Sexually Transmitted HPV Linked to Certain Head and Neck Cancers

• Author: Health Informer
• Filed under: Health News
• Date: May 23,2009

Researchers at Roswell Park Cancer Institute (RPCI) in Buffalo, New York, are strongly advocating a national discussion about the need to vaccinate both young men and women against HPV 16 to prevent head & neck cancers. The call comes amid growing evidence that certain cancers of the head and neck are strongly linked to HPV 16, a specific strain of the human papillomavirus (HPV) that is one of the most common sexually transmitted diseases in the United States. It is estimated that approximately 70% of Americans, both men and women, will be infected with HPV at some point in their lives.

The types of cancer associated with HPV 16 occur mostly at the back (base) of the tongue, in the tonsils, and in the soft palate at the back of the throat, according to Thom Loree, MD, Chair of RPCI’s Department of Head & Neck Surgery. Over the past 10 years, members of RPCI’s Head & Neck Department have seen a threefold increase in the number of throat cancers they treat.

In 2007, Roswell Park researchers began testing all head and neck tumors treated at the Buffalo-based comprehensive cancer center for the presence of HPV DNA, says Saurin Popat, MD, FRCSC, FACS, Attending Surgeon in Head & Neck and Plastic & Reconstructive Surgery, RPCI. RPCI is one of few institutions in the nation to do so. Data from the ongoing testing have been combined with data from archived tumor samples to provide a clearer picture of how many head and neck cancers treated at RPCI test positive for HPV. To date, the total is around 50 to 60 percent.

There are more than 100 types of HPV — each identified by number — but only 70 have been described so far, explains Popat. Some HPV viruses, including 16 and 18, are transmitted sexually — not just through sexual intercourse, but through any skin-to-skin contact involving the mouth, vagina, vulva (the external female genitalia), penis, anus, or fingers.

HPV 16 and HPV 18 were previously identified as the cause of most cases of cervical cancer in the U.S. HPV has also been implicated in the development of some cancers of the vulva, vagina, anus, penis, and perineum (the area between the genitals and anus).

There is no cure for HPV, just as there is no cure for the common cold. In most people, an HPV infection will clear up on its own, but it can be passed on to other people during the infection period — just as with the common cold.

In some cases, the person may continue to be infected for decades without any symptoms. During that time, the infected person can infect others without knowing it. Over time, this “silent,” chronic HPV infection increases the risk of developing certain cancers.

In 2006, the FDA approved the use of Gardasil, a vaccine that protects against HPV 6, 11, 16 and 18, for females between the ages of 9 and 26, to help prevent cancers of the cervix, vulva, and vagina, as well as genital warts.

The FDA has not approved the vaccine for males. The issue of extending approval to males to protect against HPV related cancers is under review, with a decision expected in June 2009.

Loree, Popat, and their RPCI colleagues see compelling evidence for extending the vaccine’s protection to boys. Says Popat, “The side effects of the vaccine are so small, and the potential benefits are great.” He notes that patients with throat cancer “have to undergo major treatment lasting several months, with an additional four to six months of recovery. Their ability to speak and swallow is affected. Generally, they do very well; however, it is a long, challenging road.”

Based on the evidence to date, Loree says that “with increased vaccination against HPV, you’ll see a decrease in cervical cancer and in throat cancers.” He says if everyone stopped smoking and using tobacco in any form, and also got vaccinated against HPV, “we could eliminate head and neck cancers, and I’d be out of business.”

The American Cancer Society estimates that 35,310 new cases of oral and oropharyngeal cancer are diagnosed every year — 25,310 of those in men — and 7,590 people, including 5,210 men, die of those cancers. Smoking, the use of chewing tobacco, and heavy alcohol use remain the leading causes of cancers of the head and neck.

Click here http://www.roswellpark.org/hpv to hear Roswell Park experts discuss the link between HPV and throat cancer.

Top 10 Tips to Save Your Vision

• Author: Health Informer
• Filed under: Health Advices, Health News
• Date: May 22,2009

Texas’ ophthalmologists recommend ten simple steps to reduce your chance of vision loss

More than 20 million Americans suffer from severe vision loss. While not all eye diseases can be prevented, there are simple steps that everyone can take to help their eyes remain healthy now and reduce their chances of vision loss in the future.

May is Healthy Vision Month and through its EyeSmart campaign, the Texas Ophthalmological Association (TOA) wants to remind consumers how important it is to protect your vision. “Proper care and caution is very important to prevent serious eye diseases and possible blindness,” says TOA President and Waxahachie eye doctor Galen Kemp, MD. “Something as simple as remembering to wear your sunglasses can delay the development of cataracts,” Dr. Kemp says.

Here are the top 10 tips from the TOA to safeguard your vision:

Wear sunglasses — UV blocking sunglasses delay the development of cataracts, since direct sunlight hastens their formation. Sunglasses prevent retinal damage; they also protect the delicate eyelid skin to prevent both wrinkles and skin cancer around the eye, and both cancerous and non-cancerous growths on the eye. The US standard states that the lenses should have a UVB (280 to 315nm) transmittance of no more than one per cent and a UVA (315 to 380nm) transmittance of no more than 0.5 times of the visual light transmittance.

Don’t smoke — Tobacco smoking is directly linked to many adverse health effects, including age-related macular degeneration (AMD). Studies show that current smokers and ex-smokers are more likely to develop AMD than people who have never smoked. Smokers are also at increased risk for developing cataracts.

Eat right — Vitamin deficiency can impair retinal function. The belief that eating carrots improves vision has some truth, but a variety of vegetables, especially leafy green ones, should be an important part of your diet. Researchers have found people on diets with higher levels of vitamins C and E, zinc, lutein, zeaxanthin, omega-3 fatty acids DHA and EPA are less likely to develop early and advanced AMD.

Baseline eye exam — Adults with no signs or risk factors for eye disease should get a baseline eye disease screening from an ophthalmologist (a medical doctor or doctor of osteopathy specializing in eye care) at age 40–the time when early signs of disease and changes in vision may start to occur. Based on the results of the initial screening, the ophthalmologist will prescribe the necessary intervals for follow-up exams. Anyone with symptoms or a family history of eye disease, diabetes or high blood pressure should see an ophthalmologist to determine how frequently your eyes should be examined.

Eye protection – An estimated 2.5 million eye injuries occur in the U.S. each year, so it is critical to wear proper eye protection to avoid eye injuries during sports such as hockey and baseball and home projects such as home repairs, gardening, and cleaning. For most repair projects and activities around the home, standard ANSI-approved protective eyewear will be sufficient. Sports eye protection should meet the specific requirements of that sport; these requirements are usually established and certified by the sport’s governing body and/or the American Society for Testing and Materials (ASTM).

Know your family history — Many eye diseases cluster in families, so you should know your family’s history of eye disease because you may be at increased risk. Age-related eye diseases, including cataracts, diabetic retinopathy, glaucoma and age-related macular degeneration are expected to dramatically increase–from 28 million today to 43 million by the year 2020.

Early intervention — Most serious eye conditions, such as glaucoma and AMD, are more easily and successfully treated if diagnosed and treated early. Left untreated, these diseases can cause serious vision loss and blindness. Early intervention now will prevent vision loss later.

Know your eye care provider — When you go to get your eyes checked, there are a variety of eye care providers you might see. Ophthalmologists, optometrists and opticians all play an important role in providing eye care services to consumers. However, each has a different level of training and expertise. Make sure you are seeing the right provider for your condition or treatment. Ophthalmologists are specially trained to provide the full spectrum of eye care, from prescribing glasses and contact lenses to complex and delicate eye surgery.

Contact lens care — Follow your eye doctor’s instructions regarding the care and use of contact lenses. Abuse, such as sleeping in contacts that are not approved for overnight wear, using saliva or water as a wetting solution, using expired solutions, and using disposable contact lenses beyond their wear can result in corneal ulcers, severe pain and even vision loss.

Be aware of eye fatigue — If your eyes are tired from working at a computer or doing close work, you can follow the 20-20-20 rule: Look up from your work every 20 minutes at an object 20 feet away for twenty seconds. If eye fatigue persists, it can be a sign of several different conditions, such as dry eye, presbyopia, or spectacles with lenses that are not properly centered. See an ophthalmologist to determine why you are having eye fatigue and to receive proper treatment.

Find ophthalmologists in your area or ask an ophthalmologist a question by visiting www.GetEyeSmart.org.

Poll Finds Americans See Long-term Services and Supports as a Priority, Not an Option, for Health Care Reform

• Author: Health Informer
• Filed under: Health News
• Date: May 22,2009

Eighty-five percent of Americans believe that long-term services and supports should be included in national health care reform, and will frankly be surprised if they are not, according to a poll conducted by the Mellman Group, sponsored by the American Association of Homes and Services for the Aging (AAHSA).

In a poll of 1,000 adults nationwide, 85 percent of respondents feel that health care reform should include the broad range of services and supports people need when they can no longer independently care for themselves because of age, chronic disease, or serious injury. Seventy-five percent reported they strongly support the inclusion of long-term services and supports in health care reform. Large majorities across age, gender, region and income-level, believe long-term services and supports should be covered under national health care reform. Only 13 percent of respondents felt strongly these services and supports should not be covered.

“These results prove once again that Americans do not draw the artificial line between acute care and long-term services and supports that policy makers used to exclude long-term services and supports from health care reform discussions,” said AAHSA CEO Larry Minnix. “It’s time for Congress to recognize that long-term services and supports are a part of health care that voters expect Congress to address before the baby boomers strain an already strapped system.”

Other results include:

• More than half of Americans (51 percent) feel strongly that with so many Americans needing help caring for the elderly and disabled, no health care reform plan is complete unless it addresses long-term services and supports.

• A majority of adults believe that offerings like care for people with Alzheimer’s disease (61 percent), assisted living (57 percent), and assistance for an older or disabled person in taking their medications (64 percent) will be covered when health care reform is enacted.

“This study builds on a number of studies that have repeatedly shown that Americans are concerned about long-term services and supports and view it as part of the need for health reform,” said Mark Mellman, CEO of the Mellman Group.

These findings were taken from a national survey of 1,000 adults interviewed by telephone May 14-18, 2009. To insure an unbiased sample, random-digit-dialing techniques were used. The margin of error for this survey is +/-3.0% at the 95 percent level of confidence and is higher for subgroups.

Source: American Association of Homes and Services for the Aging

Americans Who Don’t Know They Have Diabetes Incur $18 Billion in Health Expenses Each Year

• Author: Health Informer
• Filed under: Health News
• Date: May 21,2009

25 Percent Unaware They Have the Disease; Undiagnosed Diabetes Costs $2,864 Per Person Annually In Medical Services, Lost Productivity

Americans living with undiagnosed diabetes incur an estimated $18 billion in healthcare expenditures each year, or $2,864 per person in medical services and lost productivity from diabetes-related complications, according to a new study initiated by the National Changing Diabetes(R) Program and published in the journal, Population Health Management.

Undiagnosed diabetes represents 8.3 percent of the $218 billion cost of diabetes and pre-diabetes estimated for 2007. “For the first time we are beginning to get a sense of the total economic burden of diabetes to our health care system and economy,” said Timothy Dall of the Lewin Group, which conducted the study. “The cost is particularly astonishing, given that a significant number of diabetes cases and related complications are largely preventable.”

About 25 percent of the 23.6 million Americans living with diabetes are not aware that they have the disease, according to the study, published in the April issue. Data also show the prevalence of undiagnosed diabetes increased with age (until age 70) and was more common in men.

“These data demonstrate the urgent need for policies that encourage the early diagnosis of diabetes so that the disease can be managed aggressively before it leads to costly complications,” said Dana Haza, Senior Director of the National Changing Diabetes(R) Program, an initiative created by Novo Nordisk to drive change in diabetes education, treatment and policy at the national and local level.

The cost of diagnosed diabetes was estimated at $174 billion in 2007. Pre-diabetes was associated with $25 billion in health care expenditures, and gestational diabetes resulted in $623 million in costs.

Because people with undiagnosed diabetes cannot be identified using medical claims, the study identified a proxy for the undiagnosed population–people within two years of first diagnosis. The study compared medical claims from 2004 and 2005 for two groups: the undiagnosed proxy population consisting of 29,770 people diagnosed with diabetes in 2006, and 3.2 million people with no history of diabetes during this three-year period. People in the former group who went on to develop diabetes were shown to have significantly more ambulatory care, emergency visits and hospital stays than those in the group who did not develop diabetes.

Diabetes is a complex disease that affects virtually every system in the body. Diabetes is associated with increased risk of cardiovascular disease, neurological symptoms and renal and endocrine complications. Diabetes is the nation’s leading cause of blindness and amputations. Many people newly diagnosed with diabetes already have chronic conditions linked to the disease, such as neuropathy, arterial disease, cardiovascular disease and coronary heart disease.

“We would expect to see a significant impact on cost if diabetes were detected and managed early,” Dall said. “The goal is to substantially slow the progression of the disease with aggressive management of diet, exercise and medicine so that costly complications can be avoided.”

A separate study published in the journal broke down the costs associated with diagnosed cases of Type 1 and Type 2 diabetes. While about 90-95 percent of people with diabetes have Type 2, or adult-onset diabetes, costs for the 5-10 percent of people with Type 1 diabetes were shown to be far higher on an individual basis. People with Type 1 diabetes have twice as many physician visits for complications compared with people with Type 2 diabetes.

The average Type 1 patient with diabetes under age 44 had annual medical costs of $4,044 a year. Yet costs increase with age. For Type 1 patients over age 65, the average annual cost was $35,365 per patient. The increased cost associated with people over 65 is the result of high use of expensive nursing and residential facilities. Sixty-six percent of the 165,000 Type 1 patients over age 65 will spend at least some portion of the year in a nursing home.

“There are about 16 times as many people with Type 2 diabetes as with Type 1, so health care policy focusing on Type 2 diabetes has the greatest potential to lower the overall economic burden of the disease,” Dall said. “Yet the very high costs associated with Type 1 diabetes — particularly among the elderly — highlight the importance of aggressive disease management to prevent costly complications.”

The overall economic burden of diabetes is significant. However, both studies note that the total cost to society is higher than any estimate when the impact of reduced quality of life is taken into account.

Source: National Changing Diabetes Program