New Breast Cancer Technology: Molecular Breast Imaging (Part 1)

A new screening tool that is being used to detect breast cancer is shown to work three times better than mammography at finding tumors in women who have dense tissue in their breast, which can confound mammograms.

Mammography, which is an X-ray of the breasts, was shown to detect less than a third of the tumors that were found by using this new technique called molecular breast imaging, or MBI, the researchers stated in from of a breast cancer committee that is sponsored by the American Society of Clinical Oncology and other groups.
Mammography is most commonly used to screen patients for breast cancer, but only about a quarter of women have dense breast tissue, which can cause the mammogram X-rays difficulty in seeing through this to spot small tumors. The physicians are eager for other methods that could be used to perform the scans more efficiently.
This study, which involved 940 women, is the largest to date to compare the new technology MBI to mammography. The MBI is still experimental and is not readily available to women yet.

The women from the study that were considered to be at high risk for contracting breast cancer due to a family history of the disease, genetic susceptibility or other factors, underwent mammogram screenings and the new MBI screenings.

Before an MBI, the patients are first injected with radioactive agents that get absorbed by the tissue in the breast. Breast cancer cells tend to absorb more of the agent that the healthy cells, and the specialized cameras that detect the gamma rays from the agents then it can differentiate tumors from the healthy tissues.
Carrie Hruska from the Mayo Clinic in Rochester, Minnesota, and the lead researcher of the study, said, "We're certainly not advocating replacing mammography in any way. But we think it (MBI) would have a role as an additional test for those women that aren't served as well by mammography as we would like."

With using the MBI technology, the ability to see a tumor is not affected by the density of the surrounding tissue in the breast, so it offers a great promise for women whose mammograms may not provide the most accurate assessment. Among the 940 women who participated in the study, 13 tumors were found in 12 of the women. The MBI found 10 of them and the mammography found three.

Read More..

Hair Restoration Treatments: Hope or Hype? (Part 3)

Surgical hair transplantation is the fastest growing cosmetic surgery today. There are currently a few surgical procedures available: the ‘donor strip' hair transplant, ‘follicle unit extraction', and scalp reduction.

The donor strip method is the most commonly used, provides the best results and is considered the only viable surgical treatment by over 95 percent of hair restoration surgeons in the United States. The surgeon first removes a section of hair-bearing skin from the back of the head, right around the base of the skull. The removal area is sutured together, leaving a thin scar blended into the hair in the back of the head. The follicular units are extracted and placed in cool saline solution. Then, small incisions are made in the areas of thinning and loss and one-by-one the follicular units are implanted.

Follicular Unit Extraction is just that; instead of making an incision in the back of the head, each individual follicular unit is removed with a punch blade and then relocated to the areas of thinning and loss, all in one step. Unfortunately, it isn't as simple as it sounds. First of all, hair follicles do not grow straight up and down beneath the skin; they grow at angles. Not only that, but each follicle can be at a dramatically different angle than the follicle next to it. Clinical studies have shown that 25-40 percent of all follicular units being extracted are destroyed, simply cut in half. In addition, the punch blade will leave multiple scars throughout the donor area. Bottom line: follicular unit extraction procedures cost more, result in less density and compromise the donor area. This is why few surgeons employ this technique, and respected names in hair restoration caution against it.

Scalp reduction surgery involves removing an area of the scalp, eliminating part of the area affected by hair loss. The result can be a reduced bald spot and greater coverage by surrounding hair-bearing skin as it is pulled towards the spot where the skin was removed. However, there are risks associated with this procedure. Stretching is a likely possibility since the resulting scar has a great deal of tension on it. Another possibility is traction alopecia, which is the permanent hair loss caused by great stress on hair follicles. Also, reduction in scalp elasticity from a scalp reduction can compromise future hair transplant procedures.

The cost for hair transplant surgery? The average procedure is about $5,200, and depending upon the procedure, could rise to $10,000 or more.
If you are experiencing hair loss, only you can judge the procedure that is right for you. Be sure to do your homework and keep in mind the relative risks and benefits of each procedure.

Read More..

Incision-Free Weight Loss Surgery in Experimental Phase ( Part 2)

After the surgery, the patient is placed on a liquid diet for several weeks and warned that eating too much or too fast could cause vomiting. Nutritionists say the best time to lose weight is in the 6 to 12 months following the surgery, because the body will try to fight the surgery by absorbing more nutrients.

Over the past several years, 98 patients in Mexico and Europe have had the new weight-loss surgery. Those who have passed the one-year mark have lost about 40 percent of their excess weight, on average. But in the U.S., the procedure is strictly experimental and has been used on only a few patients as part of a study paid for by the device maker, Satiety Inc.

Satiety, Inc. was founded in 2001 through a collaboration of medical device incubators Thomas Fogarty Engineering and The Foundry, and is headquartered in Palo Alto, California. Other companies are also developing new devices and minimally invasive operations, but Satiety is among the first to start testing its products in people.

Karleen Perez, a 25-year-old graduate student in social work, was the second patient at New York-Presbyterian Hospital/Columbia to enter the study. Dr. Marc Bessler and Dr. Daniel Davis performed the procedure Ms. Perez, while Satiety employees advised. “It (the procedure) has a lot of promise,” Dr. Bessler said. “I deal with a lot of new technologies. This, I’m really excited about.” Dr. Bessler said that he and Dr. Davis had no financial interest in Satiety other than the company paying for their work on the study.

Dr. Philip Schauer, director of bariatric surgery at the Cleveland Clinic, called the new operation very promising and said that so far it seemed to offer “a drastic reduction in side effects and risk.” Dr. Schauer was not involved in the Toga study.

Read More..

Hair Restoration Treatments: Hope or Hype? (Part 1)

Both men and women tend to lose hair thickness and amount as they age. Inherited or "pattern baldness" affects more men than women. Approximately 25 percent of men begin to bald by the time they are 30 years old, and about two-thirds are either bald or have a balding pattern by age 60. Women, on the other hand, generally have diffuse thinning that affects all parts of the scalp. In this situation, much of the hair remains, but the thickness of the hair shaft is smaller than normal.

There are a number of treatment options available designed to re-grow hair and to replace hair that's already been lost. Currently in the United States, there are more than 2,000 topical and oral products, about five surgical procedures and several hair restoration devices, but only a few that actually work. Out of all the topical and oral treatments available, only two are approved by the Food and Drug Administration (FDA). They are Propecia and Rogaine.

Propecia is an oral medication; its chemical name is Finasteride. It was developed nearly 40 years ago as a treatment for prostate hypertrophy (extended prostate). However, users found that the hair in their crown and bridge areas of their scalps was getting thicker, and they weren't losing hair at the same rate they once were. Propecia is known as a DHT-inhibitor, actually slowing or halting the conversion of testosterone into di-hydrotestosterone (DHT), a hormone that shrinks hair follicles as men age. Because DHT is known to be the primary cause of male-pattern baldness, stopping the conversion of DHT allows genetically susceptible hair follicles to remain intact, and in some cases increase in size. The side effects of Propecia are minimal and can include a reduced desire for sex (1% chance) and possible breast enlargement (less than .25% chance).

Rogaine is a topical treatment, the latest version being foam. Its active ingredient is Minoxidil, which was originally developed as a product to control blood pressure. But users found that they were growing hair in areas where hair didn't previously exist. Minoxidil comes in a number of strengths: the maximum non-prescription strength of five percent usually recommended for men, two percent formula recommended for women and prescription strength 12 ½ percent, which is seldom used.

Read More..

Hormone Therapy for Prostate Cancer: Helpful or Harmful?(Part 2)

Lu-Yao said, "The reason patients want this is they want something that will improve their quality of life or their survival. But hormone therapy has a detrimental effect on quality of life. And we cannot find any survival benefit for these men in their 70s with very early-stage cancer."

So now we have to ask, why do so many men choose to undergo this unproven treatment that now seems to do more harm than it does good?
Otis Brawley, M.D. and chief medical officer for the American Cancer Society says that it is because it is just an American phenomenon. One of the problems is that when a man finds out that he has early stages of prostate cancer, both he and his physician feel it is necessary to do something. Unfortunately, the result in the end is that the number of men that should get conservative therapy end up getting some kind of intervention.

Brawley and Lu-Yao both suggest that these elderly men would have done just as well if their cancer had never been found. Brawley also notes that many of these men would have likely underwent continued prostate cancer screenings with PSA tests. The other men probably had possible prostate abnormalities that would have been detected by a urologist.
No matter how they got to their conclusions about their cancers, all of these men must have agreed to undergo prostate biopsies. Also, they may have not have been fully informed and could have come to the wrong decision, says the head of urology at New York's Mount Sinai School of Medicine, Simon Hall, MD.

"You have to have a discussion with an older man before he has a prostate biopsy. You have to ask them, 'Do you really want to open Pandora's Box?' Most patients with localized prostate cancer are not going to die from their disease in the first 10 years anyway. It is a legitimate question whether to screen patients this old, and whether urologists should biopsy older patients based on just a knee-jerk reaction."
Hall also noted that he would only treat a very few men with hormone therapy alone. A lot of the elderly men are at a very low risk and really don't need any treatment at all. It seems that the hormone therapy would make no difference so why put these men through the side effects or cost?
All of these experts have noted that the finding of the current study do not apply to the younger men who might receive androgen-deprivation therapy in combination with radiation or surgery. These such men may actually benefit from this type of hormone therapy.

Read More..