New study firmly ties hormone use to breast cancer

SAN ANTONIO (AP) - Taking menopause hormones for five years doubles the risk for breast cancer, according to a new analysis of a big federal study that reveals the most dramatic evidence yet of the dangers of these still-popular pills.
Even women who took estrogen and progestin pills for as little as a couple of years had a greater chance of getting cancer. And when they stopped taking them, their odds quickly improved, returning to a normal risk level roughly two years after quitting.

Collectively, these new findings are likely to end any doubt that the risks outweigh the benefits for most women.

It is clear that breast cancer rates plunged in recent years mainly because millions of women quit hormone therapy and fewer newly menopausal women started on it, said the study's leader, Dr. Rowan Chlebowski of Harbor-UCLA Medical Center in Los Angeles.

"It's an excellent message for women: You can still diminish risk (by quitting), even if you've been on hormones for a long time," said Dr. Claudine Isaacs of Georgetown University's Lombardi Comprehensive Cancer Center. "It's not like smoking where you have to wait 10 or 15 years for the risk to come down."

Study results were given Saturday at the San Antonio Breast Cancer Symposium.

They are from the Women's Health Initiative, which tested estrogen and progestin pills that doctors long believed would prevent heart disease, bone loss and many other problems in women after menopause. The main part of the study was stopped in 2002 when researchers saw surprisingly higher risks of heart problems and breast cancer in hormone users.

Since then, experts have debated whether these risks apply to women who start on hormones when they enter menopause, usually in their 50s, and take them for shorter periods of time. Most of the women in the federal study were in their 60s and well past menopause.

So the advice has been to use hormones only if symptoms like hot flashes are severe, and at the lowest dose and shortest time possible. The new study sharpens that message, Chlebowski said.

"It does change the balance" on whether to start on treatment at all, he said.

Even so, most women will not get breast cancer by taking the pills short-term. The increased cancer risk from a couple of years of hormone use translates to a few extra cases of breast cancer a year for every 1,000 women on hormones. This risk accumulates with each year of use, though.

The Women's Health Initiative study had two parts. In one, 16,608 women closely matched for age, weight and other health factors were randomly assigned to take either Wyeth Pharmaceuticals' Prempro - estrogen and progestin - or dummy pills.

This part was halted when researchers saw a 26% higher risk of breast cancer in those on Prempro.

But that was an average over the 5½ years women were on the pills. For the new study, researchers tracked 15,387 of these women through July 2005, and plotted breast cancer cases as they occurred over time.

They saw a clear trend: Risk rose with the start of use, peaked when the study ended and fell as nearly all hormone users stopped taking their pills. At the peak, the breast cancer risk for pill takers was twice that of the others.

Think of it as President Bush's public approval rating, said another study leader, Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston.

"Bush's popularity may be 50% on average, but it might have been descending the whole time he was president," Ravdin said.

In the second part of the federal study, researchers observed just 16,121 women who had already been on hormones for an average of seven years and another group of 25,328 women who had never used them. No results on breast cancer risk in these women have been given until now.

Plotting cases over time, researchers saw in retrospect that hormone users had started out with twice the risk of breast cancer as the others, and it fell as use declined. Among those taking hormones at the start of the study, use dropped to 41% in 2003, the year after the main results made news.

In the general population, use of hormone products has dropped 70% since the study, said another of its leaders, Dr. JoAnn Manson, preventive medicine chief at Harvard's Brigham and Women's Hospital in Boston.

That corresponds with big drops in breast cancer cases, but some scientists have said this could be due to a fall-off in mammograms, which would mean fewer cancers were being detected, not necessarily that fewer were occurring.

The new study puts that theory to rest. Mammography rates were virtually the same among those taking hormones and those not.

"It is clear that changing mammography patterns cannot explain the dramatic reductions in breast cancer risk," Manson said.

"The data are getting stronger," said Dr. C. Kent Osborne, a breast cancer specialist at Baylor College of Medicine in Houston.

Women who do need the pills should not panic, though the doubling of risk - a 200% increase - for long-term users is quite worrisome, cancer specialists say. Although the new study does not calculate risks in terms of actual cases, previous research showed that the average increased risk of 26% meant a difference of a few extra cases a year for every 1,000 women on hormone pills, compared with nonusers.

"Hormone therapy remains a good health care choice to relieve moderate to severe menopausal symptoms," says a statement from Wyeth, which made the pills used in the study.

"Most women should be able to discontinue hormones in three to four years," or at least reduce their dose, Manson said.

A future analysis will look at other women in the study who took only estrogen, generally women who have had hysterectomies.

 romeotuma wrote: 
I can still remember my kids' names, so it must work for me!

 romeotuma wrote: 
sorry I reread your post.  I'm gonna look more at the book. 

 meower wrote:  

I never said white noise is a cause— I said it was a major contributor to triggering autism...  things like autism are so complex that it is unlikely there is a single cause, but a complex combination of factors... here, I will quote directly from a hard copy of the book—

During the critical period BDNF turns on the nucleus basalis, the part of our brain that allows us to focus our attention — and keeps it on, throughout the entire critical period...

Merzenich's work on the critical period and BDNF helped him develop a theory that explains how so many different problems could be part of a single autistic whole.  During the critical period, he argues, some situations overexcite the neurons in children who have genes that predispose them to autism, leading to the massive, premature release of BDNF.  Instead of important connections being reinforced, all connections are.  So much BDNF is released that it turns off the critical period prematurely, sealing all these connection in place, and the child is left with scores of undifferentiated brain maps and hence pervasive developmental disorders.  Their brains are hyperexcitable and hypersensitive.  If they hear one frequency, the whole auditory cortex starts firing...

If the BDNF release was contributing to autism and language problems, Merzenich needed to understand what might cause young neurons to get "over excited" and release massive amounts of the chemical.  Several studies alerted him to how an environmental factor might contribute.  One disturbing study showed that the closer children lived to the noisy airport in Frankfurt, Germany, the lower their intelligence was.  A similar study on children in public housing high-rises above the Dan Ryan Expressway in Chicago, found that the closer their floor was to the highway, the lower their intelligence...

White noise consists of many frequencies and is very stimulating to the auditory cortex.

 romeotuma wrote: 
i skimmed it, and will look more intently later, but it seems to me that this guy isnt saying that white noise is a cause of autism (and I didnt see anything about lower IQ's of kids) but that white noise is a factor in why it is hard  for these kids to process language. 
Big Difference no?

 meower wrote: 

Sure...  here's the best reference to it online that I can find—

from The Brain That Changes Itself by Norman Doidge which is also available at the RP link to Amazon...

 romeotuma wrote: 
can you cite this please?  thanx 

 romeotuma wrote: 
Scientific studies have shown that they can make great strides with children with autism/retardation by starting to work with them at birth. It's a wonderful breakthrough.

Silencing growth inhibitors could help recovery from brain injury...

Silencing natural growth inhibitors may make it possible to regenerate nerves damaged by brain or spinal cord injury, finds a study from Children's Hospital Boston. In a mouse study published in the November 7 issue of Science, researchers temporarily silenced genes that prevent mature neurons from regenerating, and caused them to recover and re-grow vigorously after damage.

Because injured neurons cannot regenerate, there is currently no treatment for spinal cord or brain injury, says Zhigang He, PhD, Associate Professor of Neurology at Children's and senior author on the paper. Previous studies that looked at removing inhibitory molecules from the neurons' environment, including some from He's own lab, have found only modest effects on nerve recovery. But now He's team, in collaboration with Mustafa Sahin, MD, PhD, Assistant Professor of Neurology at Children's, demonstrates that re-growth is primarily regulated from within the cells themselves.

"We knew that on completion of development, cells stop growing due to genetic mechanisms that prevent overgrowth," explains He. "We thought that this kind of mechanism might also prevent regeneration after injury."

The key pathway for controlling cell growth in neurons, known as the mTOR pathway, is active in cells during development, but is substantially down-regulated once neurons have matured. Moreover, upon injury, this pathway is almost completely silenced, presumably for the cell to conserve energy to survive. He and colleagues reasoned that preventing this down-regulation might allow regeneration to occur.

He and his team used genetic techniques to delete two key inhibitory regulators of the mTOR pathway, known as PTEN and TSC1, in the brain cells of mice. After two weeks, the mice were subjected to mechanical damage of the optic nerve. Two weeks post-injury, up to 50 percent of injured neurons in the mice with gene deletions of PTEN or TSC1 survived, compared to about 20 percent of those without the deletions. And of the surviving mutant mice, up to 10 percent showed significant re-growth of axons, the fiber-like projections of neurons that transmit signals, over long distances. This re-growth increased over time.

Although this study used genetic techniques, He notes that it may be possible to accomplish the same re-growth through pharmacologic means. "This is the first time it has been possible to see such significant regeneration by manipulating single molecules," says He. "We believe that these findings have opened up the possibility for making small-molecule drugs or developing other approaches to promote axon regeneration."

While such long-distance regeneration of axons has not been seen before using other techniques, it is still unknown whether these regenerating axons can restore function, He adds.  The research group is now looking at axon regeneration after spinal cord injury and given the current availability of specific PTEN inhibitors, the researchers hope that these and similar small-molecule inhibitors of the mTOR pathway will lead to future neural regeneration therapies.

Source: Children's Hospital Boston

Pruritus is an itch or a sensation that makes a person want to scratch.

Pruritus can cause discomfort and be frustrating. If it is severe, it can lead to sleeplessness, anxiety, and depression. The exact cause of an itch is unknown. It is a complex process involving nerves that respond to certain chemicals like histamine that are released in the skin, and the processing of nerve signals in the brain. Pruritus can be a part of skin diseases, internal disorders, or due to faulty processing of the itch sensation within the nervous system.

Who gets pruritus?

There are many skin diseases like urticaria (hives), varicella (chicken pox), and eczema which may have itching associated with a rash. Some skin conditions only have symptoms of pruritus without having an obvious rash. Dry skin can itch, especially in the winter, with no visual signs of a rash.  Some parasitic infestations such as scabies and lice may be very itchy. Itchy, pigmented moles may be a sign of a malignant change.  Pruritus may be a manifestation of an internal condition. The most common example is kidney failure. Some types of liver disease like hepatitis, thyroid disease including both hyper (too much) and hypo (too little) thyroid hormone levels, some blood disorders such as lymphomas, iron deficiency anemia, polycythemia vera, multiple myeloma, and neurologic conditions such as pinched nerves and post herpetic neuralgia can cause itch. Infectious diseases like HIV can cause severe itching.

How is pruritus diagnosed and treated?

Often the dermatologist will be able to diagnose these conditions with an examination; however, to determine a specific cause of the itch, a blood test, skin scraping, or biopsy may be needed to help make the diagnosis. If the itch is due to a skin disease such as hives or eczema, treatment of the skin disease, itself, with prescription topical medications and/or oral antihistamines generally relieves the itch. If the itch is secondary to an internal disease, patients may require treatment of the disease, oral medication, or occasionally ultraviolet light therapy to relieve the itch.

Sometimes, the dermatologist will prescribe a cooling topical lotion or cream and/or an oral medication to relieve the itch.Pruritus is often disrupting and difficult to control but usually responds well to treatment. While a specific identifying cause for the itch may not be found, an appropriate work-up to exclude internal disease should be completed.

Although there are many causes for pruritus, some basics apply to most treatments:

When bathing or showering, use tepid or lukewarm water.
Use mild cleansers with low pH.
Rinse soap film off completely, pat the skin lightly, and immediately apply a moisturizing lotion or cream after bathing.
Wear light, loose clothing.
A cool work or domestic environment can help reduce the severity of itching.
For itchy conditions where blistering or weeping of the skin is present, such as chicken pox or poison ivy, a cool oatmeal bath or topical drying agents such as calamine lotion can be helpful.

To learn more about pruritus, call toll free (888) 462-DERM (3376) to find a dermatologist in your area.

Here is something to be very excited about—

doctors have come up with a possible cure for type 1 diabetes...  it is a combination of two cancer drugs— "The drugs - imatinib (marketed as Gleevec) and sunitinib (marketed as Sutent) - were found to put type 1 diabetes into remission in 80 percent of the test mice and work permanently in 80 percent of those that go into remission."

They show that remission to be permanent, which basically means it is a cure...  this treatment could be available to humans as soon as a year from now...  if you know any people with type 1 diabetes, pass on this data to them so they can research it...

 

NYT Editorial

Who Should Take a Statin?
Published: November 17, 2008

A large new study seems to suggest that millions of people with low cholesterol could benefit from taking the cholesterol-lowering drugs known as statins. That would be a boon for some drug companies, but whether it would be good for all patients remains an open question.  The study, led by researchers at Brigham and Women's Hospital in Boston, involved some 17,800 patients with normal or low levels of the bad form of cholesterol but high levels of C-reactive protein, or CRP, which is often a measure of inflammation in artery walls. Half were given the statin Crestor, made by AstraZeneca; the other half received a placebo.

The benefits of the statin were so striking that a monitoring board stopped the trial in midcourse so that the placebo group could get the medicine, too. Those who got the statin had 54 percent fewer heart attacks, 48 percent fewer strokes and 20 percent fewer deaths from all causes. The participants included men 50 and older and women 60 and older with no history of heart disease or high cholesterol. But they all had high levels of CRP, and many had such other risk factors as high blood pressure, obesity and smoking. Whether the statin helped because it reduced normal cholesterol to even lower levels or because it reduced CRP levels is not clear.

Some 16 million to 20 million Americans take statins to reduce bad cholesterol, but some experts believe the new study suggests several million more should probably take statins as well.  Before rushing ahead it will be crucial to establish who might really benefit. An editorial in The New England Journal of Medicine, where the study was published, stresses the importance of establishing the long-term safety of drastically lowering cholesterol levels before committing patients who have no clinical signs of disease to decades of drug treatment. Participants who took Crestor also had a worrisome increase in diabetes.

The results must also be evaluated in the light of two potential conflicts of interest. The lead investigator stands to benefit from a patent involving the use of CRP to evaluate the risk of cardiovascular disease, and AstraZeneca financed the study whose results it is now trumpeting as "dramatic."  Given that half of all heart attacks and strokes occur in people whose cholesterol is not considered high, it seems likely that there is a group of people with normal cholesterol who could benefit by taking statins. The task ahead for the writers of medical guidelines is to define just who those people might be.

NoEnzLefttoSplit wrote:
heh...

 triskele wrote: 
Slabby, log on under your own name goddam

Coaxial wrote:
hmmm... that sounds EXACTLY like ME during p.m.s.  Especially #4 and #7.

Specifically, the dissocial personality disorder is described by the World Health Organization by the following criteria:

1. Callous unconcern for the feelings of others and lack of the capacity for empathy.
2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
3. Incapacity to maintain enduring relationships.
4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
5. Incapacity to experience guilt and to profit from experience, particularly punishment.
6. Marked proneness to blame others or to offer plausible rationalizations for the behavior bringing the subject into conflict.
7. Persistent irritability.

 JrzyTmata wrote: 
The previous post made it totally crazy with laughter.

 Servo wrote: 
actually we're pretty worried about you Servo.

Coaxial wrote:
that smiley looks crazy. or something.