More May Health News…

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May 25, 2014

1.  More patients will die from pancreatic cancer than from breast or prostate or lung cancer.

 My mother in law Dr. Cathy Wilfert was a medical student at Harvard University in the 1960s and she told me the students in her class heard about pancreatic cancer but never personally witnessed a case.  Now, it seems as if everyone knows someone with pancreatic cancer.  Steve Jobs of Apple company died of pancreatic cancer a few years ago.  One of the anesthesiologists I have known for more than twenty years was recently diagnosed with advanced pancreatic cancer.  Ironically, after a fall several months ago, he had a CT scan revealing a totally normal abdomen, showing how rapidly this cancer can grow.   

A paper published recently in Cancer Research reported that, due to the increasing rates of pancreatic cancer and the high death rate from this particular cancer, in 16 years, more patients will die from pancreatic cancer than from breast, prostate or lung cancer. 

Pancreatic cancer is one of the faster spreading cancers; only about 4% of patients can expect to survive five years after their diagnosis.  Approximately 44,000 new cases are diagnosed each year in the U.S., and annually, about 37,000 people die of the disease.  The bad news about the mortality rate ranking of pancreatic cancer likely is tied to its increased incidence but also related to some good news, namely, that the death rates from other cancers are declining.  

Breast, colon and prostate cancers have effective and well-publicized screening programs whereas screening and detecting pancreatic cancer has been a difficult challenge.   That said, researchers trying to find a blood test that could detect pancreatic cancer at a much earlier stage than is possible at present have been encouraged by some recent work that appears to distinguish successfully patients with benign pancreatic cysts from patients with early pancreatic cancer.  Stay tuned.

For more information, see Alice Park, (May 19, 2014) 

2.  Acute Bronchitis and Antibiotic Treatment: An Unacceptable Practice. 

Every winter, I have numerous patients who either get antibiotic treatment from their primary care physicians, or request a prescription from me for their “bronchitis.”  Many of these patients even know the particular antibiotic most commonly prescribed by their primary care doctors for the symptoms of bronchitis,  

Now, an article recently released from the Journal of American Medical Association has confirmed how despite clear data, guidelines and more than 15 years of educational efforts to eliminate this unnecessary practice, 71% of patients with acute bronchitis were given antibiotic prescriptions.

Drs. Michael Barnett and Jeffrey Linder of Brigham & Women’s Hospital in Boston looked at 3,153 cases of acute bronchitis between 1996-2010 and demonstrated how antibiotic treatment for acute bronchitis has increased significantly in emergency departments despite evidence that there is no efficacy in this treatment approach.

With the multiple warnings from the World Health Organization and the FDA regarding the serious “super bugs” problem around the world as a result of the over-prescribing antibiotic habits of physicians, patients should be vigilant about not taking antibiotics unnecessarily.  Supportive treatment for symptoms of acute bronchitis is needed, but your primary care physicians should remember that antibiotic treatment for acute bronchitis generally is inappropriate.  

3.  Urinating in the Pool and its Potential Harm

As the summer is soon approaching, many private and community pools are being opened and the children can’t wait to have a fun and wet summer in their local pools.  Like these children, I try to go to the gym’s pool to swim my one mile at least once weekly.  As I work hard on my laps, I often wonder if the pool water is clean and safe for my health.  Do people get out of the pool to empty their bladder, or the pool is their toilet?  

A recent study, published in the journal Environmental Science and Technology, conducted by Dr. Ernest R. Blatchey III, professor of Civil Engineering at Purdue University, showed how urinating in pools is an unacceptable practice.  Uric acid in human urine, combined with chlorine, creates cyanogen chloride (CNCI) and trichloramine (NCL₃).  CNCI is toxic and can damage the lungs, heart, and central nervous system.  Trichloramine may also be linked to lung damage.   

Hopefully, in your neighborhood pool, swimmers remember the courtesy of getting out of the pool to go to the restroom.  Even in your private pool, however, remind the children not to use the pool as their toilet.  It’s a good practice to teach them at a young age.

4.  FDA Approval of Entyvio Injection for Ulcerative Colitis and Crohn’s Disease.

Entyvio (vedolzumab; Takeda) injection was approved recently by the FDA for the treatment of adults with moderate to severe ulcerative colitis and Crohn’s disease when other standard treatments are not successful.  

The safety and efficacy of Entyvio was established in 2 studies with about 900 ulcerative colitis patients and 3 studies of Crohn’s disease with about 1500 patients.  These patients did not have an adequate response with traditional treatments such as corticosteroids, immunomodulators or TNF-blockers. 

Entyvio will be provided in 300mg single dose vials and available in June 2014.