Genetic Clue Discovered For Why Women Outlive Men

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Academic Journal
Main Category: Seniors / Aging
Also Included In: Men's Health;  Biology / Biochemistry;  Genetics
Article Date: 05 Aug 2012 - 1:00 PDT Current ratings for:
Genetic Clue Discovered For Why Women Outlive Men

A new study of mitochondrial DNA in fruit flies offers a number of clues that might explain why females tend to outlive males across much of the animal kingdom, including humans.

Researchers from Monash University in Australia and Lancaster University in the UK, write about their work in the 2 August online issue of Current Biology.

They found male fruit flies appear to have mutations in their mitochondrial DNA that affect how fast they age and how long they live.

Scientists use fruit flies as models for studies in genes and aging because their biological processes are remarkably similar to that of other animals, such as humans, and with a lifespan of about a month, it doesn't take too long to investigate generational effects.

Senior author Damian Dowling, a research fellow in the Monash School of Biological Sciences, told the press:

"All animals possess mitochondria, and the tendency for females to outlive males is common to many different species. Our results therefore suggest that the mitochondrial mutations we have uncovered will generally cause faster male aging across the animal kingdom."

"Intriguingly, these same mutations have no effects on patterns of aging in females. They only affect males," he added.

Mitochondria are special subunits of cells, about the same size as bacteria, that provide the energy for life. They combine sugar and oxygen into adenosine triphosphate or ATP, molecular packets of energy that are usable by cells.

Mitochondria have their own DNA that is quite separate from the cellular DNA in the nucleus of the cell.

And, unlike cellular DNA, which is inherited from the sperm and egg that fuse to make the new individual, mitochondrial DNA comes only from the egg.

Thus, as mitochondrial DNA is passed down from generation to generation, the process of natural selection has no opportunity to "screen out" mutations in mitochondrial DNA that might be harmful to males. The researchers refer to this as a "sex-specific selective sieve".

For their study, Dowling and colleagues looked at differences in longevity and biological aging in male and female fruit flies whose mitochondria came from different origins.

They found genetic variations in both male and female mitochondrial DNA, but only the male ones could be linked to life expectancy. There weren't just a few mutations in one place, there were several, spread all over the mitochondrial genome:

"... our results indicate that the mitochondrial mutation loads affecting male aging generally comprise numerous mutations over multiple sites," they write.

The researchers suggest the mutations are entirely due to the way mitochondrial DNA is passed down through the female line.

"If a mitochondrial mutation occurs that harms fathers, but has no effect on mothers, this mutation will slip through the gaze of natural selection, unnoticed. Over thousands of generations, many such mutations have accumulated that harm only males, while leaving females unscathed," Dowling explained.

In an earlier study that looked at the effect of mitochondria being passed down the female line, the team had also discovered a link with male infertility.

Dowling said combining this latest study with their earlier work suggests mitochondria are "hotspots" for mutations that influece male health.

"What we seek to do now is investigate the genetic mechanisms that males might arm themselves with to nullify the effects of these harmful mutations and remain healthy," said Dowling.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our seniors / aging section for the latest news on this subject. "Mitochondria, Maternal Inheritance, and Male Aging "; M. Florencia Camus, David J. Clancy, Damian K. Dowling; Current Biology, 02 August 2012; DOI: 10.1016/j.cub.2012.07.018; Link to Abstract.
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posted by Ecologist on 4 Aug 2012 at 5:27 am

The idea is that males get mitochondria only from their mother, but the problem with it is that both males and females inherit mitochondria from their mother. This is not a nuclear scene where there are two sets of genes (or alleles), and the defect goes unnoticed in a female. At most this is a one-generation effect between the mother and her sons. There is also a one-generation effect between the mother and her daughters. Unless the researcher is proposing that male cells interact with their mitochondria in ways that females do not, then there is a logic flaw in their argument.

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posted by Kitfox on 3 Aug 2012 at 6:56 am

Is this research screening all flies or just the married ones? The data could be flawed. What we need to look into is the nagging genes of the females of the species and turn it off. Once that has been achieved the males will no longer mutate their genes ON PURPOSE in order to shorten the suffering period. :)

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'Genetic Clue Discovered For Why Women Outlive Men'

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Regaining Weight After Losing It Might Harm Menopausal Women

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Academic Journal
Main Category: Menopause
Also Included In: Women's Health / Gynecology;  Obesity / Weight Loss / Fitness
Article Date: 15 Dec 2011 - 8:00 PST

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According to a study recently published in the American Journal of Clinical Nutrition, older women who lose weight but do not maintain the loss might suffer some negative consequences in their overall health. The National Institute on Aging sponsored the investigation.

Investigators at Wake Forest Baptist Medical Center, demonstrated that within a year, some older women gain a considerable amount of weight back after losing it.

Barbara Nicklas, Ph.D., a gerontologist at the J. Paul Sticht Center on Aging and Rehabilitation at Wake Forest Baptist and lead researcher for the investigation, explained:

"The body composition of some of the women was worse than before their weight loss. When older women lose weight, they also lose lean mass. Most women will gain a lot of the weight back, but the majority of the weight regained is fat."

78 postmenopausal women were analyzed in the study, one year after losing 12% of their body weight by dieting in a completely separate studey. Participants averaged 58 years of age. The team recorded their body composition, including change in body weight, fat and muscle, immediately before and after initial weight loss, and then again 6 and 12 months later. During the first year after initial weight loss no weight loss intervention occurred.

Their was to find out if the composition of body weight regained following intentional weight loss is comparable to the composition of body weight lost.

At the six-month follow-up after the study ended, 53 of 78 (68%) of women regained some weight, while 52 of 68 (76%) of women regained some weight at the 12-month follow-up. 16 women (24%) continues to lose weight after the program, while 11 women (16%) weighed more than they did at baseline at the 12-month follow-up.

75% of women who regained weight gained over 4.4 pounds at the 6-month follow-up. At 12-month follow-up this number increased to 84%. The researchers examined whether lost lean mass from intentional weight loss was recovered in women who regained more weight.

The team discovered that the fat mass in these women was rising to a higher level than was lean mass during the post-intervention period.

During the diet program, 67% of weight loss was fat while 33% was muscle. 81% of the entire weight regained during 12 months of follow up was fat, while 19% was muscle. On average, 26% of fat lost was regained by 12-months after the diet program, while only 6% of muscle lost was gained back.

Nicklas explains:

"Most people will regain their weight after they lose it. Young people tend to regain weight in the proportion that they lost it. But the older women in our study did not appear to be regaining the muscle they lost during initial weight loss in the same way."

Although researchers are unsure what the long term effects of losing muscle mass in middle age and older women are, combined with loss of bone density which is known to occur as individuals age, the loss of muscle may increase their risk of falling, as well as other things.

Nicklas said:

"There are certainly a lot of health benefits to weight loss, if you can keep the weight off. For older women who lose weight, however, it is particularly important that they keep the weight off and continue to eat protein and stay physically active so that, if the weight does come back, it will be regained as muscle instead of fat."

Nicklas warns that study results were restricted to sedentary, abdominally obese, postmenopausal women, and the among younger populations or men the discoveries may differ. "Future studies of weight cycling are needed to determine its effects on muscle strength, quality, and function and body composition in older adults after all weight lost is regained", she said.

The investigators explain:

"Many health complications associated with overweight and obesity are improved with weight loss. However, negative consequences (such as loss of muscle mass and bone density) are also associated with weight loss and are detrimental for older adults, which results in a reluctance to recommend international weight loss in this population. Because lean mass loss in older adults may be associated with the development of adverse health events and disability, it is important to examine whether the benefits of weight loss outweigh the risks in this population."

Written by Grace Rattue
Copyright: Medical News Today
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Vaginal Progesterone Reduces Preterm Birth, Neonatal Morbidity And Mortality In Women At Risk

Main Category: Pregnancy / Obstetrics
Also Included In: Menopause;  Women's Health / Gynecology
Article Date: 15 Dec 2011 - 2:00 PST

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Women with a short cervix should be treated with vaginal progesterone to prevent preterm birth, according to a landmark study by leading obstetricians around the world. Vaginal progesterone decreased the rate of preterm birth by 42%, and significantly reduced the rate of respiratory distress syndrome and the need for mechanical ventilation, as well as a composite of several complications of premature newborns (e.g. infection, necrotizing enterocolitis, intracranial hemorrhage, etc.). An early online version of the study was published today in the American Journal of Obstetrics and Gynecology (AJOG), and is available on the AJOG website free of charge.

"Our analysis provides compelling evidence that vaginal progesterone prevents preterm birth and reduces neonatal morbidity/mortality in women with a short cervix," said lead investigator Dr. Roberto Romero, Chief of the Perinatology Research Branch and Head of the Program in Perinatal Research and Obstetrics of the Division of Intramural Research for the NICHD/NIH/DHHS, Bethesda, MD and Detroit, MI. "Importantly, progesterone reduced early preterm birth (those occurring before 33 or 28 weeks of gestation). These immature babies are at the greatest risk for complications, death, and long-term disability (e.g. cerebral palsy). Progesterone also decreased a fraction of 'late preterm births,' which are the most common preterm deliveries. The profile of adverse events was no different from placebo.

Follow-up studies of babies exposed to progesterone in utero to the age of 18 or 24 months showed no evidence of any behavioral or physical problems. The authors of this study recommend that transvaginal sonographic measurement of the cervix be performed in all pregnant women between 19 to 24 weeks of gestation to assess the risk of preterm delivery. This strategy also allows the identification of women at risk for preterm delivery during their first pregnancy. Other strategies, which are based on treating women with a previous preterm birth, do not address the challenge of prevention in women with their first pregnancy."

Preterm birth is the leading cause of perinatal morbidity and mortality worldwide. Moreover, preterm birth is also the main cause of infant mortality (death to the age of one year). Approximately 12.9 million births worldwide are preterm, of which 92.3% occur in Africa, Asia, Latin America, and the Caribbean. In the United States and Europe, there are 1,000,000 preterm births per year.

Progesterone is a natural hormone produced by the ovary during the menstrual cycle and in early pregnancy, and subsequently, in the placenta. A decline in progesterone action is considered to be important for the onset of labor. If such a decline occurs in the mid-trimester, cervical shortening may lead to the onset of preterm labor. The administration of progesterone is postulated to work by maintaining a high concentration of the hormone in the uterine cervix.

Several studies had evaluated the administration of vaginal progesterone versus placebo to prevent preterm birth when a short cervix was found by ultrasound in the mid-trimester of pregnancy. What is unique about the study published today is that investigators worldwide pooled the data from the different studies and performed a meta-analysis of individual patient data (IPD). This is the "gold standard" for summarizing evidence across clinical trials. It has the advantage of increasing the power to detect differences in efficacy and adverse events, and also allows subgroup analyses that may not have been possible in each individual study.

The IPD meta-analysis included five high-quality trials of vaginal progesterone versus placebo, was conducted at multiple centers in both developed and developing countries, and included a total of 775 women and 927 infants. The primary endpoints were: 1) preterm birth at <33 weeks; and 2) a composite index of perinatal morbidity and mortality. The authors also studied other secondary endpoints and explored the effect of cervical length, a history of previous preterm birth, maternal age, race/ethnicity, and body mass index on progesterone action.

The results were remarkably consistent and significant across trials performed in different parts of the world. Administering vaginal progesterone to asymptomatic women with a short cervix revealed by sonogram in the mid-trimester was associated with a 42% reduction in the rate of preterm birth before 33 weeks of gestation. There was also a significant reduction in the risk of preterm birth before 35, 34, and 28 weeks.

The study also found a 43% decrease in neonatal morbidity and mortality. Vaginal progesterone significantly reduced the risk of respiratory distress syndrome by 52%, and there was significantly lower admission to NICUs (placebo, 20.7% vs. progesterone, 29.1%).

Results of previous trials about the effects of vaginal progesterone or injectable progestins (synthetic compounds with progesterone action) in women with a twin gestation had been negative. However, a subset of patients in the study published today focused on women with a twin gestation and a short cervix. In this particular group, vaginal progesterone reduced the rate of preterm birth at <33 weeks by 30% and significantly reduced the composite neonatal morbidity/mortality of twins. Dr. Romero indicated that a study of vaginal progesterone in twin pregnancies with a short cervix is urgently needed to confirm these findings because the reduction in preterm birth did not reach significance (most likely due to the small number of twins available to study).

A major finding of this study is that progesterone benefits not only women who have a short cervix, but also those who have a prior preterm birth and a short cervix. This has practical implications, because vaginal progesterone is a less expensive and less invasive alternative than the placement of a cervical suture (cerclage) in patients who had a previous preterm birth and have a short cervix.

"The results of this analysis of five large randomized trials have the potential to result in a sea change in obstetrical practice in the U.S. and Europe and eventually in the rest of the world," commented AJOG Co-Editor-in-Chief, Thomas J. Garite, MD. "Prematurity is the leading cause of death and damage for newly born babies and despite enormous efforts, no impact has been made in the rate of preterm birth, which is actually rising in recent years."

As advocated in an accompanying editorial by C. Andrew Combs, MD, PhD, Obstetrix Medical Group, San Jose, CA, in the print version of the Journal, the potential for reducing prematurity lies in implementing routine vaginal ultrasound for all pregnant women in the middle months of pregnancy to measure the length of the cervix and if a short cervix is found, treat these patients with progesterone. The majority of premature births occur in women with no risk factors, so this approach has real potential to make an impact in the overall premature birth rate. Two recently published cost analysis studies, suggest that this approach can not only save lives and prevent the devastating damages often caused by prematurity, but can also result in a annual savings of nearly 1/2 billion dollars in health care costs in the U.S. alone.

Article adapted by Medical News Today from original press release. Source: Elsevier
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Side Effects Of Breast Cancer Drugs Can Be So Bad Women End Treatment And Risk Return Of Cancer

Main Category: Breast Cancer
Also Included In: Compliance;  Pain / Anesthetics
Article Date: 12 Dec 2011 - 1:00 PST

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Why do so many postmenopausal women who are treated for estrogen-sensitive breast cancer quit using drugs that help prevent the disease from recurring?

The first study to actually ask the women themselves -- as well as the largest, most scientifically rigorous study to examine the question -- reports 36 percent of women quit early because of the medications' side effects, which are more severe and widespread than previously known. The Northwestern Medicine research also reveals a big gap between what women tell their doctors about side effects and what they actually experience.

"Clinicians consistently underestimate the side effects associated with treatment," said lead investigator Lynne Wagner, an associate professor in medical social sciences at Northwestern University Feinberg School of Medicine and a clinical psychologist at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. "They give patients a drug they hope will help them, so they have a motivation to underrate the negative effects. Patients don't want to be complainers and don't want their doctor to discontinue treatment. So no one knew how bad it really was for patients."

The symptom most likely to cause women to stop using the drugs was joint pain. Other side effects women reported as compromising their quality of life were hot flashes, decreased libido, weight gain, feeling bloated, breast sensitivity, mood swings, irritability and nausea.

Wagner's research was presented at the 34th Annual San Antonio Breast Cancer Symposium.

The drugs, aromatase inhibitors, stop the production of estrogen in postmenopausal women, whose breast cancer cells are stimulated by estrogen. About two-thirds of breast cancers are estrogen sensitive, and aromatase inhibitors reduce the recurrence of cancer in postmenopausal women.

The women at highest risk for quitting the medications before the recommended five years are those who still are experiencing residual side effects from recent chemotherapy or radiation therapy when they start the aromatase therapy, according to the study. Women who had surgery for breast cancer but not chemotherapy or radiation therapy, or who weren't taking many other medications, were more likely to keep taking the aromatase medication.

"The more miserable they were before they started, the more likely they were to quit," Wagner said. "By the time they get through chemotherapy or radiation, they have to face five more years of another medication that will make them feel lousy. They feel like they already lost enough time to cancer and have reached their threshold for feeling bad."

"This is a wake-up call to physicians that says if your patient is feeling really beaten up by treatment, the risk of her quitting early is high," Wagner said. "We need to be better at managing the symptoms of our patients to improve their quality of life."

The new research exposes the disparity between clinicians' reporting of side effects and women's actual experiences. In a previous study, clinicians reported 5 percent of their patients experienced moderate to severe symptoms as a result of taking aromatase inhibitors. The new Northwestern study surveyed 686 women with a detailed questionnaire about their symptoms before treatment and at three, six, 12 and 24 months after starting treatment. The researchers found after three months of treatment that 33 to 35 percent of women had severe joint pain, 28 to 29 percent had hot flashes, 24 percent had decreased libido, 15 to 24 percent had fatigue, 16 to 17 percent had night sweats and 14 to 17 percent had anxiety. These numbers increased as women were on treatment longer.

Earlier studies also asked women to recall their symptoms after treatment ended, which is less accurate than reporting them at regular intervals while taking the drugs.

As a result of the side effects, 36 percent of women ended treatment before an average of 4.1 years. After two years, 10 percent had quit; the remainder quit between 25 months and the 4.1 years.

"These findings can help us identify women at risk for quitting the therapy, counsel them about the importance of staying on it and provide treatment for troubling side effects," Wagner noted.

Weight gain can be addressed with nutritional counseling, while mood swings and irritability can be treated with cognitive behavioral therapy or mind-body techniques, Wagner said. Joint pain can be tempered with nonsteroidal anti-inflammatory drugs, or women may be switched to a different hormonal medication. Nausea can be reduced with medication.

For the study, patients who had postmenopausal breast cancer filled out a 46-question survey rating their quality of life and symptoms associated with breast cancer and endocrine treatment. The survey included an item asking how much they were bothered by side effects of treatment from zero (not bothered) to four (severely bothered). For each additional one-point increase on this item, the patient's risk of quitting treatment early rose 29 percent. The patients were randomized to take one of two hormonal treatments (anastrozole or exemestane) daily for five years.

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Binge Drinking By Freshman Women Tied To Sexual Assault Risk, According To New Research

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Women's Health / Gynecology
Article Date: 11 Dec 2011 - 0:00 PST

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Many young women who steer clear of alcohol while they're in high school may change their ways once they go off to college. And those who take up binge drinking may be at relatively high risk of sexual assault, according to a University at Buffalo-led study in the January issue of the Journal of Studies on Alcohol and Drugs.

The college years are famously associated with drinking. But little has been known about how young women change their high school drinking habits once they start college.

So for the new study, the research team followed 437 young women from high school graduation through freshman year of college. They found that of women who had never drank heavily in high school (if at all), nearly half admitted to heavy episodic drinking -- commonly called binge drinking -- at least once by the end of their first college semester. Young women who were already engaging in binge drinking in high school continued drinking at similar levels in college.

What's more, binge drinking was linked to students' risk of sexual victimization -- regardless of what their drinking habits had been in high school.

Of all young women whose biggest binge had included four to six drinks, one quarter said they'd been sexually victimized in the fall semester. That included anything from unwanted sexual contact to rape.

And the more alcohol those binges involved, the greater the likelihood of sexual assault. Of women who'd ever consumed 10 or more drinks in a sitting since starting college, 59 percent were sexually victimized by the end of their first semester. Though young women are not to blame for being victimized -- that fault lies squarely with the perpetrator -- if colleges can make more headway in reducing heavy drinking, they may be able to prevent more sexual assaults in the process.

"This suggests that drinking-prevention efforts should begin before college," said lead researcher Maria Testa, a senior scientist at UB's Research Institute on Addictions.

The study also underscores the fact that even kids who don't drink in high school are at risk of heavy drinking once they head off to college, Testa said.

For parents, the bottom line is to talk with your kids about drinking before they go to college -- whatever you think their drinking habits have been in high school, according to Testa. And after they've left for college, keep talking. "Parents still do have an impact on their kids after they go to college," Testa said. "Parenting is not over."

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posted by Michelle Petersen on 11 Dec 2011 at 1:27 am

So in effect if a female is binge drinking she is more likely to be sexually assaulted by those waiting to take advantage of the situation. How unbelievably irresponsible for such a forward thinking medical site. As scientist and journalists we should be asking why there are gentlemen who only show their true colours when they feel the subject is vunerable, less likely to remember and less likely to fight back. Shouldn't this article be placing the onus on those that carry out these attacks rather than those on the recieving end. Linking binge drinking with sexual assault is a short term fix. If you want to write about the dangers of binge-drinking why not follow these young binge-drinkers into alcoholism in later life or study the loss of grey matter and brain cells or the addictive personality. Or we could concentrate on the perpetrators and ask why they do this in the first place?, are they just sexually assaulting women or both sexes in a dominance play? Why do they wait until someone is vunerable? Do they feel sexual assault is acceptable and if so why? So many different angles with this article and you choose the most offensive one.....

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Diagnosis Of Tuberculosis Is Increased In Postpartum Women

Main Category: Tuberculosis
Also Included In: Women's Health / Gynecology
Article Date: 10 Dec 2011 - 1:00 PST

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The incidence of tuberculosis (TB) diagnosis is significantly increased in mothers postpartum, suggesting a potential new population to target for screening, according to a new UK-wide cohort study.

In the joint study between the Health Protection Agency and the University of East Anglia, researchers analyzed data on all women with pregnancies between 1996 and 2008 from the General Practice Research Database, which contains records from 460 practices across the UK, representing 5.5 percent of the UK population. The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"Ours is the first primary care based cohort study to quantify the risk of TB during pregnancy and postpartum," said Dominik Zenner, degree? consultant in public health, Respiratory Diseases Department at the Health Protection Agency. "Although we found a significantly increased risk of TB in the six months following pregnancy, but not during pregnancy, the risk during pregnancy is almost certainly also increased."

The researchers estimated incidence rates for TB in pregnancy, six months postpartum and outside of pregnancy, and modelled adjusted incidence rate ratios (IRRs) in a retrospective cohort study. They also performed a nested self-controlled case series (SCCS) analysis, adjusting for all non-time-dependent confounders, such as country of origin and ethnicity. In the SCSS analysis, pregnant women with TB were selected from the cohort, and incidence rates (IRs) in pregnancy and post-partum were compared with rates outside pregnancy.

A total of 192,801 women with a total of 264,136 pregnancies were included in the cohort study. Of 177 TB events that occurred during the study, 22 occurred during pregnancy and 22 occurred in the 180 days after pregnancy. The crude TB rate for the combined pregnancy and post-partum period was 15.4 per100,000 person years, which was significantly higher than the rate outside of pregnancy (9.1 per 100,000 person years, p=0.02). After adjustment for age, region and socio-economic status, post-partum TB risk was significantly higher than TB risk outside pregnancy (IRR 1.95, CI 1.24-3.07), whereas no significant increase during pregnancy was observed (IRR 1.29, CI 0.82-2.03).

These observations were confirmed in the SCCS analysis. Adjusting for all non-time bound confounders, the time period of observation and patients' age, the IRR of TB during pregnancy (1.03, CI 0.64-1.65) was not significantly increased compared with the risk outside of pregnancy. However, the TB risk was significantly increased in the 6 month period following pregnancy (IRR 1.61, CI 1.01-2.58, p=0.04).

The study had a few limitations, including its observational design. Administrative delay between TB diagnosis and recording of the diagnosis may have occurred. Diagnostic delays may also occur during pregnancy. Immunological changes during pregnancy gradually increase TB susceptibility and then gradually normalize after delivery. The combination of these factors may account for the failure to show a significantly increased TB risk during pregnancy in this study.

"The incidence of TB diagnosis is significantly increased post-partum, probably reflecting an increase in TB incidence during pregnancy," concluded Dr. Zenner. "Given our results, targeted screening of pregnant and post-partum women in high-risk groups may be warranted, given that delays in treatment initiation are associated with poorer outcomes for both mothers and their children."

Article adapted by Medical News Today from original press release. Source: American Thoracic Society
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One In Three Women With Secondary Breast Cancer Needlessly In Pain, Study

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Main Category: Breast Cancer
Also Included In: Pain / Anesthetics
Article Date: 09 Dec 2011 - 2:00 PST

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A study, thought to be the first of its kind, examines the quality of life for women with secondary or metastatic breast cancer and finds that more than a third are living needlessly with uncontrolled pain. The researchers point out that as medical advances improve the prognosis for patients with secondary breast cancer, there is a growing number of patients with metastatic breast cancer who are considered survivors rather than at end of life, and health care professionals need to be prepared for that.

The study, by Breast Cancer Care and the University of Southampton in the UK, was funded by Breast Cancer Campaign, and was published online recently in the Journal of Pain and Symptom Management.

The researchers analyzed data from questionnaires filled in by women attending two UK cancer centers and also who were invited to complete them online via the Breast Cancer Care Web site. 235 women with metastatic breast cancer (that is breast cancer that has spread) completed the questionnaires, which assessed quality of life and experience of care.

The results showed that: 27% of women had shortness of breath.
26% experienced nausea.
Women whose cancer had spread to their bones were more likely to be in pain, with 44% reporting significant pain.
There was little evidence of GP (8%) or local palliative care service (7%) involvement among the participants.
Given the choice, most women (62%) opted for their hospital consultant as the professional they would want to see on a regular basis.
More than half the women surveyed had been living with their secondary breast cancer for at least two years.
Half said they were dissatisfied with the care they were receiving.The authors conclude:

"Despite improvements in treatment and survival of women with metastatic breast cancer, this group reports high symptom burden and dissatisfaction with elements of their care, indicating that alternative models of service delivery should be explored."

Principal investigator Elizabeth Reed, Secondary Breast Cancer Research Nurse at Breast Cancer Care, told the press:

"Until now there has been little research into the quality of life of women living with secondary breast cancer outside of clinical trials. This study, which is the first of its kind, shows that women with secondary breast cancer have a range of complex, multidimensional needs that are not being met."

Reed said no woman should have to live with pain that is controllable, or without the information or support they need to help them make decisions about their health.

Advances in medical treatment means those living with metastatic breast cancer are thought of as survivors, and not necessarily at the end of life.

"It is therefore vital that healthcare professionals are equipped with the knowledge and expertise they need to offer women with secondary breast cancer adequate symptom control and the medical and psychological support they need," said Reed.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our breast cancer section for the latest news on this subject. "Quality of Life and Experience of Care in Women With Metastatic Breast Cancer: A Cross-Sectional Survey"; Elizabeth Reed, Peter Simmonds, Joanne Haviland, Jessica Corner; Journal of Pain and Symptom Management , In Press, Corrected Proof published online 17 November 2011; DOI: 10.1016/j.jpainsymman.2011.05.005; Link to Abstract.
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Catharine Paddock PhD. "One In Three Women With Secondary Breast Cancer Needlessly In Pain, Study." Medical News Today. MediLexicon, Intl., 9 Dec. 2011. Web.
9 Dec. 2011. APA

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Anastrozole With Fulvestrant Can Lengthen Lives Of Women With ER+ Metastatic Breast Cancer

Main Category: Breast Cancer
Article Date: 09 Dec 2011 - 0:00 PST

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Post-menopausal women with hormone receptor-positive metastatic breast cancer may have a new treatment option that could lengthen their lives, according to results of a study by the SWOG clinical trials network that were presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.

The combination of the two anti-estrogen drugs anastrozole and fulvestrant used in the SWOG S0226 trial extended the median survival time of women with breast cancer by more than six months compared to those who underwent standard treatment with anastrozole alone (47.7 months vs 41.3 months). The combination therapy also lengthened the median time to disease progression (15 months vs 13.5 months).

Lead study coordinator Rita Mehta, M.D., of the University of California, Irvine Medical Center says the results of the phase III trial are particularly exciting because "these patients have not had a new treatment that gave them an overall survival benefit in more than a decade."

Anastrozole (Arimidex®) and fulvestrant (Faslodex®) are both already used in treating breast cancer, though not in combination. The former reduces the production of tumor-promoting estrogen, while the latter interferes with the receptors that allow estrogen to signal cells to grow and reproduce.

Researchers think it's these two different modes of action together that make the combination so effective against hormone receptor-positive breast cancer, the subtype that accounts for more than half of all breast cancers.

"If we take away estrogen and the estrogen receptor, the two together should be better than just doing one at a time," says Mehta.

Starting in the spring of 2004, she and colleagues at 72 other institutions enrolled 707 postmenopausal women with metastatic hormone receptor-positive breast cancer to the trial.

Women were assigned at random to one of the study's two arms. Patients on both arms got a standard 1 mg oral daily dose of anastrozole. Those on the combination arm also got a 250 mg injection of fulvestrant every 28 days, after an initial set of injections to raise the level of fulvestrant in their bloodstream. Researchers saw no significant differences in how well patients tolerated the two therapies.

The overall survival benefit was particularly strong in women who had not previously had tamoxifen therapy for their breast cancer. Among this tamoxifen-naive group (about 60 percent of patients in each arm), median overall survival time on the combination therapy was 47.7 months as compared to 39.7 months for those taking only anastrozole.

The trial researchers are hesitant, however, to focus too much attention on this aspect of the findings. Because plans to analyze the results by prior tamoxifen use were not built into the original trial design, the results of that analysis must clear a higher bar to be found statistically significant.

"We need to better understand other possible factors, since the prior tamoxifen factor could be a false lead from an unplanned analysis," says Mehta, who is eager to see whether even more patients might benefit from this combination treatment.

"The next step for researchers," she says, "would be to try the combination in even earlier stages of breast cancer to test whether long-term cures could be increased at those stages."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our breast cancer section for the latest news on this subject. Funding for the trial came primarily from the National Cancer Institute, one of the National Institutes of Health. Additional support, and the anastrozole and fulvestrant for the trial, were provided by AstraZeneca Pharmaceuticals LP, of Wilmington, Del.
Abstract reference:
Mehta RS, Barlow WE, Albain KS, et al. "A Phase III randomized trial of anastrozole versus anastrozole and fulvestrant as first-line therapy for postmenopausal women with metastatic breast cancer: SWOG S0226." Presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, December 6 - 10, 2011 (presentation S1-1).
Other authors on the abstract include WE Barlow and DL Lew of the SWOG Statistical Center, KS Albain of Loyola University, TA Vandenberg of London Regional Cancer Centre/NCIC-CTG, SR Dakhil of Wichita CCOP, NR Tirumali of Northwest CCOP, DF Hayes of University of Michigan, JR Gralow of Seattle Cancer Care Alliance, RB Livingston of University of Arizona, and GN Hortobagyi of MD Anderson.
University of Michigan Health System Please use one of the following formats to cite this article in your essay, paper or report:

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University of Michigan Health System. "Anastrozole With Fulvestrant Can Lengthen Lives Of Women With ER+ Metastatic Breast Cancer." Medical News Today. MediLexicon, Intl., 9 Dec. 2011. Web.
9 Dec. 2011. APA

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Researchers Find Smoking Is Strongly Associated With Squamous Cell Carcinoma Among Women

Main Category: Women's Health / Gynecology
Also Included In: Cancer / Oncology
Article Date: 09 Dec 2011 - 2:00 PST

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Women who have non-melanoma skin cancers are more likely to have smoked cigarettes compared to women without skin cancer, said researchers at Moffitt Cancer Center in Tampa, Fla., who published study results in a recent issue of Cancer Causes Control.

The study investigated the relationship between cigarette smoking and non-melanoma skin cancers, including basal cell carcinoma (BCC) and squamous cell carcinomas (SCC). Smoking histories were assessed and compared between patients diagnosed with BCC and/or SCC, and a group of controls comprised of patients who were screened for skin cancers, but who were not diagnosed with and had no history of skin cancer.

The study's 698 participants were recruited through Moffitt's Lifetime Screening and Prevention Center and the University of South Florida's Dermatology and Family Medicine Clinics. Participants were asked about their smoking behaviors in terms of years smoked, how many cigarettes per day they smoked, and when those who once smoked quit smoking. The results were stratified by sex.

Study results showed that cigarette smoking was associated with non-melanoma skin cancer overall, and that the risk increased with numbers of cigarettes per day, total years of smoking, and pack-years smoked. Associations were particularly strong for SCC, with SCC being more than two times as likely in those who have smoked for 20 or more years compared to controls.

"Among men, positive associations with smoking of equal magnitude were observed for BCC and SCC, although none of the associations were statistically significant," said Dana E. Rollison, Ph.D., study lead author and an associate member in the Moffitt Department of Cancer Epidemiology. "However, among women, smoking was not associated with BCC, while highly statistically significant associations were observed with SCC. Women with SCC were almost four times more likely than controls to have smoked for 20 or more years."

The researchers concluded that:

Cigarette smoking was associated with non-melanoma skin cancer, and the risk increased with increasing dose (cigarettes per day) and number of years smoked.

Among men, smoking was modestly associated with BCC and SCC.

Among women, smoking was strongly associated with SCC, but not BCC.

Why women smokers should be more likely than men to be diagnosed with SCC is not clear, said the researchers.

"Observations from the lung cancer literature may provide possible explanations for why smoking was a higher risk factor for SCC in women," wrote Rollison and co-authoring colleagues both at Moffitt and across USF's College of Medicine. "Female current smokers have higher lung cancer risks than men. Women have been shown to have more active CYP enzyme activity in the lung, where CYP is responsible for metabolizing 70-80 percent of nicotine. In addition, the up-regulation of CYP by estrogen may play a role."

Also, women have been shown to have higher levels of DNA adducts and lower levels of DNA repair in the lung as compared to men, said Rollison.

"Further study is needed to shed more light on the sex-based differences and the role of smoking in non-melanoma skin cancers," concluded Rollison.

Article adapted by Medical News Today from original press release. Source: Moffitt Cancer Center
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Moffitt Cancer Center. "Researchers Find Smoking Is Strongly Associated With Squamous Cell Carcinoma Among Women." Medical News Today. MediLexicon, Intl., 9 Dec. 2011. Web.
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