The Salina Journal from Salina, Kansas on May 1, 1997 · Page 13
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The Salina Journal from Salina, Kansas · Page 13

Salina, Kansas
Issue Date:
Thursday, May 1, 1997
Page 13
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THURSDAY MAY 1, 1997 THE SALINA JOURNAL Health BRIEFLY Vitamin E, other drug can slow Alzheimer's BOSTON — Researchers have found ordinary vitamin E pills modestly slow Alzheimer's — the first time any treatment has been shown to change the course of the mind-robbing disease. Patients with moderately severe Alzheimer's who took high doses of the vitamin delayed such major milestones as going into a nursing home by seven months. Selegiline, or Eldepryl, a standard prescription drug for Parkinson's disease, does the same thing and works about as well. Both appear to help by protecting brain cells from the damaging effects of oxygen. Dr. John Growdon of Massachusetts General Hospital has begun routinely giving his Alzheimer's patients vitamin E, the cheaper of the two treatments. Persons over 40 at risk for diabetes need test HOUSTON — A diabetes expert at Baylor College of Medicine in Houston recommends anyone over age 40 who is at high risk for the disease be tested every year. Risk factors include: • A family history of diabetes. • Obesity, especially being more than 30 percent over the standard body weight for your height. • Age, with people over 50 being at greater risk. • Ethnic background: Hispanics, African Americans and Native Americans are more likely to develop diabetes and run a greater risk of complications if they do. "By diagnosing diabetes before symptoms develop, physicians can intervene sooner with medication and recommend lifestyle changes to minimize the complications of this potentially deadly disease," says Dr. Alan J. Garber, Baylor professor of medicine. Bony heel ailment called 'pump bump' The name may be catchy, but . the ailment itself can be, well, a pain. According to the American Or- thopaedic Foot and Ankle Society, "pump bump" is a bony prominence at the back of the heel, typically accompanied by inflammation and degeneration of the tissue between the Achilles tendon and the heel bone. Also known as Haglund's deformity, the condition is often caused by repetitive irritation from shoes with rigid heels (pumps, cowboy boots, etc.). While most cases can be treated with appropriate footwear or shoe modifications, the problem sometimes persists and surgical removal is necessary. New brochures help with headache relief ' The National Headache Foundation has published two new brochures on the prevention and treatment of headaches. "Headache: A Guide to Prevention & Treatment" and "A Patient's Guide to Migraine Prevention & Treatment" discuss such topics as the causes, treatment and prevention, drug and non- drug approaches and diet advice. You can order one or both by sending a self-addressed, business-sized envelope with 32 cents postage for one, or 55 cents postage for both, to The National Headache Foundation, 428 West St. James Place, 2nd Floor, Chicago, IL 60614-2750. Indicate which yQU prefer by marking the envelope either Brochure A or B. You also can visit their web site at or call the foundation at 800-8432256. Asthma inhaler alert: High doses harm eyes MONTREAL — Prolonged continuous use of high doses of inhaled steroids may increase the risk of glaucoma or ocular hypertension, according to a recent article in the Journal of The American Medical Association. Dr. Edeltraut Garbe, of the McGill University Health Centre in Montreal, Canada, studied the relationship between the use of inhaled and nasal steroids and glaucoma in 48,118 patients. "Both factors — high-dose administration and prolonged continuous duration of use — had to be present to elevate the risk," note Garbe and colleagues. High dose is defined as 1,500 micrograms (meg) or more of the inhaled steroid flunisolide, or 1,600 meg or more of the other inhaled steroids. From Wire Service Reports "This is basically a one-shot treatment, whereas radiation may require up to 35 treatments, and repeated surgery can take a toll cosmetically and physically on the patient." Dr. Clark Julius dermatologist in Knoxville, Tenn. Scripps Howard News Service Dr. Clark Julius (left) and Masoud Panjehpour of Knoxville, Tenn., hold a medical laser they use to treat tumors. The tumor is treated with a chemical that makes it photo-sensitive, then the bright laser light Is focused on the tumor, causing the affected cells to die. LET THERE BE LIGHT New laser treatment painless alternative for the thousands of annual skin cancer patients By BRIAN COURTNEY Scripps Howard News Service NOXVILLE, Tenn. — A cancer treatment that doesn't involve freezing,. . cutting, burning or radiation. Sound too good to be true? It's not. Scientists at Thompson Cancer Survival Center and local physicians have been working together for years to offer an innovative treatment to patients suffering from certain forms of cancer. The treatment is called pho- todynamic therapy. It uses lasers and light- activated drugs to destroy malignant tumors. The most recent application of the procedure, previously used to treat esophageal cancers, involves clinical trials in the care of patients with squamous cell and basal cell carcinomas, the two most common skin cancers. Dr. Clark Julius, a Knoxville dermatologist who spearheads the experimental PDT skin cancer program for Thompson Center along with research scientist Masoud Pan- jehpour, described the treatment as an "exciting alternative" for approximately 700,000 people who are diagnosed with skin cancer each year. "A single treatment usually eliminates most cancers without having to surgically cut, freeze or burn the tumor. It's really quite remarkable," Julius said. During the procedure, patients are injected with a light-sensitive drug called Photofrin that quickly leaves healthy tissues but remains concentrated in tumor cells for days. It's still unknown why the drug gravitates to malignancies. Forty-eight hours later, a delicate optical fiber is positioned a few inches away from the skin. The fiber delivers red laser light to the cancerous area and kills the malignant cells by converting normal oxygen in the cells to a toxic agent. For bulky tumors, a tiny incision is made in the tumor that allows the tip of a fiber optic probe to be inserted. "This basically enables you to physically reach the base of the tumor and deliver the light where you need it," Panjehpour said. Typical treatments last about 24 minutes per tumor. No anesthesia is required for shallow tumors. Bulky tumors might require a local anesthetic and are typically treated in 12-minute intervals. To date, Julius and Panjehpour have treated about 40 skin cancer patients using the procedure, some of whom have traveled from as far away as New York and Iowa. They report a cure rate of greater than 90 percent. Multi-tumor treatment is the biggest advantage, according to Julius. Case in point: Winston Burbage of Maryville, Tenn. Burbage, a self-described "needle baby," said he couldn't bear the thought of being poked, prodded, cut on and scraped to treat the 17 cancerous lesions that covered his neck, shoulders and back. He jumped at the opportunity to have them treated using photodynamic therapy. "It tickled me to death when they told me about the treatment," Burbage said. "It's perfect for the needle baby because you only have to have one injection." With multi-tumored patients, they treat the lesions in succession, waiting about five minutes between each tumor. If they are unable to treat all the patient's tumors in one day, they resume treatment the next day. Patients can be treated up to seven days after the injection. "This is basically a one-shot treatment, whereas radiation may require up to 35 treatments, and repeated surgery can take a toll cosmetically and physically on the patient," Julius said. "That is the major advantage. Should re-treatment become necessary, we would not have to keep cutting away tissue or administering radiation." Burbage said he experienced no pain during treatment and described the laser light's focus as a "warm tingling sensation." Some pain and swelling did follow the procedure, he said. Panjehpour said patients will experience a heightened sensitivity to light until the Photofrin leaves their systems and must avoid bright sunlight for about four weeks. HAY FEVER / C2 MONEY/ C3 NEWS / C4 V MEDICINE c DR. PAUL DONOHUE North America Syndicate Weakness in the hand could signal future stroke Dear Dr. Donohue: Over the years I have had a problem that is annoying, to say the least. In the morning my right hand feels weak. I cannot pick up a coffee cup for fear of dropping it. It does go away later in the day. Last night I had trouble writing. Again, it did not last very long. I am not too worried about this, but I hope you can find an answer for me. I always like to know what is going on with me. — A.K. Dear A.K.: Get to your doctor. Those fleeting lapses in muscle control could be transient is- chemic attacks. Such attacks are often preludes to a stroke. I don't want to send you in a tizzy, but I don't want you to neglect symptoms that could point to future troubles. Take the worry off my mind as well as yours. Get that examination soon.. Dear Dr. Donohue: Recently my niece, who is 62 years old, was diagnosed as having mycosis fun- goides on the inside of her upper left arm. From what I've heard, it sounds pretty grim as to prognosis and lack of effective treatment. The onset seems to be a mystery. When signs first appeared, she was treated for a rash. Any hope? — S.C. Dear S.C.: Mycosis fungoides sounds like a fungal disease. It is not. It is a form of a special kind of cancer. . Cancerous lymphocytes, one type of the body's white blood cells, infiltrate the skin. In the early stages, the infiltration looks like a red, scaly rash, somewhat like psoriasis. Untreated, mycosis fungoides progresses into the tumor stage. The affected skin sprouts growths that look like mushrooms. That's where the "fungoides" name came from. Caught early, mycosis runs a prolonged course. Nitrogen mustard, a chemotherapy drug, is applied to the skin to contains its spread. Electron beam irradiation also can be used to keep the unusual cancer in check. Sure, there's hope, especially when the illness is caught in its early stages. Dear Doctor: When one has fibroids that are beginning to be uncomfortable, when is it time to have a hysterectomy? Can surgery safely be delayed? — A Reader Dear Reader: You can delay surgery until the fibroids make life miserable for you. Fibroids are noncancerous growths of the uterus's muscle wall. As many as 40 percent of women develop one or more fibroids after age 35. Most women are not in the least bit bothered by them. They shrink with menopause. However, fibroids can cause real trouble. If they are associated with heavy menstrual bleeding, if they are rapidly enlarging or if they are compressing structures adjacent to the uterus, then have them removed. If, on the other hand, they are not causing distress, it's safe to leave them alone. T PERSONAL HEALTH Steroids interfere with calcium and hormones Steve Tim of Brooklyn N.Y., is among millions of Americans whose life, or quality of life, depends on continuous treatment with a steroid drug that unfortunately can cause osteoporosis. Tim has a complicated autoimmune disorder that is treated with prednisone, a corticosteroid he must take daily to suppress the runaway immune system that is attacking his blood ves- * sels, joints and bone marrow. But while prednisone is protecting those vital body parts, it can also be eating away at Tim's JANE BRODY The New York Times bones. To help protect those bones from otherwise inevitable decay and possible fractures, Tim's rheumatologist told him to take daily supplements of calcium and vitamin D. According to experts at the American College of Rheumatol- ogy, millions of others who must take steroid medications for prolonged periods are unaware of the risk to their bones and are not taking" appropriate preventive measures. Without proper protection, within the first six months of cor- ticosteroid therapy, a person can lose 10 percent to 20 percent of bone mass. One in four of these people can expect to suffer a fracture as a result. Unlike osteoporosis associated with aging, steroid- induced osteoporosis can occur at any age, even in children. More than 30 million Americans have disorders that may require treatment with corticos- teroids. These drugs, which mimic the action of cortisone-like hormones produced by the outer shell of the adrenal gland, are extraordinarily helpful in suppressing the symptoms of a broad spectrum of diseases. Steroids are essential to the treatment of many chronic inflammatory and autoimmune diseases, including chronic severe asthma, rheumatoid arthritis and other connective tissue diseases, chronic obstructive lung disease, inflammatory bowel disease, lupus and multiple sclerosis. Transplant patients usually depend on steroids to prevent rejection of the transplanted tissue. See STEROIDS, Page C2 Prevention and treatment The American College of Rheumatolgy issued these guidelines to help prevent osteoporosis In patients who get long-term steroid treatment: • Step 1. Either before or at the very start of steroid therapy, patients should be given a bone density test. This should be repeated every six to 12 months to monitor the effectiveness of preventive measures, • Step 2. Patients should consume at least 1,500 milligrams of calcium and 800 international units of vitamin D a day, either through diet or supplements. Vitamin D is needed to enhance the body's ability to absorb calcium and use it to build bone. • Steps. Patients should not smoke or drink more than moderate amounts of alcohol and should be sure to get regular weight-bearing exerctee. » Step 4. Women at or past menopause should, if possible, be on hormone replacement therapy. Women who have not yet reached menopause whose periods become irregular or stop while on steroid* should take oral contraceptives unless there is a medical reason for not taking them. Men on steroids should have their testosterone level measured and, if found to be low, given testosterone replacement. • Step 5. Patients on steroids should be examined to determine their risk of falls. They should correct situations at home that might cause falls. SUGGESTIONS? CALL SHERIDA WARNER, LIFE EDITOR, AT (913) 823-6363 OR 1-800-827-6363 OR E-MAIL AT V

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