Best Advice- All women should discuss screening with their doctor to decide what is best for them
As the U.S. Preventive Services Task Force (USPSTF) recommended two years ago, the government-appointed Canadian panel of experts is also suggesting that women aged 40 to 49 who are at average risk for breast cancer not get routine mammograms.
The Canadian task force has also dropped recommendations for breast self-exams and clinical exams for women with no symptoms.The new guidelines, replacing those issued in 2001, are for women at average risk of breast cancer only. The new guidelines also recommend longer mammogram screening intervals for women aged 50 to 74 -- to once every two or three years. Previous guidelines had recommended mammograms once every two years for women aged 50 to 69 and did not address women aged 70 to 74.The earlier guidelines had said women between 40 and 49 could be screened, but they were not to be actively recruited for screening, noted Patrice Lindsay, an expert in "best practices" for medical care and an appointed member of the Canadian task force.According to Lindsay, "there has been a considerable amount of evidence out over the past few years looking at the benefits and harms of screening practices. The evidence really doesn't support more frequent screening in terms of having an impact on the outcome." The outcomes considered, she said, are a diagnosis of breast cancer and breast cancer death.
The guidelines are published Nov. 21 in the Canadian Medical Association Journal.The new guidelines may rekindle the debate on mammography among experts in the United States
"I believe the U.S. Canada University of Missouri Columbia
In 2009, the USPSTF recommended every-other-year mammograms for women aged 50 to 74. They advised women under 50 to discuss the test with their doctor and only then decide whether to get a mammogram, based on patient preference and other factors. They also recommended against teaching breast self-exam. The USPSTF said evidence was insufficient to assess the benefits and harms of doing clinical breast exams in women aged 40 and older.LeFevre believes that both panels' recommendations hinge on a balancing of risks and benefits to women. Benefits include finding tumors early; harms include the risk for a false-positive test and then unnecessary worry and over-treatment."Both Canada and the U.S. recommendations recommend regular screenings for women 50 to 74, although the U.S. task force recommends every two years and theirs (Canada's) provides the option of every two or three," LeFevre said."The (U.S.
Not everyone agrees with the USPSTF on that assessment, however. The American Cancer Society, for example, continues to recommend annual mammograms beginning at age 40. In a commentary that accompanies the Canadian guidelines, Dr. Peter Gotzsche of Copenhagen
Other experts took a different view of the Canadian guidelines.
"These are ridiculous recommendations," said Dr. Stamatia Destounis, a radiologist in Rochester , N.Y.
Still, the experts did agree on one piece of advice for women: All women should discuss screening with their doctor to decide what is best for them.LeFevre said that when he talks to other U.S. doctors about mammography screening, he tells them: "At age 40, discuss. At age 50, recommend or encourage. At age 60, strongly encourage."
The other side of the coin is underdiagnosis, Wadden argues. Premenopausal cancers tend to be more aggressive and if not undetected early, are more likely to result in negative outcomes, she says. "That's why if we do screen women 40 to 49, they need to be screened annually."
But proponents of the new guidelines argue that if a cancer is that aggressive, early detection is immaterial.
The disease "spreads so rapidly even early detection doesn't make a huge difference in that age group, whereas in the older group it does," says Dr. Walter Rosser, former head of the family medicine department at Queen's University in Kingston , Ontario
Wadden also took issue with the task force’s recommendation for less frequent mammograms for women over the age of 50. “We have data that shows that if women wait more than 30 months to have a mammogram, we get an increase in palpable and later stage cancers, /and therefore I strongly disagree with the recommendation for a three-year interval." (Canadian Medical Association Journal)
Chewing gum gets you Skinny
I just bought 4 packs of Chewing gum and I hope I will be skinny next week….
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Most people understand that serious weight loss requires changing attitudes toward what they eat and how often they exercise. But, what if the process could be aided by simply chewing a stick of gum after meals? That’s the question a team of scientists, led by Syracuse University
Doyle’s study was published online Nov. 4, 2011 in the American Chemical Society’s Journal of Medicinal Chemistry and is forthcoming in print. The journal is the most cited in the field and one of the leading primary research journals internationally. Doyle is an associate professor in the Department of Chemistry in SU’s College of Arts Murdoch University Australia
“PYY is an appetite-suppressing hormone,” Doyle says. “But, when taken orally, the hormone is destroyed in the stomach and that which isn’t destroyed has difficulty crossing into the bloodstream through the intestines.” What’s needed is a way to disguise the PYY so that it can travel through the digestive system relatively unharmed. Several years ago, Doyle developed a way to use vitamin B12 as a vehicle for the oral delivery of the hormone insulin. B12 is able to pass through the digestive system with relative ease and carry with it insulin, or other substances, into the bloodstream. Similarly, his research team attached the PYY hormone to his patent-pending vitamin B12 system. “Phase one of this study was to show that we could deliver a clinically relevant amount of PYY into the bloodstream,” Doyle says. “We did that, and we are very excited by the results.” The next step involves finding ways to insert the B12-PYY system into such things as chewing gum or an oral tablet to create a nutritional supplement to assist individuals in losing weight in much the same way as nicotine-laced gum is used to help people stop smoking. “If we are successful, PYY-laced gum would be a natural way to help people lose weight,” he says. “They could eat a balanced meal, and then chew a stick of gum. The PYY supplement would begin to kick in about three to four hours later, decreasing their appetite as they approach their next meal.”
(Journal of Medicinal Chemistry)
