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WEDNESDAY May 15, 2013 — Film star Angelina Jolie will have her ovaries removed to help lower her odds for ovarian cancer, People magazine reported Wednesday.
The news comes just a day after Jolie, 37, revealed in an article published on the editorial page of The New York Times that she had undergone a double mastectomy. Jolie wrote that she made the decision after learning she carried a gene, called BRCA1, that is linked to a significantly higher risk for both breast and ovarian cancers.
Now, Jolie “is also planning to undergo surgery to remove her ovaries,” an operation known as oophorectomy, according to People.
Jolie’s mother, actress Marcheline Bertrand, died of ovarian cancer at the age of 56.
According to the Mayo Clinic, preventive removal of the ovaries can cut the risk of ovarian cancer in a woman with a BRCA mutation by 80 percent to 90 percent.
In the Times article, Jolie said she began the process to have both of her breasts removed in early February.
Writing about her mother’s nearly 10-year-long battle with cancer, Jolie said: “She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.”
Jolie, who has six children with her companion and fellow film star Brad Pitt, said she often finds herself trying to explain to her children about the disease that killed her mother. “They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a ‘faulty’ gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer,” she wrote.
The BRCA1 and related BRCA2 genes belong to a class of human genes known as tumor suppressors. According to the U.S. National Cancer Institute, in normal cells, the BRCA1 and BRCA2 genes help to maintain the stability of a cell’s genetic material — called DNA — and help prevent uncontrolled cell growth. Mutation of these genes has been linked to the development of hereditary breast and ovarian cancer.
The cancer institute estimates that 14 out of every 1,000 women in the general population will develop ovarian cancer in their lifetime. However, that risk rises steeply among women with mutations in either the BRCA1 or BRCA2 genes to anywhere between 155 to 400 women per 1,000.
These genetic mutations are most commonly found in Jewish women of eastern European descent. Also, Norwegian, Dutch, and Icelandic peoples have higher rates of BRCA1 and BRCA2 mutations, according to the cancer institute.
Dr. Michael Cowher, a breast surgeon at the Cleveland Clinic, said the BRCA mutation doesn’t just affect women’s breasts or ovaries — males who carry the genetic mutation face an increased risk of breast and prostate cancers. Also, there’s an increased risk of pancreatic cancer in BRCA2 and some BRCA1 carriers, he said.
Oophorectomy does come with its own risks for premenopausal women, according to the Mayo Clinic, and the decision should be carefully considered. Risks include bone-thinning (osteoporosis), menopausal symptoms such as hot flashes and an increased risk of heart disease.
The procedure itself “is a generally safe procedure that carries a small risk of complications, including infection, intestinal blockage and injury to internal organs,” the Mayo Clinic said.
In regards to Jolie’s double mastectomy, experts stressed that breast removal isn’t the only choice facing a woman with BRCA mutations. “There are other options they can discuss with their doctor,” Cowher said. “These include chemoprevention with medications like tamoxifen, and increased frequency of clinical and image-based screening regimens,” he explained.
A double mastectomy involves removing as much “at-risk” tissue as possible to reduce the risk of cancer. The procedure does not, however, guarantee complete protection against cancer, according to the cancer institute.
Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, called a double mastectomy “the best option for someone who is BRCA-positive.”
“The risk of cancer is extremely high and we know that you can watch them, but there is no guarantee that you will catch the cancer at an early stage,” she said. “If you have the ability to prevent a cancer, that’s probably the best route,” Bernik explained.
“Not everyone wants a prophylactic mastectomy and they don’t all do that,” Bernik said. “But women should certainly be informed.”
Bernik said more women are opting for the procedure. “The reconstructive options have improved dramatically over the past 15 years, so women can at least feel confident knowing that if they remove their breasts they will be left with a very good to excellent cosmetic result,” she said.
Writing in the Times article, Jolie said, “My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
“Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much as I could. I made a decision to have a preventive double mastectomy.”
Jolie said the process of having her breasts removed was finished by late April, and included the reconstruction of both breasts with implants. “There have been many advances in this [reconstruction] procedure in the last few years, and the results can be beautiful,” she wrote.
According to the cancer institute, genetic testing can reveal whether a woman carries a BRCA1 or BRCA2 mutation. There are benefits to such testing, whether a woman receives a positive or a negative result. “The potential benefits of a negative result include a sense of relief and the possibility that special preventive checkups, tests, or surgeries may not be needed. A positive test result can bring relief from uncertainty and allow people to make informed decisions about their future, including taking steps to reduce their cancer risk,” the agency said.
For her part, Jolie said: “I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”
“For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”
To learn more about the BRCA1 and BRCA2 mutations, visit Susan G. Komen for the Cure.
Posted: May 2013
All of what you take into your body comes out somewhere, and that somewhere is often in your urine. Gross thought, but it has some major health implications when it comes to carcinogens like cigarettes and other tobacco products that can increase your risk of bladder cancer.
But that doesn’t seem to be the case cannabis according to a recent Kaiser Permanente study in Los Angeles. In fact, the good herb might lower your risk of developing such problems.
A study of more than 83,000 California men concluded that marijuana smokers are about 45 percent less likely to have bladder cancer than average, while cigarette smokers were about 52 percent more likely to develop bladder cancer. Those who smoked both saw a decreased rate from those who smoked strictly tobacco but still a higher rate than those who only toke the ganja.
According to the American Cancer Society, about one in 26 men will develop tumors on their bladder in their lifetime.
But there is a catch: the study only took a look at men who smoked cigarettes, marijuana or both. There wasn’t a control group of non-smokers taken from the same general population. According to Dr. Karim Chamie, a urology professor at the University of California not involved with the study who spoke with USA Todayover the weekend, smoking cigarettes increases the risk as much as three times that of non-smokers.
And the doctors who conducted the study are distancing themselves from any pro-cannabis perceptions as well, saying the study shouldn’t be used to advocate cannabis use as a preventative measure. They did admit that the findings are worth further examination and that cannabis could have a future role in bladder cancer research.
The study looked at men age 45 to 69 who were Kaiser patients in California. The men were first looked at in 2002, and 11 years later the study pulled them back in for a follow-up. Forty-one percent were ganja tokers, 57 percent smoked tobacco and 27 percent smoked both. In 11 years, 89 pot smokers developed tumors. Cigarette smokers more than doubled that, with 190.
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FRIDAY May 10, 2013 — New research says smoking pot may be less likely to cause bladder cancer than smoking cigarettes.
The finding is potentially valuable, the study authors said, given the ongoing debate over legalizing marijuana for medical purposes.
But one urologist not involved with the study was skeptical of the finding, and noted that nonsmokers weren’t among the men included in the study.
For the study, the researchers compared the risk of bladder cancer in more than 83,000 men who smoked cigarettes only, marijuana (cannabis) only, or both substances. The investigators found that men who only smoked pot were the least likely to develop bladder cancer over the course of 11 years.
“Cannabis use only was associated with a 45 percent reduction in bladder cancer incidence, and tobacco use only was associated with a 52 percent increase in bladder cancer,” said study author Dr. Anil A. Thomas, a fellow in urology at Kaiser Permanente Medical Center in Los Angeles.
Smoking both tobacco and marijuana raised the risk of bladder cancer, but less so than for those who only smoked tobacco, Thomas found. He presented the findings Monday at the American Urological Association annual meeting in San Diego.
Dr. Karim Chamie, an assistant professor of urology at the David Geffen School of Medicine at the University of California, Los Angeles, took issue with the fact that every man in the study smoked something, so there was no comparison to men who did not smoke at all.
“It’s hard to judge a study when the reference group is not nonsmokers,” Chamie said. And the number of bladder cancers diagnosed in the study seemed low, he added, especially because everyone smoked something and smoking tobacco is considered a leading risk factor for the disease.
“We know smoking increases your risk of bladder cancer by two- or threefold,” Chamie noted.
Also, the men in the study weren’t representative of the entire United States, Chamie said, noting all were insured residents of California.
Thomas said his research team wasn’t looking at all age groups and was not collecting data on lifetime prevalence.
Thomas stressed that he’s not condoning or recommending marijuana as a way to affect risk of bladder cancer. The value of the study may be to spur other research into new treatments for bladder cancer, he said.
The men in the study, aged 45 to 69, were patients at Kaiser Permanente in California. Thomas and his team evaluated data on their lifestyle habits, including tobacco and marijuana smoking, between 2002 and 2003.
The researchers cross-referenced the study data with medical records to see who was diagnosed with bladder cancer. They omitted men with a history of bladder cancer.
Overall, 41 percent of the men reported marijuana use, 57 percent said they used tobacco and 27 percent reported using both.
During 11 years of follow-up, 279 men — 0.3 percent — were diagnosed with bladder cancer. Eighty-nine pot smokers (0.3 percent) developed bladder cancer compared to 190 (0.4 percent) who did not smoke pot.
More frequent marijuana use — smoking pot more than 500 times — was associated with greater risk reduction than infrequent marijuana use — smoking once or twice, the researchers found.
Thomas said that while the study saw a link between smoking marijuana and lower bladder cancer risk, compared to tobacco smokers, it did not prove a cause-and-effect relationship. He couldn’t explain the link, but speculated on the possible mechanism.
“The theory is that there are receptors in the bladder that are affected by cannabis,” he said. The cannabinoids [compounds] in the marijuana may link with the cannabinoid receptors in the bladder and somehow protect against cell changes that can lead to cancer, he said.
A man’s lifetime risk of bladder cancer is almost 4 percent, according to the American Cancer Society. This means about one in 26 men will develop bladder tumors.
The study was funded by the Kaiser Permanente Research and Evaluation Center. Findings and conclusions of research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
To learn more about bladder cancer, visit the U.S. National Cancer Institute.
Posted: May 2013
Vegetables that contain nicotine may offer some protection, research suggests
WebMD News from HealthDay
By Robert Preidt
THURSDAY, May 9 (HealthDay News) — Eating vegetables that naturally contain nicotine, such as peppers and tomatoes, may reduce your risk of developing Parkinson’s disease, according to a new study.
Previous research has found that smoking and other types of tobacco use are associated with a lower risk of developing Parkinson’s disease, and it is believed that nicotine provides the protective effect. Tobacco belongs to a plant family called Solanaceae and some plants in this family are edible sources of nicotine.
This new study included nearly 500 people who were newly diagnosed with Parkinson’s and another 650 unrelated people who did not have the neurological disorder, which is typically marked by tremors and other movement problems. The study participants provided information about their tobacco use and diets.
In general, vegetable consumption had no effect on Parkinson’s risk. The more vegetables from the Solanaceae plant family that people ate, however, the lower their risk of Parkinson’s disease. This association was strongest for peppers, according to the study, which was published May 9 in the journal Annals of Neurology.
The apparent protection offered by Solanaceae vegetables occurred mainly in people with little or no prior use of tobacco, which contains much more nicotine than the foods included in the study.
“Our study is the first to investigate dietary nicotine and risk of developing Parkinson’s disease,” Dr. Susan Searles Nielsen, of the University of Washington in Seattle, said in a journal news release. “Similar to the many studies that indicate tobacco use might reduce risk of Parkinson’s, our findings also suggest a protective effect from nicotine, or perhaps a similar but less toxic chemical in peppers and tobacco.”
Nielsen and her colleagues recommended further studies to confirm and extend their findings, which could lead to ways to prevent Parkinson’s disease.
Although the study found an association between consumption of certain nicotine-containing foods and lower risk of Parkinson’s, it could not prove a cause-and-effect relationship.
Still, one Parkinson’s expert called the study “intriguing.”
“It provides further evidence of how diet can influence our susceptibility to neurological disease — specifically Parkinson’s disease,” said Dr. Kelly Changizi, co-director of the Center for Neuromodulation at the Mount Sinai Parkinson and Movement Disorders Center in New York City. “Patients often ask what role nutrition plays in their disease, so it’s very interesting that nicotine in vegetables such as peppers may be neuroprotective.”
Another expert said more research into the role of nicotine in Parkinson’s disease is already underway.
“The observation that cigarette smokers have a reduced risk for Parkinson’s disease has long been known, and has raised the idea that nicotine may reduce the risk for [the illness],” said Dr. Andrew Feigin, who is investigating the illness at the Feinstein Institute for Medical Research in Manhasset, N.Y.
“A nicotine skin patch is currently being tested in patients with early Parkinson’s disease,” he said.
The illness occurs due to a loss of brain cells that produce a chemical messenger called dopamine. The symptoms of the disease include loss of balance, slower movement and tremors and stiffness in the face and limbs. There is currently no cure for the disorder. Nearly 1 million Americans — and 10 million people worldwide — have Parkinson’s, according to the Parkinson’s Disease Foundation.