Monthly Archives: September 2009

Hidden Signs of Progress Against Cancer

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Millions of dollars are funneled into the war on cancer every year. Furthermore, cancer research has been a top category of medical research for decades. Yet, for all that time and money, many question whether or not we’ve made any sort of progress whatsoever.

Indeed, news publications are quick to point out that death rates related to cancer have remained relatively stable. However, experts point to several hidden factors that suggest cancer researchers have made considerable gains in cancer treatment.

Cancer is presently the second leading cause of deaths in America, right behind heart disease. Skeptics of the cancer research movement often point out that dramatic strides have been made in death rates related to heart disease. Why not are these same strides being seen in cancer death rates? Well, the sheer fact that people are more regularly beating heart disease could be one contributor.

As Harvard Associate Professor Deborah Schrag explains: ” “If heart disease goes down by 50% or 60%, people are living longer, and they will die of other things, and those other things often are cancer.”

Additionally, signs of improvement begin to manifest when looking at the short-term. The American Cancer Society notes that overall cancer rates have fallen since the early 1990s (when overall cancer mortalities peaked). This, they argue, shows that concerted cancer-fighting efforts have slowed and begun to reverse the previously ever-rising annual death rates associated with the disease.

Optimists also point to figures that show that sufferers are routinely dying at older ages than previous generations. So, while individuals may ultimately succumb to their illness, this indicates that cancer treatments are prolonging life considerably.

Numbers are also often skewed due to the aging U.S. population. Simply put, more senior citizens equals more cancer patients. This aging patient base often clouds out major advances seen in younger patients. For example, cancer deaths among individuals in their 40s dropped by 35 percent between the periods of 1925 and 1964.

If cancer death rates are weighted by age range, then the data reveals that cancer rates have been decreasing since the 1960s.

While measuring the actual success of cancer research over time is difficult, if not impossible, digging through the data ultimately reveals that significant victories have been won in the war on cancer. Still, the majority of cancer researchers will admit that they would have liked to see more pronounced improvements over the long-term.

Resources:

http://online.wsj.com/article/SB125185000130377889.html?mod=rss_Health

http://blogs.wsj.com/health/2009/09/02/finding-good-news-in-the-numbers-on-cancer-deaths/

Fatal Occupational Injuries Decline 10 Percent in 2008

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The U.S. Bureau of Labor Statistics has just released a slew of intriguing data pertaining to 2008 work-related deaths. Overall, the news is good, with a full 10 percent decrease in workplace fatalities when compared to 2007 figures. Furthermore, 2008 occupational deaths (5,071 in total) register as the smallest annual preliminary total for any year since the BLS began recording such data in 1992.

Why did the U.S. see such a dramatic drop in workplace fatalities? At first glance, one might hypothesize that the high rate of unemployment witnessed in 2008 may have played a part. After all, if people are not working as much, they are also not being placed in as many hazardous work situations.

However, when comparing fatality rate of full-time workers, the BLS also reports a significant drop – 3.6 deaths per 100,000 workers in 2008 as opposed to 4.0 deaths per 100,000 workers in 2007.

Still, industries in which worker safety is generally an issue (construction, mining, etc.) have experienced larger drops in hours of employment than other sectors. Such a shift may have diminished the number of potentially dangerous work situations over all.

Additionally, the downturn in the economy has also resulted in smaller staffs at government agencies. This means that short-staffed agencies such as the Census of Fatal Occupational Injuries may be backlogged with processing of documents related to workplace statistics. Again, the 2008 figures are only preliminary findings, and may be updated in the future.

Regardless of cause, the report is good news for the U.S. economy as a whole. Additional stats gleaned from the report include:

  • Workplace suicides rose 28 percent (251 total cases)
  • Workplace homicides declined 18 percent
  • Industries in which fatal injuries rose for 2008 include farming, fishing and forestry
  • 16 percent of all 2008 workplace fatalities involved a foreign-born employee
  • Men accounted for 93 percent of all workplace-related deaths
  • Fatal workplace falls across all industries diminished by 20 percent
  • Injuries among the private construction sector dropped by 20 percent

Resources:

http://economix.blogs.nytimes.com/2009/08/31/why-did-workplace-deaths-fall-in-2008/

http://www.bls.gov/news.release/cfoi.nr0.htm

http://www.reliableplant.com/article.aspx?articleid=19554&pagetitle=Report+shows+workplace+fatalities+decreased+substantially

Kenney to Get Roof Repair, Asbestos Remediation

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On August 3, work began on the roof of the Dennis M. Kenney Middle School as part of a construction project approved in January by Hannibal Central School District (HCSD) voters.

The school, located in Hannibal, New York, serves 505 students in grades 6 through 8, and is the only middle school in the district. Like many schools in the nation, it faces the need to renovate aging buildings, not merely to accommodate greater numbers of students but also to prevent buildings from falling into disrepair and presenting a danger to students, teachers and other staff.

This particular repair is aimed at a leaky roof on the older portion of the building, and is estimated to take about three weeks, according to HCSD District Superintendent Michael DiFabio.

The repairs and asbestos abatement will begin with a small, newer section toward the north end of the building, which does not require asbestos abatement. During the second week, however, workers will be doing double shifts on older roof portions for the first six days in order to complete the remediation before students and teachers return to school.

This secondary phase will accomplish asbestos abatement during the first shift, from 1 a.m. through 7 a.m. (Eastern Time), and roof replacement during the second shift, from 7 a.m. to 3 p.m. According to DiFabio, this allows the building to remain watertight during the remediation and repair.

Fabio has assured nearby residents that every effort will be made, during the pre-dawn hours, to keep lighting glare to a minimum and reduce the noise from the generator being used to run the lighting.

Asbestos remediation in older school buildings is often done during the summer months because this insures the safety of students and faculty. Improper, accidental or poorly managed asbestos remediation can lead to the spread of asbestos fibers and the potential for a number of asbestos-related diseases like asbestosis, lung and digestive system cancers, and mesothelioma.

Asbestosis is a respiratory disease that usually results from prolonged exposure to asbestos, and causes increased difficulty breathing and general debilitation. Lung and digestive system cancers caused by asbestos fibers are often treatable with either surgery or combination therapies. Mesothelioma, however, is rarely treatable because its long period of dormancy (up to five decades) allows tumors to become so advanced they frequently affect vital organs.

Most patients with advanced mesothelioma are commonly given from a year to 18 months to live.

http://www.syracuse.com/news/index.ssf/2009/08/roof_repairs_including_asbesto.html

http://www.hannibal.cnyric.org/Acrobat%20docs/NR%20–%20Start%20of%20KMS%20Roof%20Project%208-09.pdf

http://www.hannibal.cnyric.org/C4E%20Page.htm

http://www.greatschools.net/modperl/browse_school/ny/1073

FDA Outlines New Rules Intended to Improve Access to Experimental Drugs

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The U.S. Food and Drug Administration (FDA) has announced two new rules related to experimental drug access. The goal of these rules is to clarify existing regulations and provide access of experimental drugs to a broader group of patients.

Until now, the only clear way to access experimental drugs was to take part in a clinical trial. While participation in a clinical trial was not mandatory, FDA regulations outside of the trial system have been muddy and a constant hurdle for those suffering from potentially fatal illnesses.

The first new regulation intends to clarify these rules so that individual patients and small patient groups have improved access to experimental drugs.

Experimental drugs are defined as those that are still in the process of being approved by the FDA. Clinical trials are a key component of approval, and serve to indicate the safety and expected results of new drugs. Typically, they are only available to individuals with serious, life-threatening illnesses, such as cancer and HIV/AIDS.

The second new regulation pertains to the ability for pharmaceutical companies to charge for experimental drugs. As Dr. Janet Woodcock, director of the FDA Center for Drug Evaluation and Research, explains: “Making these drugs available outside of a clinical trial can be costly to manufacturers. By permitting charging for expanded access we hope to stimulate more companies to provide investigational drugs.”

It should be noted that the FDA does not intend to allow a cost charge for all experimental drugs administered outside of clinical trials. Rather, the pharmaceutical company must provide financial data that indicates drug administration would only be feasible with some form of fee attached to the drug.

Regardless of payment approval, the FDA confirmed that drug manufacturers are not allowed to turn a profit off of experimental drugs.

Resources:

http://online.wsj.com/article/SB125009914220626473.html

http://health.usnews.com/articles/health/healthday/2009/08/12/fda-details-access-to-investigational-drugs.html

Nanoparticles Linked to Lung Disease in Seven Chinese Workers

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Seven female employees of a polyacrylic coating facility in Beijing, China have been diagnosed with severe lung disease. The root cause, as described in a case report published in the European Respiratory Journal, is inhaled nanoparticles present in the polystyrene boards that the women worked with on a daily basis.

All seven women were admitted to the hospital between January 2007 and April 2008 for shortness of breath. Lab tests confirmed a myriad of other side effects, including hypoxemia (low oxygen saturation in the blood), severe skin rash from constant itching and fluid in the thoracic cavity and heart. These symptoms proved life threatening, and two of the seven workers eventually died from their illness.

A myriad of medical tests eventually found the presence of nanoparticles (30 nm in diameter) present in each worker’s lungs. Toxic chemicals the women frequently worked with include n-butyl ester, di-tert-butyl peroxide, butonic acid and toluene.

Some experts hypothesize that the workers’ exposure could have been avoided had the Chinese plant installed proper ventilation systems and personal protective equipment had been provided.

Nanoparticles are particles less than 100 nanometers in diameter. Frequently, they are chemically altered compounds used to improve the properties of consumer products. For example, titanium oxide is used in sunscreen to improve transparency.

The topic of nanoparticles has been a heated source of debate recently. While the use of such particles has the potential to greatly improve a wide range of products, their long-term effects on human health have only just begun to be researched.

In previous studies, researchers have expressed concern for the ability of nanoparticles to behave much like asbestos fibers when inhaled. Asbestos is a naturally occurring fiber that, when breathed in, becomes lodged in the lungs. Asbestos is the sole known cause for mesothelioma, a rare type of lung cancer.

Resource:

http://thepumphandle.wordpress.com/2009/08/21/case-report-nanoparticles-in-workers-lungs/#more-6273

Senate Introduces Bill to Amend Occupational Safety and Health Act of 1970

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Senate Majority Leader Harry Reid introduced a bill to amend the Occupational Safety and Health (OSH) Act of 1970. The bill, marked as S. 1580 and backed by Senator Edward Kennedy, seeks to expand the power of OSHA. Major changes that would result from the bill’s approval include:

  • An expansion of OSHA protection to public sector workers – presently, 8.5 million government workers are not covered by an OSHA State Plan
  • Improving protection for whistleblowers and restructuring administrative procedures related to whistleblower investigations
  • Bolstering rights and access to information for workers injured on the job (as well as their family members)
  • Raising civil penalties and adding inflation adjustments to those who violate OSHA laws
  • Redefining criteria for criminal violations

The bill is strongly backed by those advocating legislation geared towards reducing work-related injuries, illnesses and deaths. In the Senate itself, support comes largely from liberals, with 20 cosponsors (19 Democrats a one Independent) presently backing the bill.

Bill S. 1580 is presently the only OSHA-related bill being circulated in the Senate. However, several work-related safety bills are currently being introduced in the House of Representatives. These bills are varied, and pertain to similar topics, including whistleblowers, how companies report injuries and illnesses and mandatory inspection reporting to OSHA from large firms. More mesothelioma news.

Cancer Death Rates on the Decline

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According to new research, cancer death rates have been on the decline since the 1950s. The report, which was published in Cancer Research, concludes that improvements in cancer treatment have been especially beneficial for children and young adults. More recently, cancer death rates among adults have also shown significant improvements.

According to Dr. Eric Kort, lead author of the study, “older Americans have only experienced decreased [cancer] mortality very recently, but younger Americans have been seeing benefits for a long time so, as a result, everyone born in the last 60 years has been reaping the benefits of efforts in prevention research and treatment research and early detection research.”

The good news may seem counter-intuitive to people who have heard recent reports of rising cancer deaths. The confusion comes in the difference between “cancer death rates” and “number of cancer deaths.” While cancer death rates among all age groups continues to decline, the number of people who die from cancer has remained stable or increased slightly.

This is not only due to a larger population, but an aging population as well. As baby boomers grow beyond retirement age, their likelihood of being diagnosed with cancer increases. So while more people are being diagnosed with cancer, their chance for survival is improving.

To come to these conclusions, researchers looked at mortality rates from cancer beginning in 1955. They looked at specific age groups, and found that the youngest group showed the sharpest decline in death rates (25.9 percent). In contrast, older age groups returned a 6.8 percent decline in cancer death rates.

The researchers attribute the declining cancer death rates to chemotherapy treatments that have been applied to childhood leukemias, testicular cancer and lymphomas. More recently, early detection programs for breast, colon and prostate cancer have also been successful.

Resources:

http://www.usatoday.com/news/health/2009-08-14-cancer-rates_N.htm

http://wellness.blogs.time.com/2009/08/13/u-s-cancer-death-rates-on-the-decline/

Childhood Cancer Treatment Increases Risk for Diabetes

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In a retrospective examination, researchers have determined that specific types of childhood cancer treatments result in elevated risks for developing diabetes later in life.

Six American research hospitals, along with the University of Alberta in Canada, collaborated on the study, which looked at more than 8,500 cancer cases in which a cancer patient age 21 or younger was treated for leukemia, bone tumors, central nervous tumors, Hodgkin lymphoma, non-Hodgkin lymphoma, renal tumors, soft-tissue sarcomas or neuroblastoma.

Through a survey, each patient was asked whether or not they had taken diabetes medication for longer than a month in the past two years. The same survey was given to the siblings of each cancer survivor.

In total, 2.5 percent of all survivors surveyed reported that they had taken diabetes medication. Only 1.7 percent of healthy siblings reported doing so. Following adjustments for age, gender, race, body mass index and other factors, researchers determined that childhood cancer survivors are 1.8 times more likely to develop diabetes.

More over, cancer patients will develop diabetes at a younger age. Figures show that 57 percent of cancer survivors with diabetes were under the age of 35, as opposed to only 35 percent of the siblings.

Diabetes risk varied depending on the specific type of cancer treatment performed. Patients undergoing total body irradiation were at the highest risk (12.6 times more likely than siblings). Patients receiving abdominal irradiation were three times more likely to develop diabetes. In total, patients treated for total body, abdominal or cranial irradiation were found to be 90 percent more likely to experience diabetes later in life.

Additionally, it was found that patients who were treated for cancer earlier in life were more likely to eventually develop cancer. Diabetes was 2.4 times more likely to occur in patients who were diagnosed with cancer before the age of five than those who were diagnosed in their late teens.

Doctors are still struggling to understand the link between cancer treatment and diabetes. One theory is that irradiation damages the pancreas, which is responsible for manufacturing and secreting insulin. Radiation may also alter hormones, resulting in insulin resistance.

Resource:

http://www.medpagetoday.com/Radiology/TherapeuticRadiology/15460

http://latimesblogs.latimes.com/booster_shots/2009/08/does-cancer-treatment-lead-to-diabetes.html

Understanding What An End-Of-Life Cancer Prognosis Means

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All cancer patients, for better or worse, are confronted with a prognosis from their doctors. A prognosis serves as a prediction of how the illness is expected to progress over time. It may also include how different treatment methods may affect survival. For those that are confronted with a fatal type of cancer, an end-of-life prognosis also estimates how long a patient can expect to survive.

However, just because a doctor suggests a survival time of 6 months, 1 year or whatever, that does not mean patients necessarily need to start counting down the days. Though an end-of-life prognosis can provide a good estimate of survival time, it is important to understand the data and downfalls associated with where these numbers come from.

A prognosis is based on how a patient’s particular type of cancer has advanced in past patients. Since 1973, the National Cancer Registry has painstakingly tracked survival statistics and treatment effectiveness for all types of cancers. From this vast mountain of data, means and averages for survival can be culled.

While data collection and number crunching are both extensive, the process is not without its flaws. For example, many prognoses are based purely on a single variable, most likely the stage of cancer progression. However, there are multiple variables that can affect survival time, including histology of the tumor, how early the cancer was detected, attempted treatments and age/general health of the patient. These facts are sometimes not taken into account when collecting data.

With this in mind, cancer patients are encouraged to ask doctors what factors were considered when determining their prognoses. Even when patients are further broken down into smaller subgroups, patients need to be aware of what exactly a prognosis means.

Most doctors hand down a prognosis that aligns with the median survival time of past cases of the patient’s particular cancer. Therefore, if a median survival time for a type of cancer is 1 year, that means half of all patients survived less than 1 year. In contrast, half of all patients also survived longer than 1 year. In some cases, patients survive significantly longer than the median average.

Another issue at hand is a doctor’s general inclination to not want to be overly optimistic about survival. This may lead him or her to offer conservative estimates in relation to an end-of-life prognosis. To counter this, patients may wish to talk to their oncologists about the probabilities of survival over different ranges of times.

Resource:

http://www.newsweek.com/id/208057/page/2