection; eighty percent of these are in men. The rates for HPV-associated cancers like these are increasing; for sites like the mouth and larynx that are associated with tobacco and alcohol use, the rates are decreasing (though still too high since too many people still smoke and abuse alcohol).

An infection rate of 50 percent for a virus that can cause cancer sounds scary. But knowing a few more facts about HPV helps put the risk in perspective. About 90 percent of men and women infected with HPV virus get rid of it on their own within about two years. There are many different strains of HPV — some that cause cancer and some that don’t. Only about 6 percent of men have genital infection with HPV 16 — the strain linked to more than 90 percent of cancers of the head and neck. And only about 0.6 percent of men have HPV 16 in specimens taken from their mouths; what percentage of those men go on to develop head and neck cancer is unknown. Read more »

How Experienced Is The Radiologist Who Reads Your Mammogram?

There’s a new study out on mammography with important implications for breast cancer screening. The main result is that when radiologists review more mammograms per year, the rate of false positives declines.

The stated purpose of the research*, published in the journal Radiology, was to see how radiologists’ interpretive volume — essentially the number of mammograms read per year — affects their performance in breast cancer screening. The investigators collected data from six registries participating in the NCI’s Breast Cancer Surveillance Consortium, involving 120 radiologists who interpreted 783,965 screening mammograms from 2002 to 2006. So it was a big study, at least in terms of the number of images and outcomes assessed.

First — and before reaching any conclusions — the variance among seasoned radiologists’ everyday experience reading mammograms is striking. From the paper:

…We studied 120 radiologists with a median age of 54 years (range, 37–74 years); most worked full time (75%), had 20 or more years of experience (53%), and had no fellowship training in breast imaging (92%). Time spent in breast imaging varied, with 26% of radiologists working less than 20% and 33% working 80%–100% of their time in breast imaging. Most (61%) interpreted 1000–2999 mammograms annually, with 9% interpreting 5000 or more mammograms.

So they’re looking at a diverse bunch of radiologists reading mammograms, as young as 37 and as old as 74, most with no extra training in the subspecialty. The fraction of work effort spent on breast imaging –presumably mammography, sonos and MRIs — ranged from a quarter of the group (26 percent) who spend less than a fifth of their time on it and a third (33 percent) who spend almost all of their time on breast imaging studies. Read more »

*This blog post was originally published at Medical Lessons*

Breast Implants And Lymphoma: New Safety Alert From The FDA

From the Food and Drug Administration (FDA) safety alert yesterday:

ISSUE: The FDA announced a possible association between saline and silicone gel-filled breast implants and anaplastic large cell lymphoma (ALCL), a very rare type of cancer. Data reviewed by the FDA suggest that patients with breast implants may have a very small but significant risk of ALCL in the scar capsule adjacent to the implant.

BACKGROUND: In total, the agency is aware of about 60 cases of ALCL in women with breast implants worldwide. This number is difficult to verify because not all cases were published in the scientific literature and some may be duplicate reports. An estimated 5 million to 10 million women worldwide have breast implants. According to the National Cancer Institute, ALCL appears in different parts of the body including the lymph nodes and skin. Each year ALCL is diagnosed in about 1 out of 500,000 women in the United States. ALCL located in breast tissue is found in only about 3 out of every 100 million women nationwide without breast implants.

While the FDA’s new report is interesting, as it stands it’s of little consequence. A mere 60 cases of a unusual breast cancer worldwide is a tiny number compared to the huge number who develop the much more common ductal breast cancers (about one in seven women in the U.S.) Breast implants have not been found to affect this more common cancer incidence. I do expect this statistic to be misquoted by the anti-breast implant factions online.

As an aside, I do remember a case in a fellow plastic surgeon’s mother of a lymphoma near a breast implant capsule when I was a resident. This is the only breast cancer of this type I have ever seen, however, in 14 years of practice. While I don’t doubt the association, I do focus on the significance of this report to the average breast implant patient, which is very little at this point.

– John Di Saia, M.D.

*This blog post was originally published at Truth in Cosmetic Surgery*

Alcohol And Cancer: A Beverage Guide For The Holidays

Guest post submitted by MD Anderson Cancer Center*

When you raise your glass at this year’s holiday toast, choose your beverage wisely. Research shows that drinking even a small amount of alcohol increases your chances of developing cancer, including oral cancer, breast cancer and liver cancer.

Yet, other research shows that drinking small amounts of alcohol may protect the body against coronary heart disease and type 2 diabetes. Some evidence even suggests that red wine may help prevent cancer.

Researchers are still trying to learn more about how alcohol links to cancer. But, convincing evidence does support the fact that heavy drinking damages cells and contributes to cancer development.

Confused? Use our beverage guide to choose a drink with the lowest health risk, and learn your recommended drink limit and what alcoholic drinks to avoid. Read more »

*This blog post was originally published at Health in 30*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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