The government estimates that more than 15,000 women died last year from ovarian cancer.
But routine screening of women with no symptoms isn’t recommended by the United States Preventive Services Task Force, American Congress of Obstetricians and Gynecologists or other professional groups, even for women at high risk for the disease. That’s because the benefits of the available tests — a transvaginal ultrasound and a blood test that detects an antigen called CA-125 — haven’t been shown to outweigh their risks (such as complications from unnecessary surgery), or to reduce the number of deaths.
Despite that evidence, a new study finds that when presented with a scenario of a woman coming to her annual check-up, a significant percentage of physicians surveyed would screen for ovarian cancer.
Some 28.5% of the 1,088 primary-care docs — OB/GYNs, family physicians and general internists — surveyed said they “sometimes” or “almost always” offered or ordered ovarian-cancer screening tests for low-risk women. When the vignette involved a woman at medium risk of the disease, that proportion jumped to 65.4% of physicians.
About a third of physicians reported believing that ultrasound or CA-125 blood testing is an effective screening test for ovarian cancer, the study found. It’s unclear why that is, and more research is needed to discover why, says Laura-Mae Baldwin, an author of the study and professor of family medicine at the University of Washington.
“We know that in medicine we have an enthusiasm for screening,” she says. “We want to find diseases before they can cause harm.”
The study also found that physicians were more likely to say they’d order screening for patients who requested it — even if the doctor herself didn’t believe screening was effective.
In that scenario, physicians may be trying to maintain a relationship with the patient, or they “may lack confidence in explaining why the test is more harmful than beneficial,” says Baldwin. She says there’s an important role for clinical tools that could accurately illustrate the level of risk faced by a particular woman and also illustrate the harms and benefits of the test.
The study is published in the Annals of Internal Medicine.
There are limitations to the research: doctors were reporting how they’d react to the scenarios presented to them, not discussing actual patients. And while there was a 62% response rate to the initial questionnaire sent to physicians, the results may not generalize to the doctors who didn’t respond, the authors write.
Image: iStockphoto
Ever clam up at a meeting even though you knew a lot and wanted to contribute? Have you tripped over yourself as you tried to explain a complex subject? Have you felt tongue-tied when the spotlight turns to you at a party? You’re not alone. WSJ’s Bonds columnist Elizabeth Bernstein writes this week about research which shows that some people become, in effect, less intelligent when in professional or social gatherings.
Elizabeth will take reader questions in a live chat on Tuesday, Feb. 7 at 12 p.m. ET. The chat will be moderated by Personal Journal news editor Laura Bird. Ask your questions now.
Does online dating work?
Well, it’s a great way to meet people, but not for leading you to the partner of your dreams, according to a comprehensive new review published in this month’s issue of the journal Psychological Science in the Public Interest.
The authors, all academic researchers without any financial ties to dating services, combed through the literature on relationships (those begun both on- and offline) and other areas of psychology to take a stab at answering the question.
Using an internet dating site has the advantage over in-person dating in expanding one’s access to the dating pool. That’s especially helpful for people who tend to face more limited opportunities, such as working, single parents without much free time or those with a minority sexual orientation, says study author Eli Finkel, a psychology professor at Northwestern University. In addition, users know immediately that their matches are available and interested in a romantic relationship, in contrast to the uncertainties surrounding meeting someone in, say, a bar.
But, the typical online dating site — where individuals view profiles of those to whom they are matched based on certain characteristics or values — doesn’t improve one’s chance of meeting a compatible mate, according to Finkel.
That’s because it’s really hard to judge chemistry or rapport — so-called “experiential” information — from searchable information, like height, age and education. And, people may not even make decisions based on the characteristics they say are important — they might say kindness is important, for example, but then not go for the super-kind people any more frequently than someone who says intelligence is really important. Ultimately, this means that online services are matching people based on characteristics that haven’t been shown to predict relationship success, says Finkel.
A prime example is similarity, which some dating sites say is the key to finding a suitable mate and serves as the basis for complicated matching algorithms. In relationship research, similarity between couples doesn’t well predict the long-term success of the relationship. Rather, people simply perceive that they are more similar to people they like, says Finkel.
The take-home message isn’t that people should stop on-line dating, says Finkel. Rather they should “use the online dating site to get off-line,” he says.
Don’t spend extensive periods of time scouring profiles and interacting electronically. Instead, use the profiles to find people who look interesting or appealing, then relatively quickly try to meet that person — in a public setting, for safety’s sake — to assess whether that spark is there in-person, he says.
Those who like to go out and are willing to be spontaneous may find more success using new “mobile” dating options where users are see via smartphone who else signed up for the service is near where they are, and can immediately meet up for coffee to assess whether there’s chemistry, says Finkel.
“Theres no substitute for face-to-face communication,” says Finkel.
Bonus: The Psychology of Online Dating
Image: iStockphoto
Cancer patients with advanced disease should have access to palliative care early on in their illness, according to new guidelines from the American Society of Clinical Oncology.
That doesn’t mean oncologists are being encouraged to give up on extending the lives of those patients, says Thomas Smith, an author of the guidance and director of palliative care for Johns Hopkins Medicine and a professor of palliative care in the Hopkins School of Medicine’s oncology department.
Rather, the guidelines recommend combining palliative care — open and honest communication about the progress of the disease and the patient’s wishes, medical appropriate goal-setting and careful attention to symptom management — with standard oncology care, says Smith. (The “provisional clinical opinion” is published online by the Journal of Clinical Oncology.)
Practically, that would mean patients would still receive whatever treatments were likely to help fight their disease. But they’d also get help from a palliative care team trained in having tough conversations about prognosis, quality of life and death.
“It’s not hard for oncologists to tell who can be cured and who can’t,” says Smith. “But it’s hard to sit down and explain to people what will happen to them, and to have a discussion about how that person wants to spend their last weeks, months and years of life,” he says.
There aren’t a huge number of large randomized clinical trials on which to base recommendations for palliative care, says Smith; the area is not particularly well funded.
But one study that did get a lot of attention, published in the New England Journal of Medicine in 2010, found that advanced lung-cancer patients who were randomly assigned to receiving early palliative care in conjunction with standard care not only reported better quality of life, but lived a few months longer than patients receiving only standard care.
What comes through “loud and clear” from the available research is that there’s no harm in incorporating palliative care early on with patients with metastatic disease, says Smith. Patients tend to have their pain and symptoms better managed, to have a better understanding of their illness, and to receive more medically appropriate care, he says. Research also shows they and their family members are less likely to be depressed.
The statement from ASCO says that more research is necessary to figure out the best timing and venue for providing palliative care, to evaluate reimbursement models and to gauge the effectiveness of various components, among other things.
Bonus: ASCO: How to Talk About End-of-Life-Care With Cancer Patients
The Food and Drug Administration questioned the clinical benefit of using Amgen’s bone drug Xgeva to prevent or delay the spread of prostate cancer to the bones.
Xgeva is currently approved to delay fractures and other bone injuries in patients whose cancers have already spread to the bones.
The company is seeking approval for use of Xgeva to prevent the spread of prostate cancer in a group of men that has not responded to other therapies.
Xgeva will be reviewed Wednesday by the FDA’s oncologic drugs advisory committee, which is made up of non-FDA medical experts. The FDA today posted a review of Xgeva in preparation for the meeting.
Amgen conducted a study of Xgeva in 1432 men with prostate cancer that had not responded to previous therapies, but had not spread to the bones. Many types of cancer spread to the bones and cause tumors to grow, destroying the bone around the tumor, causing fractures and other problems.
Half of the men were treated with Xgeva while the other half received a placebo. The study examined the time until men developed bone metastases or died, whichever occurred first. The study showed Xgeva prolonged median bone metastatis-free survival by 4.2 months compared to men in the placebo group.
While the FDA said the study met its primary objective, the agency said it was unclear whether the results were “clinically meaningful” given that there was no difference in overall survival between the two patient groups. The agency said the risk-benefit ratio of Xgeva must also take into account the overall toxicity of the drug. One of the side-effects includes a risk of developing osteonecrosis of the jaw, or ONJ, a rare jaw-decay problem.
Michael Severino, Amgen’s vice president of research and development, said today that the company believes Xgeva does provide a clinically meaningful benefit because it delays the spread of cancer to the bone, which causes significant pain and other problems such as incontinence.
Xgeva is also sold under the brand name Prolia as an osteoporosis treatment but is administered at a lower dose and less often than used to treat cancer-related bone complications. Xgeva and Prolia’s combined sales in 2011 topped $550 million. The drugs target a protein called RANK Ligand, which helps regulate cells called osteoclasts that break down bone.
(This post originally ran on Dow Jones Newswires.)
Social Media and Funding Brouhaha: Social media helped galvanize supporters of Planned Parenthood last week after Susan G. Komen for the Cure said it would cut off funding for the women’s health nonprofit — and then reversed its stance, the WSJ reports. According to social-media monitor NetBase Solutions, Komen-related chatter rose 80% from last Monday to Tuesday, when the story broke, with 66% of online conversations against the breast-cancer advocacy group.
The Toll of Child Abuse: Research published in Pediatrics finds that more children under one year of age are admitted to hospitals for child abuse than for reasons related to sudden infant death syndrome, Time’s Healthland blog reports. Researchers found the death rate from child abuse was 6% in 2006, with 300 deaths of 4,569 hospitalizations.
Under Observation: Medicare beneficiaries not officially admitted to the hospital but who spend time there under “observation care” may be surprised that they owe for hospital co-pays and any subsequent nursing-home care , the WSJ reports. The number of observation hours — considered outpatient care by Medicare — rose to 36 million in 2009 from 23 million in 2006, including a rising number of visits lasting longer than 48 hours, the paper says.
Public-Health Debate: What’s a better way to convey public-health messages about diet, smoking and other lifestyle choices — stark, if harrowing, ads about the consequences of obesity, diabetes and lung cancer, or more positive, empowering messages? As the New York Times reports, there’s a debate about whether some of New York City’s ad campaigns will make an impact, with critics saying the harsher messages won’t resonate with the people who need to hear them most. NYC’s health department says the campaigns reflect the true consequences of diseases.
Image: iStockphoto
The overall economy added 243,000 jobs last month — with the health-care sector continuing to show strength — while the unemployment rate fell to 8.3%.
As the WSJ reports, that’s the lowest the jobless rate has been since Feb. 2009. (Here’s the full report from the Bureau of Labor Statistics.)
The health-care industry added 30,900 jobs in January, following a revised increase of 17,600 jobs the previous month. (Originally the government reported a larger December gain of 22,600 jobs in the sector, as we reported.)
Data from the BLS gives a snapshot of job growth by facility rather than job function. For example, the report shows that hospitals added 12,700 jobs, but doesn’t say whether those were nursing, IT or cafeteria positions.
Ambulatory health-care services added 12,900 jobs as doctors’ offices, outpatient care centers and home-health services all saw growth.
Nursing-care facilities added 2,700 jobs, while the broader category of nursing and residential-care facilities overall gained 5,300 jobs in January.
Image: iStockphoto
It hasn’t been a great week for Susan G. Komen for the Cure, the breast-cancer advocacy group known for its pink-ribbon fundraising efforts.
Today the group reversed a decision — made public only Tuesday — to end Planned Parenthood’s eligibility for grants. Critics had said Komen planned to cut funding to the group for breast exams and education under pressure from anti-abortion organizations; Komen denied that.
In a statement, Komen’s board and its founder and CEO, Nancy Brinker, apologized “to the American public for recent decisions that cast doubt upon our commitment to our mission of saving womens lives.” The statement continues:
The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.
Komen’s short-lived move to defund Planned Parenthood spurred controversy, to put it mildly. Komen’s public rationale for its action changed over the week: A spokeswoman originally told the Associated Press it had changed its criteria to end grants to any organization under government investigation. But later in the week it said the decision sprang from a broader review of its criteria for grantees.
Today it said it would “amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.”
Planned Parenthood is the subject of a congressional investigation.
Komen’s statement continues:
Our only goal for our granting process is to support women and families in the fight against breast cancer. Amending our criteria will ensure that politics has no place in our grant process. We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities.
It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women. We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics — anyones politics.
Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the publics understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.
We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.
Planned Parenthood, in a statement, said it is “enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers. What these past few days have demonstrated is the deep resolve all Americans share in the fight against cancer, and we honor those who are at the helm of this battle.”
So, readers, have the week’s events changed your opinion of Susan G. Komen for the Cure?
Photo: Associated Press
Medical Device Price Gap: A report from the Government Accountability Office finds that some hospitals pay thousands of dollars more than others for the very same medical device, the WSJ reports. The higher prices could affect Medicare spending, since payments to hospitals are in part based on the institutions’ costs, the paper says.
New Malaria-Death Estimate: A new calculation of malaria deaths published in the Lancet is about two times as big as the World Health Organization’s current estimate, the Washington Post reports. The report, which is expected to be controversial, agrees with the WHO that malaria deaths peaked in 2004 and are now on the decline. The two estimates diverge most widely when it comes to deaths in Africans aged five and older.
Nonprofit Controversy Continues: New York City Mayor Michael Bloomberg personally pledged $250,000 in matching funds to Planned Parenthood to make up for monies that will be lost when Susan G. Komen for the Cure stops most grants to the women’s health nonprofit’s affiliates for breast exams and education, the WSJ reports. Both groups say donations are up since Komen’s decision — which it says was prompted by several changes to its standards for grants — was made public earlier this week.
Supplement Ingredient Scrutinized: Dietary supplements containing an ingredient called DMAA are the subject of a safety review by the U.S. Army and have been removed from stores on military bases following the heart-attack deaths of two soldiers during workouts, the New York Times reports. Toxicology reports say DMAA was present in the soldiers when they died, but whether it played a role in the deaths isn’t yet known. Supplement makers and retailer GNC say products containing DMAA are safe, while other experts claim it should be classified as a drug rather than a supplement.
Image: iStockphoto
There are many mysteries when it comes to understanding Alzheimers disease, with one of the biggest questions centering on how the memory-robbing disease progresses.
Decades ago, researchers discovered that the damage starts in the same part of the brain in all patients and systematically moves on to affect nearby regions. It wasnt clear, however, why this progression occurred. One intriguing theory was that the pathology “spreads” between neurons. But for years there wasnt a good way of testing the hypothesis.
Now, two new studies conducted in mice, one published in PLoS ONE and the other in press at Neuron, offer evidence that the damage – specifically the misfolding of a protein called tau – is likely passed from one neuron to another.
The exact mechanism isnt clear, but the researchers believe that somehow a flawed “template” for how tau should be folded gets released by one neuron and picked up by the next one, which then starts misfolding tau based on that new template, says Bradley Hyman, a Harvard neurology professor who is an author of the upcoming Neuron study.
Now, researchers can start figuring out how the errant message gets transmitted and picked up. Interrupting any step of this process could “plausibly” interrupt the progression of the disease, Hyman tells the Health Blog.
The papers have garnered a lot of interest. But some experts urge caution in interpreting the results.
The research “proposes a certain mechanism for tau spreading but that mechanism is unproven at this point, William Thies, chief medical and scientific officer of the Alzheimer’s Association, tells the Health Blog.
Theres a lot of work that needs to be done to clarify whether this is real as well as how the findings could be used to inform therapy, says Thies.
Image: iStockphoto
Tobacco, alcohol … and sugar?
A new commentary published in Nature argues that just as the first two substances are regulated in various ways by government authorities, so should be sugar. While acknowledging that food, unlike alcohol and tobacco, is required for survival, the authors say taxes, zoning ordinances and even age limits for purchasing certain sugar-laden products are all appropriate remedies for what they see as a not-so-sweet problem.
The authors of the piece, Robert Lustig, Laura Schmidt and Claire Brindis, are all from the University of California, San Francisco. Lustig has been a particularly harsh (and longtime) critic of the impact of added sugars on health — here’s his widely viewed 2009 lecture on that topic. (Lustig was also a central character in a New York Times magazine piece on this subject last year.)
Note that they are talking about sugar added to foods. No one is arguing that we should spurn fruit, for example, because of the naturally occurring fructose.
“We believe attention should be turned to ‘added sugar,’ defined as any sweetener containing the molecule fructose that is added to food in processing,” the authors write. (And they argue the current dietary “bogeymen” — saturated fat and salt — deserve less scrutiny than the sweet white stuff.)
They’re talking about foods sweetened with sucrose — about half fructose and half glucose — and high-fructose corn syrup, which despite its name is mostly used in formulations that are 55% and 42% fructose.
The authors write that sugar is more than just empty calories — that growing evidence links fructose overconsumption with health problems including hypertension and diabetes. “Early studies” link it to cancer and cognitive decline, they write. They also argue that like tobacco and alcohol, “it acts on the brain to encourage subsequent intake.”
So, what’s a country to do? The authors propose taxing processed foods containing any kind of added sugars, including drinks and cereal. In addition, they suggest tightening licensing requirements on vending machines and snack bars selling sugary drinks in schools and at work, instituting zoning ordinances to restrict the number of fast-food restaurants and convenience stores in low-income neighborhoods and near schools, and even instituting an age limit for purchasing sugary drinks such as soda.
And they want the FDA to consider removing fructose from the list of ingredients deemed Generally Recognized as Safe. (Douglas Karas, an FDA spokesman, says that step is not currently being considered.)
The Sugar Association, not surprisingly, found a lot to dislike in the commentary. In a response published on its website, the industry group says that USDA stats show people are consuming about 425 more calories per day now than 40 years ago, with caloric sweeteners accounting for about 38 of those calories. Meantime, the group contends that consumption of cane and beet sugar has been falling even as obesity rates have been rising.
“We consider it irresponsible when health professionals use their platforms to instill fear by using words like ‘diabetes,’ ‘cancer,’ and even ‘death,’ without so much as one disclaimer about the fact that the incomplete science being referenced is inconclusive at best,” the association says.
The obesity problem “originates from the combination of overconsumption of all foods and lack of exercise. To label a single food as the one and only problem misinforms, misleads and confuses consumers, and simply adds to the problem,” the association says.
The National Confectioners Association, meantime, said that the group “supports realistic advice to Americans that accommodate all foods including occasional treats in moderation. There is a place for little pleasures, such as candy, in an overall lifestyle that supports health, wellness and happiness. In fact, helping the public understand how to incorporate little pleasures in their diet may well play the most important role in achieving and sustaining recommended dietary behaviors.”
If you do want to keep an eye on your sugar intake, the nutrition facts panel that appears on food packages now does not break out added and naturally-occurring sugars. But you can certainly see how many total grams of sugar you’re consuming.
Image: iStockphoto
Update: This post has been updated with comment from the NCA.
By Louise Radnofsky
The Obama administration is touting good news for seniors from the health-care overhaul law, pointing to $2.1 billion in discounts on prescription drugs for 3.6 million older consumers in 2011.
Part of the law was intended to fill the gap in prescription-drug coverage, the so-called doughnut hole, when Medicare beneficiaries have to to pay up to $4,550 out of pocket for drugs after their costs pass $2,840 for the year.
Under the law, drug companies have to offer discounts on brand-name and generic drugs for Medicare beneficiaries after they reach the gap. Discounts increase annually until 2020, when the hole is supposed to be filled entirely. In 2010, the first year when the discounts were in effect, seniors also got a $250 rebate check if they hit the doughnut hole.
The 2011 discounts — 50% on covered brand-name drugs and 7% on generic drugs — were worth an average of $631 per person who did reach the doughnut hole, the Department of Health and Human Services said.
Democrats have made closing the doughnut hole a priority in recent years and have tried to make the new provision a key element in their appeal to seniors to support the health-care overhaul law.
“Today’s good news is the latest evidence that as we continue to implement the Affordable Care Act, we’re taking the right approach to Medicare,” said Health and Human Services Secretary Kathleen Sebelius.
Blood-sugar-lowering drugs accounted for the largest single share of the discounts, according to the administration’s data.
Image: iStockphoto
The controversy over the defunding of Planned Parenthood affiliates by breast-cancer group Susan G. Komen for the Cure is showing no signs of cooling off.
A spokeswoman for Komen, Leslie Aun, told the Associated Press — which broke the story Tuesday — that the charity was ending its grants to Planned Parenthood affiliates after adopting a policy prohibiting the funding of organizations that are under investigation by government authorities.
That would apply to Planned Parenthood because a Republican congressman, Cliff Stearns, is leading an inquiry into whether the group spent public funds on abortion services, the A.P. says.
Planned Parenthood responded by saying that Komen had caved to pressure from “anti- women’s health political organizations,” and that low-income women in underserved communities stand to be hurt by the end of the grants, which cover breast health education, screenings and referrals for mammograms.
Komen tried to quell criticism with a video, released late yesterday. In it, the group’s founder and CEO, Nancy Brinker, says the decision was the result of a review of the group’s policies and procedures for making grants. “We are working to eliminate duplicative grants, freeing up more dollars for higher-impact programs, and wherever possible we want to grant to the provider that is actually providing the lifesaving mammogram,” she says. The group also added “more stringent eligibility and performance criteria to support these new strategies,” she says.
“We will never turn our backs on the women who need us the most,” Brinker says, calling criticisms of the group’s supposed cave-in to political pressure “scurrilous.”
But the Atlantic’s Jeffrey Goldberg reports today, citing “three sources with direct knowledge of the Komen decision-making process,” that the Komen rule was specifically adopted with Planned Parenthood in mind and that it’s the only organization that has been affected so far.
(We have reached out to Komen for comment, and will tell you if we hear back.)
Goldberg also reports that Mollie Williams, who was until recently managing director of community health programs at Komen, “resigned in protest immediately following the Komen board’s decision to cut off Planned Parenthood.”
Williams had no comment for Goldberg. When we reached out to her, she said via email that she “must honor the confidentiality of my former employer, Susan G. Komen for the Cure, and for this reason, I’m not responding to questions about Komen’s decision to no longer fund Planned Parenthood.”
She added that she believes “it would be a mistake for any organization to bow to political pressure and compromise its mission” and expressed her admiration for both groups.
Planned Parenthood, meantime, raised more than $400,000 online (from more than 6,000 donors) in the 24 hours ending Wednesday, according to Andrea Hagelgans, a spokeswoman for the group. She said the donations will “continue to help expand Planned Parenthood’s critical health care services nationwide, especially those affiliates impacted by the Komen cuts.”
Hagelgans added that the controversy has made more women aware that Planned Parenthood provides breast exams, leading to an increase in scheduled appointments.
Komen has come under fire in the past from anti-abortion groups for its grants to Planned Parenthood. In December a Christian publisher pulled from the market a “Cancer Awareness Bible” because some of the proceeds from the book went to Komen.
Readers, how do you think this will play out in coming days and weeks?
Bonus: Breast Cancer Charity in Bucket of Hot (KFC) Chicken
Photo: Associated Press
As we all gather ’round the Super Bowl snack spread this Sunday, how worried should we be about the health consequences of the party foul known as double dipping?
We tackled that question as part of our “Is It True?” video series here at the Health Blog — you can see the video below.
The WSJ’s Christina Tsuei set out to find if, as Seinfeld’s George Costanza was told by a horrified party guest, that re-dipping a chip after you’ve already taken a bite is “like putting your whole mouth right in the dip.”
The answer is probably not — but it could be compared to sharing a kiss with your fellow dippers, according to an expert she spoke with. (The Health Blog has written about of the research discussed in the video.)
Watch the video and tell us your best strategies for avoiding the double dip.
And look here, here, here, here, here and here for our previous videos, on weight-loss and sleep, giving and health, Thanksgiving dinner and tiredness, smiling and mood, the freshman 15 and melatonin’s effects on sleep.
Have a suggestion for a future video topic? Please email us at healthblog@wsj.com or leave a comment below.
Image: iStockphoto
Birth-Control Recall: Pfizer has recalled about a million packs of birth-control pills on concerns that incorrect packaging could lead to unplanned pregnancies, but says it believes only 30 packs actually had the troublesome glitches, the WSJ reports. Pfizer has identified three production problems that could permit pills to be placed incorrectly in the packs and go undetected. It’s not clear how many pills have already been used and how many are still in medicine cabinets, the paper says.
Regulating Sugar?: A commentary published in Nature calls for sugar added to foods to be regulated, using the taxes and limited availability of tobacco and alcohol as a model, WebMD reports. Commentary author Robert Lustig, of the University of California, San Francisco, says excess sugar is linked to health problems, while the Sugar Association disputes that sugar intake causes disease. The FDA says it is not reconsidering sugar’s current regulatory status as a “generally recognized as safe” product, WebMD reports.
Device Pact: Medical-device firms will pay the FDA $595 million over five years under the tentative terms of a new user-fee agreement, the WSJ reports. The FDA will add more full-time employees to consider medical-device applications and will have concrete goals for approval times, the paper says.
Surgery Risk Suggested: Research published in Mayo Clinic Proceedings suggests that children who undergo two or more surgeries by the age of two are more likely to develop ADHD in the future compared to children who experience one operation, possibly because of the effects of general anesthesia on the developing brain, Time’s Healthland blog reports. The study cannot prove that anesthesia causes the future problems, however, and a study author says that the benefits of surgery for infants usually outweigh any potential risk, Time says.
Image: iStockphoto
Why get a massage? Well, because it feels good, for one thing. But many people also hop on the table with the hope that massage therapy can help promote muscle recovery after a tough workout or provide other benefits.
No one has looked closely at what massage does to muscle at a cellular or molecular level, however. Researchers set out to do just that, and their findings are published in Science Translational Medicine.
The researchers exercised 11 young men to exhaustion over about 70 minutes, then massaged a single leg (determined randomly for each man) for ten minutes. The subjects received a muscle biopsy in both quad muscles to gather samples for massaged and non-massaged legs. The biopsy was repeated after a 2.5-hour rest period.
Researchers analyzed the samples from the different legs to see what was going on after the massage. They found two major changes: reduced signs of inflammation, and an increase in production of mitochondria, the cell’s energy factories.
Curbed production of inflammatory molecules “may reduce pain by the same mechanism as conventional anti-inflammatory drugs” like aspirin and ibuprofen, the authors write.
The authors say that an increase in the number of mitochondria can promote better recovery after a tough exercise session. That finding also means that massage after exercise could help enhance endurance, says Mark Tarnopolsky, an author of the study and a professor of pediatrics and medicine at McMaster University Medical Center in Hamilton, Ont. Nailing down that link would require further research, says Tarnopolsky.
The study didn’t turn up any signs that massage flushes out lactic acid from the muscle, he says.
Image: iStockphoto
Here at Health Blog headquarters, weve been intrigued by the career of John Johnson ever since he left a company called Johnson & Johnson.
That was back in 2007, when he became CEO of ImClone Systems, which was eventually acquired by Eli Lilly.
Today, Johnson, who is 53, was named president, chief executive and chairman-elect of Dendreon, succeeding 43-year-old Mitch Gold, who remains executive chairman until June 30. Gold has been CEO for nearly a decade. (Here’s the WSJ story.)
In an interview with the Health Blog, the two men described the move as a natural transition as Dendreon, which sells the prostate treatment Provenge, seeks to morph from a company that was focused on getting its first drug to market to one commercializing a product for a global market.
“Were right at that cusp in the evolution of a company where you have to step outside the way youve operated,” says Johnson, who has been a Dendreon board member for about six months.
He takes over as the company is trying to regain traction after missing ambitious sales targets for Provenge in last years second half by a wide margin. The company partly blamed physician uncertainty around reimbursement for the $93,000 treatment, an issue it says is now essentially resolved.
Johnson says his top two priorities in his new post are to increase prescribing of Provenge by oncologists and urologists in the U.S. and to cut the cost of producing the treatment. Provenge, given in three separate infusions, works by prompting the bodys immune system to fight prostate tumors. It uses a patients own cells, which are shipped for processing at one of three manufacturing facilities and then returned to the patients doctor for infusion.
The treatments complexity and, some analysts believe, its hefty price have also affected adoption of Provenge. We asked Johnson if achieving lower production costs might lead to a price reduction.
“I havent dug into the sensitivity to the price and what physicans reactions are,” he says. He plans to meet with doctors at a cancer meeting in San Francisco during the next couple of days “to understand whats going through their minds and what we can do to help.”
Dendreon may also have to contend with an increasingly competitive market for treatments for advanced prostate cancer, including a drug being developed by Medivation called MDV3100. Researchers released data Tuesday showing the pill extended survival in such patients and it could be on the market as soon as later this year.
Gold says he considers the data good news for Dendreon because he believes the drugs will be used in combination. “Thats going to result in a [better] overall survival benefit,” he says.
Johnson said he also plans to ramp up efforts to get Provenge on the market in Europe, which could happen beginning next year if it’s approved by regulators there.
Dendreon shares were up more than 6% to $14.43 in early afternoon trading.
Photo: Bloomberg News
The simple act of putting photos of green beans and carrots in cafeteria-tray compartments sparked increased consumption among elementary-school students, according to a small study that suggests one more potential avenue for getting kids to eat their veggies.
A research letter published online in the Journal of the American Medical Association describes the experiment, which took place at a Minnesota school cafeteria serving kindergartners through fifth graders. Researchers from the University of Minnesota compared carrot and green-bean consumption on a control day — with the usual cafeteria trays — to consumption on a day in which photographs of the two veggies were placed in tray compartments.
Researchers weighed all the uneaten vegetables left in the containers and even on cafeteria tables and on the floor in order to get an accurate gauge of consumption.
“You don’t just want them to take the food, you want them to eat it,” says Traci Mann, an associate professor of psychology at the University of Minnesota and an author of the study.
The photographs were associated with a bump in the percentage of kids taking green beans — from 6.3% to 14.8% — and of carrots — from 11.6% to 36.8%, the study found. The average amount of green beans eaten by students who took them didn’t change between the non-photo and photo days, and the average amount of carrots eaten fell slightly.
But because so many more kids took the veggies, more carrots and beans were consumed overall, she says.
Mann cautions that the kids still weren’t eating a ton of vegetables and that this type of intervention needs to be shown to work over a longer time period. The novelty of the photos might wear off, she says. “On the other hand, getting kids to even eat a few bites” of vegetables can help kids develop a taste for them over time, she says.
The researchers think this worked because seeing the photos in the compartments gives kids the impression that “this must be where everyone puts their vegetables,” and that everyone is eating them, says Mann. Kids don’t want to be told what to do, but they’re sensitive to what they think is the norm, she says.
Prepping the trays cost about $3 and took 20 minutes per 100 trays, the study says.
Schools will have to offer students more fruits, veggies and whole grains in lunches as part of new USDA rules announced last month.
“Getting kids to eat vegetables is the hardest thing in nutrition,” says Mann.
Image: iStockphoto
Prostate-Cancer Drug Studies: The results from two trials of experimental drugs for advanced prostate cancer add to recent progress against the disease, the WSJ reports. Medivation’s MDV3100 extended survival by nearly five months in a 1,199-patient study, while Bayer and Algeta’s Alpharadin, which homes in on cancer that has already spread to the bone, boosted survival by almost three months in a 922-patient study, the paper reports.
No Consensus on Repeat Breast-Cancer Surgery: Rates of repeat lumpectomies vary widely from doctor to doctor, according to a study published in JAMA, and averaged 22.9%, the New York Times reports. There is no broad agreement on when a second surgery — intended to make sure all cancer has been excised — is necessary. The study found that almost half of the repeat surgeries were in women whose lab reports showed no cancer had been left behind, while 14% of patients who did have some remaining traces of cancer did not receive a follow-up surgery to remove it, the NYT reports.
Birth-Control Recall: Pfizer is recalling about a million blister packs of birth-control pills because of packaging errors, including in some cases a lack of enough active tablets to prevent pregnancy, Time’s Healthland blog reports. Pfizer says 14 lots of Lo/Ovral-28 tablets and 14 lots of generic Norgestrel and Ethinyl Estradiol tablets with expiration dates ranging from July 31, 2013, to March 31, 2014 were affected, and that women who have been taking the pills should use back-up, non-hormonal birth control, Time says.
Grants Are Cut Off: Susan G. Komen For the Cure is ceasing hundreds of thousands of dollars in grants to Planned Parenthood affiliates for activities including breast exams and breast-cancer education, the WSJ reports. Komen said in a statement that had “implemented more stringent eligibility and performance criteria” for its grant programs. Planned Parenthood, which is being investigated by a Republican member of Congress about its compliance with federal restrictions on funding abortion, says Komen “appears to have succumbed to political pressure.” The Associated Press first reported Komen’s move.
Image: iStockphoto
Certain cystic-fibrosis patients will now have an FDA-approved treatment that targets an underlying cause of their disease.
But that drug — Kalydeco, from Vertex Pharmaceuticals — won’t come cheap.
As Dow Jones Newswires reports, the annual cost will be $294,000. Vertex has set up a patient-assistance program to help patients pay for the treatment.
Kalydeco was approved to treat the estimated 4% of cystic-fibrosis patients who have a mutation called G551D in a certain gene responsible for the disease. About 1,200 people in the U.S. have that mutation, DJN says.
Kalydeco was approved for use only in patients aged six and up; Vertex is planning to study the drug in younger children. The company is also studying the drug in cystic-fibrosis patients with different mutations and in combination with other medications.
As the WSJ reported in the fall, progress in drug development for cystic fibrosis has come more than 20 years after the gene responsible for the disease was identified, in 1989. Pinpointing the gene was only one step. Scientists had to come up with a hypothesis as to how the defective gene actually causes the disease, then devise a way to address the problem. As the paper reported:
The gene makes the channels that carry chloride in cells up to airways, where it’s needed for clearing mucus that builds up, some scientists believe. Mutations impede the flow of chloride, causing the mucus to accumulate and impeding the hair-like particles called cilia from beating back and forth to clear out the mucus.
Attempts to use gene therapy to replace the mutated gene didn’t pan out, so researchers have instead turned to drugs to help chloride to reach the airways.
Other companies, including PTC Therapeutics, have experimental therapies at various stages of the development pipeline.
The median lifespan for cystic-fibrosis patients has risen over the years thanks to aggressive treatments addressing the disease’s symptoms. But most will still not live beyond their 30s and 40s.
Bonus: Not Just a Cheerleader: Foundation Helped Drive Cystic-Fibrosis Research
Correction: An earlier version of this post gave the incorrect number of U.S. patients with the mutation.
Image: Brett Deering for the WSJ