Word: breast
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...most agonizing choices a patient with a life-threatening illness has to make is when to put quality of life ahead of length of life. Case in point: chemotherapy after breast-cancer surgery. Although the side effects of chemo (among them nausea, fatigue and hair loss) can be brutal, the treatment does work: patients who go through it will, on average, live longer. So I was surprised to read in the current issue of Annals of Internal Medicine that only 29% of breast-cancer patients actually take their doctor's advice and get chemotherapy after surgery. Even more striking...
...results are based on an examination of the medical records of more than 5,000 women who were diagnosed with breast cancer between 1991 and 1997. According to Dr. Xianglin Du, assistant professor of internal medicine and geriatrics at the University of Texas Medical Branch at Galveston and lead author of the study, there was "a clear divergence between recommendations from the National Institutes of Health and what is seen in clinical practice." The NIH guidelines, developed by experts in the field and released in November 2000, found "substantial" benefit from chemotherapy for both premenopausal and postmenopausal women...
...suspect there are a couple of reasons, one good and one not so good. The first probably stems from the definition of substantial benefit. While chemotherapy is typically thought of as life-prolonging (rather than lifesaving), its benefits definitely fall off with age. According to the Early Breast Cancer Trialists' Collaborative Group, women 50 and younger were 27% less likely to die within 10 years of surgery if they were also treated with chemo. By contrast, women 60 to 69 had their 10-year mortality rate reduced by only 8% with post-surgical chemotherapy...
...filed a brief supporting Ohio's partial-birth-abortion ban in an appellate court (not waiting, as it normally would, for the case to hit the Supreme Court). A few months later, it quietly removed from a government website information saying that abortions do not increase the risk of breast cancer. (A replacement fact sheet suggests a possible link, though major studies turn up no evidence for one.) Last March the Administration made fetuses eligible for the Children's Health Insurance Program, keying off the antiabortion groups' strategy of establishing "fetal rights" as a way of eventually undermining...
Opponents of bed sharing point to the safety hazards of adult beds, including the danger of falls or suffocation. Advocates say that the practice allows for easier breast feeding, makes for a stronger parent-child bond and means parents have to get up less often during the night to tend to a fussy baby. Some claim the practice even leads to more self-confident, independent children. "We found that in families who shared a bed, the children later rated themselves as more independent and loving than children who had slept alone," says Maria Goodavage, co-author of Good Nights...