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Health News: Pregnancy Risks in Cancer Survivors; Lymphoma in Breast Implants; BRCA Testing Rate; Depression on the Rise; Gum Disease and Shortened Lifespan; Marathon Runners and Kidney Disease...

written by Thu Tran, MD,FACOG
on Saturday, 1st April ,2017

Cancer Survivors and Pregnancy Risks

A study from the School of Public Health at the University of North Carolina shows potential risks of preterm labor, low birth weight infants, and higher cesarean section rate in women with history of cancer.  The study gathered data from 15,000 births of women ranging from 15-39 years old.  The study was published online in JAMA Oncology.  These pregnancy risks were highest in those with cancer during pregnancy.  The highest risks were found in women with gynecologic cancers. 

This finding may not be a big surprise to many physicians, but they show how important it is to counsel cancer survivors before pregnancy about potential risks.  More studies should also be conducted to see how we physicians should care for these patients to possibly reduce their risks.  It might be beneficial to patients to also seek counseling in nutrition, fitness and wellness to maintain a healthy pregnancy and hopefully reduce these potential risks. 

Lower Rate of BRCA Testing in High-Risk Women 

BRCA testing is used to identify those with a BRCA mutation which can put them at much higher risk for ovarian and breast cancer.  Angelina Jolie, a well known Hollywood actress, is one of those who carry a BRCA mutation.  Gilda Radner, a famous comedian who died of ovarian cancer, also was a carrier of this genetic mutation. 

A recent study, released in the American Journal of Preventive Medicine, reported how from 2004 to 2014, there were more women with lower risk for these cancers who were tested as compared to those in the higher risk group.  The rate of screening for BRCA in the low risk group was up from 24.3% in 2004 to 61.5% in 2014.  The screening rate in the high risk group, however, was up from 17.6% to 41.7%.  The authors believe the lack of knowledge in primary care providers might contribute to this difference in testing. 

If you have a family history of ovarian, uterine, breast, colon or pancreatic cancer, be sure to inform your primary care physicians.  Investigate thoroughly your family history for the number of people who had these cancers, which side of your family, and age of the relatives when they were diagnosed.  A thorough family history can save your life and the generations to come, if you carry the BRCA mutations. 

Large Cell Non-Hodgkin’s Lymphoma Link to Breast Implants 

The FDA recently confirmed the link between the nine deaths from a rare but deadly form of Non-Hodgkin’s Lymphoma, anaplastic large cell lymphoma (ALCL), to breast implants.  This report from the FDA agrees with the conclusion from the World Health Organization (WHO) in 2016.  ALCL accounts for 1% of all Non-Hodgkin’s Lymphoma cases.

The FDA noted that these cancer cases tend to occur in “textured” implants more than “smooth” implants.  The agency, therefore, advised those who plan to have breast implants to consult with their surgeons regarding the risks and benefits of textured versus smooth surfaced implants, and to educate themselves on the different options of breast implants.

The FDA examined 359 medical reports of ALCL and found nine deaths.  The agency concludes that breast implanted patients have a very low but increased risk of ALCL.  The agency, however, does not recommend that all breast implants should be removed.  Patients with implants should be observant of potential symptoms of ALCL, such as persistent pain or fluid build up around the implants.  

Association between gum disease in postmenopausal women and shorter life span 

A large study from University of Buffalo (NY), of more than 57,000 women, published in the Journal of the American Heart Association, shows a potential link between postmenopausal women with gum disease and early mortality.  

The researchers in this study found that women with tooth loss had 17% higher rate of early death, while those with gum disease have 12% higher risk of death from any cause.  There is, however, no certain association between gum disease and heart disease. 

The authors concluded that good oral hygiene is important for postmenopausal women to avoid early death. 

Depression as Leading Cause of Illness and Disability Worldwide 

The World Health Organization (WHO) announced recently that the depression rate has increased 18% since 2005, affecting now 300 million people.  WHO believes that the lack of support for mental health diagnosis and intervention and the stigma of mental illness have prevented patients from receiving proper treatment.  WHO has started the campaign “Let’s Talk,” to try solving these issues.  

Marathon runners and Acute Kidney Injury 

A study from Yale University of Medicine in New Haven, CN, published online in the American Journal of Kidney Disease, reported Acute Kidney Injury (AKI) in marathon runners.  The study consisted of 22 marathon runners with the mean age of 44 who participated in the 2015 Hartford Marathon.  Urine and blood samples were used in this study.

The authors found that 82% of runners had creatinine level in the range of stages 1 and 2 of AKI, while 73% of them had structural injury to kidney tubular system.   

Although the study sample was small, this study result should alert long distance runners of potential kidney injury.  Those with a history of kidney problems should consult their physicians or nephrologists before deciding to participate in marathons.

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