Thursday, August 21, 2008

Breast Cancer: weekly taxol vs. tri weekly tch?

Question posted in Breast Cancer Forum:

I'm very concerned over the 2 different paths of treatment proposed to me by 2 different oncologists. Onc #1 proposes a 12 week regimen of taxol administered weekly adding herceptin later then followed by tamoxafin, while onc #2 suggests taxotere, carboplatin, herceptin every 3 weeks for 6 cycles then followed by tamoxafin. Not sure who to go with.
I had an excisional biposy done for a breast tumor that measured 4 x 4 x 1 and during a pet scan a vauge area on my liver approx 2.1 x 1.8 in size which onc #1 believes metastasis has occured and will not order a liver mri while onc #2 wants a liver mri to confirm but believes that metastasis is definitely possible. My tumor is her 2 positive and estrogen sensitive.
Because of my age of 27 they both believe that aggressive treatment is necessary. I just don't want to make a fatal mistake. What are the + / - of either treatment and why are the 2 onc on different pages?

Reply from the Cleveland Clinic:

There is no absolute correct way to approach breast cancer treatment. Certain factors about the tumor may help to direct aspects of therapy, such as whether the tumor is HER2 positive or Estrogen and Progesterone receptor positivity, but these do not dictate the exact treatment regimen. An MRI may or may not clarify the appearance of the liver lesion (it may increase or decrease suspicion) but it will not be absolute. The only way to know for certain is to biopsy and this may or may not be advised depending on your situation. Without evaluation, we cannot determine what regimen we would recommend. If you are not comfortable with either option, consider a third opinion, preferably with an oncologist who specializes in breast cancer. These are often affiliated with large academic medical centers.




Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Full Text of this article can be found on MedHelp at: weekly taxol vs. tri weekly tch?-

Wednesday, August 20, 2008

Americans Made Over 1 Billion Hospital and Doctor Visits in 2006

According to the Centers for Disease Control ...
"Americans Made Over 1 Billion Hospital and Doctor Visits in 2006
Patients in the United States made an estimated 1.1 billion visits to physician offices and hospital outpatient and emergency departments in 2006, an average of four visits per person per year, according to new health care statistics released today by the Centers for Disease Control and Prevention.

The data come from various components of CDC’s National Center for Health Statistics National Health Care Survey and are featured in a series of new National Health Statistics Reports. Some of the findings include:

  • The number of visits to physician offices and hospital outpatient and emergency departments increased by 26 percent from 1996 to 2006, faster than the growth of the U.S. population, which rose by 11 percent.
  • The rise in visits can be linked to both the aging of the population, as older people have higher visit rates than younger people in general.
  • In 2006, seven out of 10 visits had at least one medication provided, prescribed, or continued, for a total of 2.6 billion medications overall. Analgesics (pain relievers) were the most common, accounting for 13.6 percent of all drugs prescribed, and were most often used during primary care and emergency department visits.
  • The emergency department served as the route of admission to hospital inpatient services for roughly 50 percent of non-obstetric hospital patients in 2006, up from 36 percent in 1996.
  • Patients with Medicaid use the emergency department more frequently than patients with private insurance – 82 per 100 persons for Medicaid vs. 21 per 100 for private insurance.
    Most emergency department visits occurred after business hours (defined as 8 a.m. to 5 p.m. on weekdays), when 63 percent of adults and 73 percent of children younger than age 15 arrived.
  • The overall average waiting time to see a physician in the Emergency Department was nearly 56 minutes.
  • Over the past 36 years, the percent of hospital inpatients who were 65 years of age and older grew from 20 percent in 1970 to 38 percent in 2006. Over the same time period, the percent of inpatients who were 75 years of age and older grew from 9 percent to over 24 percent.
  • The rate of knee replacement for those aged 65 years old and over increased 46 percent between 2000 and 2006, and the rate doubled among those aged 45-64 years during the same time period.
  • The rate of coronary atherosclerosis (clogged heart arteries) more than doubled during the 1990s but since 2002 declined for all age groups, particularly for those 65 years and over.
    Between 1996 and 2006, the percentage of visits to hospital outpatient departments made by adults 18 years and over with chronic diabetes increased by 43 percent and visits with chronic high blood pressure increased by 51 percent.
The full text of this article can be found at the CDC website.

Tuesday, August 19, 2008

New Brain Tumor forum

Med Help has recently launched a new Brain Tumor forum. Questions in the forum are being answered by doctor Michael Lim from John's Hopkins. In researching this, it appears that this is the first brain tumor message board that is being moderated by a doctor and especially compelling is that he is from a renowned medical institution- John's Hopkins.

In reviewing the Brain Tumor forum, the questions and answers appear to range from; what's wrong with me/do I have a brain tumor? to more in depth Q&A from those that have been diagnosed (e.g. Diffusely Infiltrating Low Grade Glioma (grade 2) - astrocytoma)

Such a poorly understood disease- at last some professional support.

Monday, August 18, 2008

New drug for Huntington’s Disease

Federal regulators approved the first treatment for Huntington’s disease in the U.S. Huntington's, is a rare disease that causes uncontrolled movements, deterioration of mental abilities and, ultimately, death. The disease is inherited. The new medication called, Xenazine, is not a cure, and has some potentially serious side effects. The full text of this article may be found on the Newsday website among others.