Friday, October 26, 2012

New Breast Cancer Therapy Tied to More Complications


October 23, 2012, 5:07pm
NEW YORK, (Reuters Health) --- Women about to have breast cancer surgery may want to pay extra attention to the radiation treatment they could be offered afterward.
A new study shows a new and increasingly popular treatment called brachytherapy is tied to more wound and skin complications than the standard radiation technique.
Yet as many as one in six women on Medicare, the government's health insurance program for people over 65, end up getting the new therapy following breast-conserving surgery, researchers found.
"We were very surprised to see that brachytherapy is as commonly used as it is, particularly given that there is no clear evidence that it offers better cancer outcomes," said Dr. Cary P. Gross of Yale University School of Medicine in New Haven, Connecticut. His findings were published Monday in the Journal of Clinical Oncology.
Not all patients will benefit from radiation treatment, but in many cases doctors recommend it to reduce the chance that the cancer will return.
Typically the whole breast is irradiated from the outside over several weeks, but in brachytherapy the radiation is delivered from inside the breast.
With the MammoSite device, for instance, a small balloon is inflated in the cavity that remains after the tumor is removed. It delivers high-dose radiation in less than a week and has been used on more than 50,000 women so far, according to its Massachusetts-based manufacturer Hologic.
But there is no solid research showing brachytherapy is a safe and effective alternative to whole-breast radiation, Gross and his colleagues say.
In fact, previous research has found a higher rate of breast removal and acute complications among women who get the new treatment instead of the traditional one.
The new study is based on nearly 30,000 Medicare beneficiaries who underwent breast-conserving surgery in 2008 or 2009.
It found 16 percent had brachytherapy, although rates varied widely across the country - from none to more than 70 percent in some areas.
"This strongly suggests there are providers in those regions who are playing a major role in steering women toward brachytherapy, and we find that to be very concerning," Gross told Reuters Health.
He said whole-breast radiation costs about $6,000, whereas Medicare shells out roughly $12,000 for brachytherapy.
After accounting for factors such as patients' income, overall health and whether they had chemotherapy, the researchers found 35 percent of women who got brachytherapy had a complication over the following year - usually an infection or other problem related to the wound or skin.
By contrast, only 18 percent of women getting whole-breast radiation experienced a complication. That means that for every 100 women who undergo radiation therapy after breast cancer surgery, there are 17 extra complications after brachytherapy compared with the standard treatment.
Hologic declined to comment on the new findings.
UNPROVEN TECHNOLOGY
The new findings add to a report from 2010 showing that from 2001 to 2006, the use of brachytherapy after breast surgery rose steadily from less than one percent of cases to 10 percent.
"There is often a great deal of excitement for new treatments, but just because something is new doesn't mean it's better," said Gross. "Women should ask their providers to discuss with them, ‘What do we really know about the risk and benefits of different treatment options?'"
An editorial published with the report echoes Gross's concerns, although it adds that the study was observational and so is less robust than an experiment comparing the two treatments head-to-head.
In the editorial, entitled "When Hope Hinders Science and Patient-Centered Care", Dr. Jennifer Malin of the University of California, Los Angeles, notes that the regulatory requirements for new medical devices do not include proving that they improve patient outcomes - a requirement when companies apply for drug approvals.
"After a capital investment has been made to acquire the device (…) uptake of the new technology occurs even in the absence of evidence of improved or even comparable outcomes," she writes.
About one in eight women will be diagnosed with breast cancer at some point in her life, according to the American Cancer Society, but only a minority die from the disease.
After breast-conserving surgery, up to 40 percent of women see the cancer return, but that number can be reduced to about 10 percent with external-beam radiation of the whole breast. Common side effects are swelling and redness.
According to Gross, the benefits of radiation outweigh the harms for younger women, but some older women may safely skip the treatment.
"The first question (to ask your doctor) is, ‘Do I need radiation at all?'" Gross said. "The second question is, ‘What are the risks and benefits of the different radiation treatments?'"


When in Cebu City, please visit gregmelep.com for your real estate and retirement needs. 

Wednesday, October 10, 2012

Parents warned vs toxic kids’ toys


By Jonathan Fernandez
Posted on 10 Oct 2012 at 12:01am
Consumers were reminded on Tuesday to buy only safe and non-toxic toys this Christmas after the environment watchdog EcoWaste Coalition found that 60 out of 100 toys they tested contained lead and other harmful chemicals that can cause cancer, reproductive abnormalities, endocrine disorders, as well as behavioral developmental and learning problems.
Anthony Dizon, coordinator of the EcoWaste’s Project Protect, issued the warning after they found 43 out of 100 samples they tested were tainted with high levels of lead, which were above the US regulatory limit of 90 parts per million (ppm).

Non-toxic Christmas. Looking forward to a non-toxic Christmas, children sporting Santa Claus hats hold up posters warning the public against toxic toys that have been found in stores in Baclaran and Pasay. Health and chemical safety advocates from the EcoWaste Coalition asked toy makers, importers, distributors and vendors to prioritize children’s health and halt the trade in untested, unlicensed and unlabeled children’s toys. MANNY PALMERO
He said 32 toys contained more than one toxic metal such antimony, arsenic, cadmium, chromium, and mercury also above levels of concern.
Dizon said that among the samples found tainted with harmful metals were some dolls with PVC materials, play makeup sets, toy animals, toy boxing gadgets, toy cars, toy guns, toy musical instruments and other toy products.
Not a single toy, Dizon noted, listed its chemical ingredients on the label and “it deprives consumers of their right to know what the products are made of and, consequently, to make informed choices.”
The EcoWaste bought the samples, worth from P2 to P165 each, last week at various retail shops in Baclaran and Pasay City.
Bill Menrath, a visiting expert from Ohio, said that the test results give credence to the urgency to phase out lead and other substances in paints and children’s products that may undermine brain development and wreak havoc on kids’ health.
“Children are not able to protect themselves against lead and other hazardous substances lurking in toys, and it is really up to us, adults, to shield them from these hidden toxins. In the US, over a million children have high levels of lead in their blood because of exposure to lead in paint, dust and soil, necessitating for strong preventive measures to combat childhood lead poisoning at the source,” Menrath said.
When in Cebu City, please visit gregmelep.com for your real estate and retirement needs.

Wednesday, April 18, 2012

Cough relief sans the risk: Plant-based remedies safe, effective



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Who would have thought that unassuming plants and herbs that grew in our backyard would be parlayed into a multi-million-peso industry one day? Clinical studies proving phytomedicines’ (or plant-based drugs) efficacy and growing consumer trust and patronage  have created a huge market for such natural-based remedies. As a result, big pharmaceutical companies in the Philippines have begun to aggressively develop new products from  indigenous sources.
Sales figures, from Lagundi-based cough medicines alone, rose from P38 million in 2004 to an astounding P500 million in October 2011. Pascual Laboratories (PascualLab), the first pharmaceutical company to develop and market the first licensed herbal medicine in the country, accounts for 90 percent of this figure thanks to its Ascof Lagundi brand, the most  successful  phytomedicine in  the Philippines.
Ascof was the first herbal medicine licensed by the Philippine Council for Health Research and Development and the Department of Science and Technology. It was introduced by PascualLab in 1996 in collaboration with the National Integrated Research Program of Medicinal Plants, the government institution that undertakes research on herbal plants for medicinal purposes.
Today, PascualLab has its own Herbal R&D and Product & Process Development groups which collaborate with independent medical and research institutions in the country to continuously improve its products. Innovations that the company has implemented in over two decades have resulted in the Ascof that it is today—having higher quality than products produced using an older technology.
The brand has since then become synonymous to safe and natural healing  that is anchored on scientific foundation, all-natural ingredients and PascualLab’s heritage that is respected by consumers and the industry as a whole.
The company gives consumers the assurance that only organically grown and 100-percent natural lagundi leaves are used in the formulation of Ascof, making it the superior brand in the market. It has an all-organic, award-winning 40-hectare Leoni Agri Corp. plantation in Nueva Ecija that is free of all  pesticides, herbicides, fertilizers and other chemicals. It is a vast herbal repository where the best and high quality medicinal plant varieties are nurtured. Lagundi leaves used in Ascof come from here, carefully processed before being packaged into capsule, tablet and syrup forms.
But in the midst of all the buzz on phytomedicines, Ascof should not be confused with herbal or food supplements. It is categorized as a medicine developed through years of scientific research and validated by clinical trials. Its HMR-01 registration number shows that Ascof is the first plant-based medicine registered under the Food and Drug Administration.
Trusting Ascof is an easy decision for Filipino households to make because it has proven useful in solving their loved ones’ cough problems, keeping them safe from further health risks.

Tuesday, January 31, 2012

Danilo Casimiro–one of the world’s top vaccine developers, and a Filipino



The UP graduate is the only Filipino scientist in Merck’s vaccine discovery department, which produced the world’s leading vaccine against HPV

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Danilo Casimiro, the only Filipino scientist who was part of the team that worked on Gardasil, the world’s leading vaccine against the human papillomavirus (HPV), is now busy working with colleagues on a vaccine to help prevent dengue.
Casimiro flew to Manila recently from West Point, Pennsylvania, where a number of Merck’s state-of-the-art laboratories and manufacturing plants are located, to give a series of talks to local pediatricians and gynecologists/ obstetricians about the need to address HPV at a young age through a series of vaccinations.
A magna cum laude with a BS Chemistry degree from the University of the Philippines Diliman, Casimiro later took postgraduate and doctorate studies in biochemistry and chemistry at the California Institute of Technology in Pasadena.
He holds the distinction of being the only Filipino scientist in Merck’s vaccine discovery department, composed of close to 90 people.
Second-generation drug
“To be honest with you, I was involved in Gardasil more on the tail-end,” the soft-spoken Casimiro said. “But, obviously, after Gardasil’s licensure, there were more studies that needed to be conducted.”
And those studies have led Merck to work on a second-generation HPV vaccine that works not only on four, but nine types of HPV. It’s now on its “phase three” or late-stage development.
It may be the gold standard in HPV vaccines today, but Gardasil, which was first introduced in the market in 2006, only covers 70 percent of HPVs, which cause cervical cancer among women. In effect, there are still so-called high-risk HPV types that aren’t covered by Gardasil.
“The second generation [Gardasil] adds five more types, which brings the coverage to 87 percent,” said Casimiro.
According to a Center for Diseases Control fact sheet, HPV is the most common sexually transmitted infection among sexually active men and women. The more than 40 types of HPV can cause anything, from benign but unsightly genital warts to life-threatening cancers such as cervical, anal, rectal, penile and even cancer of the oropharynx (back of throat).
Even monogamous couples who have had previous relationships are still at risk, as the virus, even if acquired from a previous sex partner and remains inactive in the body, can still be passed on to a current sex partner.
In most instances, as long as your immune system isn’t compromised, the body is eventually capable of neutralizing the virus by itself. But there are certain types of HPV that are resilient to the body’s immune system. These are the ones that could pose health problems to the individual later on.
In the Philippines, Gardasil, which comes in three shots ideally administered within a six-month period, is given to boys and men 9-26 years old, and girls and women 9-45 years old.
Age disparity
Why is there a need to give the vaccine early, and why the age disparity between men and women?
The immune system Gardasil brings about is better on a young person, even though he or she may not yet be sexually active. It’s just the way the body’s immune system works, said Dr. Ina Crisologo, an obstetrician-gynecologist and one of Merck’s medical advisers in the Philippines.
“In the Philippines, we have approval to make Gardasil available to girls as young as nine,” said Crisologo. “I’m not aware of any vocal opposition to giving the vaccine at such a young age.”
“As you age, you become less responsive to vaccines,” Casimiro added. “It has been shown for HPV, but I think it can apply generally.”
Certain consequences of HPV on males, particularly genital warts, can be acquired at any age. But studies Merck conducted are limited to the 9-26 age group.
“There may be some doctors who dispense Gardasil to male patients older than 26, but this is considered off-label,” said Crisologo. “Patients can just be informed that scientific evidence was based only on a specific population belonging to a specific age group.”
In other words, because of the absence of additional tests, it hasn’t been proven to be beneficial to people beyond certain ages. The same condition applies to women. Gardasil’s full efficacy has also been proven with the completion of three shots.
The way Casimiro sees it, Gardasil has revolutionized the market in more ways than one.
“Now you have adolescent and a young adult market, which before wasn’t very robust for vaccinemanufacturers,” he said.
No stumbling block
As for his being a Filipino, it never became an issue or a stumbling block in his 15 years at Merck.
“One thing good about Merck is that they provide you with opportunities regardless of your racial origins,” he said. “Diversity as well as ethics and integrity are integral parts of the company’s core values. As long as you dedicate yourself to your work, the rewards and recognition will come.”
But his being Filipino does come into play with his work. This can be seen in the latest studies he and his colleagues are working on.
“I think my being a Filipino ties me to what’s important in the [Asia-Pacific] region,” he said. “For example, I was involved in the initial part of formulating the team for the dengue vaccine Merck is publicly working on. I feel passionate about vaccines not only on what’s relevant to the developed market, but also for the emerging markets.”