Marion County Medical Center

Health Shorts

March 2003

Incidence of Melanoma Increasing
The prevalence of melanoma has increased steadily over the past 70 years. Whereas the lifetime risk for Americans in the 1930s was 1 in 1,500, the risk is now 1 in 75. Exposure to the ultraviolet rays of the sun is one of the risk factors for melanoma, the least common but most deadly type of skin cancer. Scientists believe the increased prevalence may be due to too much time spent in the sun, particularly during youth, combined with depletion of the ozone. Because of early detection and improved treatment, the mortality rate from melanoma has remained fairly stable. About 80 percent of melanomas are now detected while the cancer is localized and treatable.
[SOURCE: "Skin Cancer-Shedding Light on Melanoma," Harvard Women's Health Watch, September, 2001]

Are We Getting Lax about Sun Protection?
Skin cancer can be prevented by avoiding direct sunlight as much as possible and by wearing protective clothing and sunscreen when venturing out. That message has been well publicized, but results of the National Health Interview Survey (NHIS) indicate that Americans have become lax about following these preventive measures. In 1992, the NHIS found that 28 percent of white adults were very likely to wear protective clothing, 30 percent made an effort to stay in the shade and 32 percent applied sunscreen. In the 1998 survey, those percentages had fallen to 27 percent, 23 percent and 30 percent respectively. Although women interviewed in 1998 were more likely to desire a tan, they were also more likely than men to practice sun-protective behaviors.
[SOURCE: "Americans Are Less Likely To Protect Themselves than in 1992," Cancer Weekly, September 18, 2001]

Some Sun Not All Bad
There's no question that sunbathing or lying under a tanning lamp will significantly increase your risk of skin cancer, but some exposure to sunlight is healthy. Recent studies conducted at the National Cancer Institute found that individuals living in sunny areas and working outside had a significantly reduced risk of dying from breast, colon, prostate and ovarian cancer. Sunlight provides about 90 percent of the average person's vitamin D, and researchers believe that this vitamin may prevent malignant cells from growing and spreading.
[SOURCE: Marnie Ko, "Go Ahead, Catch Some Rays; New Studies Suggest Heliophobic North Americans Should Stop Being So Afraid of the Sun," The Report Newsmagazine, October 7, 2002]

Basal Cell Cancer on Face Is High Risk
Basal cell carcinoma, the most common kind of skin cancer, does not spread to other organs and is almost never life threatening. Yet when a basal cell carcinoma appears on the face, as it often does, it is considered "high risk." Left untreated or treated inadequately, it may damage the eyes, lips or nose and is difficult to remove with good cosmetic results. For best results, many doctors recommend Mohs micrographic surgery, a procedure in which the cancer is removed layer by layer, with each one examined under the microscope until the entire area is free of cancer cells.
[SOURCE: "Mohs Surgery for Basal Cell Carcinoma on the Face," Harvard Women's Health Watch," February, 2003]

Umbilical Cord Offers Lifeline
Leukemia patients can often get new life through stem cell transplants, but only 20 percent of patients have a sibling with blood matched closely enough for a bone marrow transplant. A study published in the New England Journal of Medicine found that umbilical cord blood from a non-matched donor was effective in prolonging life for 26 percent of 68 adult patients with terminal leukemia. Umbilical cord blood had previously been used successfully for children but was not considered safe for adults.
[SOURCE: Mary J. Laughlin, et al, "Hematopoietic Engraftment and Survival in Adult Recipients of Umbilical-Cord Blood from Unrelated Donors," NEJM, June 14, 2001]

Endurance, Winter Athletes at Risk
At highest risk of exercise-induced asthma are endurance athletes such as long-distance runners and winter athletes such as cross country skiers, ice skaters and hockey players. Sports requiring constant activity such as cycling, soccer and field hockey are also likely to trigger asthma symptoms in susceptible individuals. Swimming is often considered the ideal activity for a person with asthma because of the warm, humid environment and the horizontal position of the body in the water. Some swimmers are vulnerable, however, because of sensitivity to chlorine. Other activities less likely to trigger an asthma attack include walking, hiking, racquet sports, baseball and downhill skiing.
[SOURCE: American Academy of Allergy, Asthma & Immunology, "Tips to Remember: Exercise-Induced Asthma; Christopher C. Randolph, "Exercise-Induced Asthma, Part 1: How To Make the Diagnosis," Journal of Respiratory Diseases, July, 2002]

Undertreated Asthma Can Be Fatal
A study of 263 competitive and recreational athletes who died of a sudden asthma attack found that more than 77 percent were not using anti-inflammatory medication at the time of death. "They probably were not treated well enough," wrote the authors.
[SOURCE: Miriam E. Tucker, "Undertreated, Mild Asthma Can Be Fatal in Athletes; Monitor Closely," Family Practice News, July 1, 2002]

23% of 1998 Olympians Had Asthma
Testing under controlled conditions revealed that 23 percent of athletes competing in the 1998 Winter Olympics had exercise-induced asthma. In the 1996 Summer Olympics 30 percent of U.S. athletes with asthma won medals. Of athletes without asthma, 28.7 percent won medals.
[SOURCE: R.L. Wilbur et al, Med Sci Sports Exerc; 200, 32:732-7, "Just for Kids: Dispelling the Myths of Exercised-Induced Asthma by Joanna Zieger, American Academy of Allergy, Asthma Immunology; Jeffifer Gollhard and Michele Martinez, "Athletes and Asthma, AAAAI, August 6, 2001]

Diabetics Face Greater Heart Risk
Of the one million Americans who are admitted to the hospital because of a minor heart attack or prolonged chest pain, 20 to 30 percent are diabetics-many of whom do not know they have the disease. According to a pooled analysis of four studies involving 24,000 patients, those with diabetes had a mortality rate of 5.5 percent compared to 3.0 percent for those without diabetes.
[SOURCE: Jean McCann, "Cardiologists Hail Stats on Standards, Stents, and Statins," Drug Topics, April 15, 2002]

Longer Stent Found Effective
In addition to using drug-coated stents in an effort to reduce the re-narrowing of arteries that can occur after balloon angioplasty, researchers are investigating the use of longer stents. According to research presented at the Transcatheter Cardiovascular Therapeutics conference [November, 2002], even a little additional length can be effective. "The longer the stent, the better the restenosis rates are," wrote Martin Leon, M.D. "We found that for every 10 millimeters of added stent, we gained an additional 13 percent [in reduction] of restenosis."
[SOURCE: Kevin New and Larry Haimovitch, "Drug-Coated Stents Dominate, But Other Technologies Edge onto Stage," Cardiovascular Device Update, November, 2002]

Statins Improve Angioplasty Results
Patients receiving a cholesterol-lowering statin medication prior to an angioplasty procedure to clear blockages in coronary arteries had better results and were less likely than other patients to die, according to a study conducted by Albert Chan, M.D., of the Cleveland Clinic Foundation. In a review of 5,000 cases, Dr. Chan found that 26.5 percent had been receiving a statin, and their death rate was 33 percent lower than that of other subjects six months after angioplasty.
[SOURCE: Jean McCann, "Cardiologists Hail Stats on Standards, Stents, and Statins," Drug Topics, April 15, 2002]

Obesity Trims 6 to 7 Years from Life
The health risks of obesity are well known, but a study published in the Annals of Internal Medicine confirmed that it creates a significant risk of early death. Using data on 1550 men and 1907 women from the Framingham Heart Study followed for 40 years, researchers in the Netherlands found that those who were obese at the start of the study had a decreased life expectancy of six to seven years. The increased risk of death attributed to obesity was similar to that caused by smoking.
[SOURCE: A. Peeters et al, "Obesity in Adulthood and Its Consequences for Life Expectancy: A Life-Table Analysis, Annals of Internal Medicine, January 7, 2003]

Eat Fish To Head Off Stroke
Men who ate fish one to three times a month and those who took omega three fatty acid supplements had a significantly lower risk of suffering an ischemic stroke with no increased risk of a hemorrhagic stroke, according to data from the Health Professional Follow-Up Study. An ischemic stroke, the most common kind, is caused by interruption of blood flow to the brain; a hemorrhagic stroke, by uncontrolled bleeding in the brain.
[SOURCE: K. He et al, "Fish Consumption and Risk of Stroke in Men," JAMA, December 25, 2002]

Healthy Eating: An Alternative
Harvard School of Public Health researchers have suggested an alternative to the U.S.D.A. food pyramid, separating healthy fats from unhealthy ones, distinguishing between simple and complex carbohydrates and stressing plant-based sources of both fat and protein. In a study of 105,000 health professionals, Harvard researchers found that subjects following either diet had a reduced risk of heart disease and other chronic disorders, but the reductions were significantly greater for those who followed the Harvard diet.
[SOURCE: "Food Pyramid in Need of Renovation," Harvard Women's Health Watch, February, 2003]

Health Shorts

March 2003

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