Health Tip: Avoid Weight Gain During Menopause

(HealthDay News) -- Menopausal women are more prone to weight gain, particularly in the abdominal area, due to the many hormonal changes they face.

The Academy of Nutrition and Dietetics offers this advice to help avoid weight gain during menopause:

Stay active and get plenty of regular physical activity. Incorporate both aerobic and strength training exercises into your routine.Cut back on calories by about 200 per day. Focus on eating nutritious foods, including bananas, blueberries, dark leafy greens, soy, salmon, whole grains, yogurt and plenty of water.Limit alcohol and salt.Maintain a positive, healthy attitude

Time Spent With Grandkids Might Boost Women's Brain Power

 FRIDAY, April 11, 2014 (HealthDay News) -- Spending a little time each week caring for grandkids may help older women stay mentally sharp, a new study finds.

But there's a potential downside: Taking care of the grandkids five days a week or more may have a negative impact on brain power, the researchers reported.

The study included 186 Australian women, aged 57 to 68, who took three different tests of mental acuity. Those who spent one day a week looking after grandchildren did best on two of the three tests.

However, those who looked after grandchildren for five or more days a week did worse on one of the tests, which evaluated memory and mental processing speed.

The researchers were surprised by this result, but also discovered that the more time grandmothers spent taking care of grandkids, the more they felt that their children placed greater demands on them. So mood may be a factor in the unexpected finding, the study authors suggested.

While the study found an association between the amount of time caring for grandchildren and mental sharpness in older women, it did not prove a cause-and-effect relationship.

The study was published online April 8 in the journal Menopause.

Previous research has examined the link between older people's mental sharpness and their levels of social contact, but this is believed to be the first study to look at the effects of looking after grandchildren.

"Because grandmothering is such an important and common social role for postmenopausal women, we need to know more about its effects on their future health. This study is a good start," Dr. Margery Gass, executive director of the North American Menopause Society, said in a society news release.

Sex Is Important to Many Midlife Women

By Brenda Goodman
HealthDay Reporter

MONDAY, Feb. 10, 2014 (HealthDay News) -- The mechanics of sex may become a bit more difficult after menopause, a new study finds. But most women will continue to be sexually active as long as they feel sex is important.

The study, published online Feb. 10 in JAMA Internal Medicine, included 354 women who ranged in age from their 40s to mid-60s. All of the women reported being sexually active at the start of the study.

Each year for four years, researchers queried the women about their menopausal status and physical health. In the fourth year, women were specifically asked about their sexual function -- how strong their sex drive was, how easy or difficult it was to reach orgasm, and whether they had any trouble with arousal or vaginal dryness, or felt pain during intercourse.

After another four years, about 85 percent of the women continued to be sexually active. Women who stayed sexually active were more likely to be white, to have a lower body mass index (be thinner) and to say they felt sex was important.

"Women who felt that sex was highly important were about three times as likely to continue having sex as women who thought it was a little or not important," said study author Dr. Holly Thomas, a general internal medicine fellow at the University of Pittsburgh School of Medicine.

The good news is "if you go into midlife still sexually active, chances are, you're going to continue to be sexually active," Thomas said.

What caught the researchers off guard was that most women also scored poorly on the test of sexual function, meaning they reported significant physical difficulties with sex.

Thomas said that could mean a couple of things. The first is that the test, which was designed for premenopausal women, doesn't accurately reflect sexual intimacy at midlife. She thinks that after menopause, women may place a higher priority on kissing and touching than on intercourse, and the test they used in the study didn't really capture that.

She said the other thing it could mean is that women are using sexual aids, like lubricants, to overcome some of the trouble they have.

One expert on menopause was not surprised by the new findings.

"I think it resonates with what many of us have thought all along," said Dr. Margery Gass, an obstetrician/gynecologist at the Cleveland Clinic, in Ohio. She was not involved in the study.

"The quality of sexual activity for women as they age is much more than the sum of the various physical function components," said Gass, who is also executive director of the North American Menopause Society.

"That's not to say that there aren't some women who aren't having a very difficult time, but there are things that can be done for that," she said.

Health Tip: When Early Menopause Strikes

(HealthDay News) -- Menopause that begins before age 40 is considered premature.

The Womenshealth.gov website explains these possible causes of early menopause:

Medical treatments, from chemotherapy or radiation, or surgical removal of the ovaries.Chromosomal abnormalities affecting the ovaries.A family history of early menopause.A medical problem, such as rheumatoid arthritis or thyroid disease.

Bleeding Irregularities Common in Menopause, Study Finds

 WEDNESDAY, April 16, 2014 (HealthDay News) -- Extended and heavy menstrual bleeding during menopause is common, according to a new study.

"For most women in their 30s, menstrual periods are highly predictable. With the onset of the menopausal transition in their 40s, women's menstrual periods can change dramatically," study author Sioban Harlow, a University of Michigan professor of epidemiology, said in a university news release.

"These dramatic changes can be disconcerting, and often provoke questions about whether something is wrong," she added.

The findings should reassure women who worry about what is and isn't normal, she said.

When a woman's ovaries stop producing the hormones estrogen and progesterone, she enters menopause. This life stage can last anywhere from two to 10 years, the researchers said. Menopause usually occurs after age 45.

"Women need more descriptive information about the bleeding changes they can expect. We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention," she added.

The researchers looked at 1,300 American women, aged 42 to 52. They found that 91 percent had experienced bleeding for 10 or more days, 88 percent reported spotting for six or more days, and more than three-quarters had heavy bleeding for three or more days during menopause.

More than one-third of the women had as many as three episodes of 10-plus days of bleeding over six months, according to the study published April 15 in BJOG: An International Journal of Obstetrics and Gynaecology.

The women in the study -- from Michigan, Los Angeles and northern California -- were white, black, Chinese and Japanese. Previous studies have been mostly limited to white women, the investigators noted.

They said further research is required before their results could be used to change patient care.

Still, one expert welcomed the study. "We think this paper will be helpful to professionals, both clinical and investigational, as it describes in much more quantitative terms the range of bleeding patterns women may normally experience through the menopausal transition," Dr. John Randolph Jr., a U-M professor of obstetrics and gynecology, said in the news release.

The findings might reassure some doctors that "watchful waiting is an acceptable option" when women patients report changes in bleeding patterns, Randolph added.

Menopause: 10 Questions To Ask Your Doctor

Note: We recommend you print this page to use as a reference for your consultation with your doctor.

Could my symptoms be due to a condition other than menopause? (Be ready with a diary of symptoms - the character, frequency, duration, intensity, triggers, etc.) What are the medications that I might consider to control my menopause symptoms? Are there lifestyle or other modifications I can make to help alleviate the symptoms?If I choose to use hormone therapy, what are the advantages and disadvantages of the various routes of administration (pill, patch, cream, vaginal, etc.)? What are the side effects of hormone therapy, and how does my individual health/family history affect my decision to take hormone therapy? What are the risks?If I choose a non-hormonal prescription medication that is not FDA-approved for menopause symptoms (such as a selective serotonin reuptake inhibitor or SSRI medication), what is the scientific evidence that it works? How do the side effects differ among the various non-hormonal prescription medications commonly used for menopause symptoms? Given that long-term safety is not yet established for any of the herbal or food supplement (over-the-counter) remedies, are any suggested to be effective by reliable scientific trials? What are the herbal and/or food supplement remedies that women commonly buy to treat menopause symptoms (for example, hot flashes, painful sexual intercourse), and what are the side effects of these remedies? What are the potential risks or dangers of these treatments?Which herbal or food supplements might interact with my current medications? Are there over-the-counter menopause remedies that I have to discontinue prior to undergoing any surgery or procedure?REFERENCE: UpToDate.com. Patient information: Menopause (Beyond the Basics).

Last Editorial Review: 3/4/2014

Early Menopause Linked to Heart Failure Risk in Swedish Study

 WEDNESDAY, May 14, 2014 (HealthDay News) -- Early menopause may increase a woman's risk for heart failure later in life, especially if she is a smoker, a new study suggests.

Researchers analyzed data from more than 22,000 older women in Sweden. Those who experienced early menopause (ages 40 to 45) were 40 percent more likely to suffer heart failure than those who went through menopause in the normal age range of 50 to 54, the investigators found.

For every one-year increase in the age a woman began menopause, there was a 2 percent lower risk of heart failure, according to the study in the May 14 online edition of the journal Menopause, which is published by the North American Menopause Society (NAMS).

The risk of heart failure was highest in current or former smokers who had early menopause, the researchers found. Current or former smokers who went through menopause only somewhat early -- ages 46 to 49 -- also had an increased risk of heart failure.

The researchers at the Karolinska Institute in Stockholm said this is the first study to show a link between early menopause and heart failure, a condition where the heart can't pump enough blood to meet the body's needs.

However, while the study found an association between age at menopause and heart failure risk, it did not prove a cause-and-effect relationship.

"Menopause, early or late, is always a good time to take more steps to reduce heart disease risk through exercise, a healthy diet, weight loss and quitting smoking," Dr. Margery Gass, NAMS executive director, said in a news release from the group.

"This thought-provoking study should encourage more research to find out how early menopause and heart failure are linked," Gass said. "Do the factors that cause heart failure also cause ovarian failure?"

'Nerve Block' to Neck Might Help Ease Hot Flashes

By Steven Reinberg
HealthDay Reporter

MONDAY, Feb. 17, 2014 (HealthDay News) -- Women suffering from hot flashes might get some relief through an injection of an anesthetic near a nerve bundle in the neck, a small new study finds.

This technique, called a stellate ganglion block, is a common treatment for pain and might be an alternative for women who can't take or are reluctant to take hormone replacement therapy, the researchers said.

"Women are looking for nonhormonal alternatives for hot flashes," said senior researcher Pauline Maki, an associate professor of psychiatry and psychology at the University of Illinois at Chicago.

Maki said some women who had a stellate ganglion block to relieve pain also reported a decrease in the frequency and intensity of their hot flashes, which is what led to this study.

"The findings from our study provide some compelling data that this procedure may offer women a novel, nonhormonal approach to controlling their hot flashes," she said.

The procedure isn't painless, and the most common side effect is pain at the injection site. "If a woman wants to try this procedure, she needs to go to a trained anesthesiologist," Maki said.

The study, which received support from the U.S. National Institutes of Health and Northwestern University, was published recently in the online edition of the journal Menopause.

Dr. Margery Gass, executive director of the North American Menopause Society, said, "stellate ganglion block is a very exciting area for research for treatment of moderate to severe hot flashes."

Gass said many women -- particularly those with breast cancer -- might find stellate ganglion block an acceptable alternative to hormone therapy or antidepressants such as Paxil, which have been approved to treat hot flashes.

More research is needed, however, to see how well stellate ganglion block stacks up against other treatments, she said.

"These initial reports beg for larger and longer studies," Gass said. "We want to know how long the treatment lasts, how often it would need to be repeated, whether this is the ideal dose and if hot flashes return. We don't know the answers to these questions."

Not everyone sees the benefit of the nerve-block procedure.

"It's great that it decreases the number of severe hot flashes, but patients still have hot flashes a lot of times per day," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "That's still really disruptive."

"I am not sure that a majority of patients will want to try this therapy," she said.

For the study, Maki's group randomly assigned 40 women, aged 30 to 70, with moderate to severe hot flashes to receive either stellate ganglion block or a fake treatment with a plain saline solution.

On average, these women had 10 hot flashes a day, with two-thirds either moderate or severe. Moderate hot flashes were defined as those lasting up to 15 minutes with symptoms such as perspiration, clammy skin, dry mouth, tense muscles and rapid heartbeat.

Severe hot flashes were those lasting up to 20 minutes with symptoms such as "raging furnace" warmth, weakness, feeling faint, extreme perspiration and heart irregularities.

For six months, the women reported the frequency and severity of their hot flashes. In addition, for the first three months after treatment, the women wore a monitor that objectively measured hot flashes.

Although the total number of hot flashes was about the same in both groups, the number of moderate to severe hot flashes was significantly reduced among the women given the nerve block, the researchers found.

The number of moderate to severe hot flashes was cut by 52 percent among women who got the nerve block, compared with 4 percent for women who got the fake injection, the researchers said.

What's more, the intensity of the hot flashes was cut by 38 percent for the women who got the nerve block, compared with 8 percent for those given the placebo injection, the researchers said.

"We don't know why this works, but it opens up new avenues for exploring the generation of hot flashes," Maki said. Moreover, the findings might lead to new ways to treat hot flashes, she added.

The researchers said they would like to do a study among women with breast cancer -- for whom hormone therapy for hot flashes is not recommended -- to see if a stellate ganglion block could be an alternative treatment, Maki said.

"[Women with breast cancer] experience more hot flashes than other women, and, unfortunately, they can't take hormone therapy," she said. "That will be the group that will likely benefit most from this."

Could More Coffee Lower Your Odds for Diabetes?

By Steven Reinberg
HealthDay Reporter

THURSDAY, April 24, 2014 (HealthDay News) -- Drinking more coffee might lower your risk for type 2 diabetes, a new large U.S. study suggests.

People who boosted their daily java intake by more than one cup over four years reduced their diabetes risk, while adults who drank less coffee in that time frame saw their odds for diabetes rise, the study of over 123,000 adults found.

"It looks like there is a dose-response relationship between increasing coffee consumption and a lower risk of diabetes," said lead researcher Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health.

"Basically, the more coffee, the lower the risk of diabetes," Hu said. "People who drink three to five cups of coffee a day enjoyed a significant reduction in type 2 diabetes risk."

However, people can drink too much coffee, particularly those who don't respond well to caffeine, Hu cautioned. Caffeine, a stimulant, keeps some people awake, and can also cause the heart to speed up.

"It's hard to pinpoint which components of coffee may contribute to a decreased risk of type 2 diabetes," Hu said. "Current thinking is that it is the combination of antioxidants and other nutrients in coffee that are responsible for a lower risk of developing diabetes."

The study, published online April 24 in Diabetologia, shows an association between more coffee and lower diabetes risk but can't actually prove that one causes the other, Hu said. However, experiments in animals and a small human trial did find a cause-and-effect relationship between coffee and reduced insulin resistance, he said. Insulin resistance is a warning sign of diabetes.

Coffee can be part of a healthy diet, but people shouldn't look to it as a way to prevent type 2 diabetes, Hu said. "People should still watch their weight and be physically active," he added.

Like Hu, other experts aren't ready to advise patients to up their coffee intake just yet.

"It appears from the study that coffee can protect at least certain populations from developing type 2 diabetes," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"However, as with everything else, the message is not drinking coffee to prevent diabetes, but rather balancing all good elements in life so they can all be used and consumed with moderation," he said.

Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, said a drawback of the study is that the data was all self-reported by the participants.

"You don't know if they are telling the truth," he said.

Moreover, weight loss and exercise are more effective ways to reduce diabetes risk than drinking more coffee, Mezitis said.

"I am not recommending that anyone drink coffee to prevent diabetes," he said.

For the study, Hu's team collected data from three major U.S. studies: the Nurses' Health studies of 1986-2006 and 1991-2007, and the Health Professionals Follow-up Study of 1986-2006.

Study participants completed questionnaires every four years that included their coffee and tea intake. Overall, 7,269 cases of type 2 diabetes were reported.

The researchers calculated that people who increased their coffee consumption by more than one cup a day for four years reduced the risk of developing type 2 diabetes over the next four years by 11 percent compared with those who didn't boost their daily coffee intake.

However, people who drank at one less cup of coffee or more daily over the four years had a 17 percent higher risk for diabetes in the subsequent four years, the researchers said.

Hu's group defined a cup of coffee as 8 ounces of coffee, black or with a small amount of milk and/or sugar. Drinking coffee loaded with sugar or cream may reduce any benefit coffee may have in reducing diabetes risk, Hu said.

The findings only applied to caffeinated coffee. Decaffeinated coffee and caffeinated tea weren't associated with changes in risk for type 2 diabetes, the researchers said.

Dr. Alyson Myers, an endocrinologist at North Shore University Hospital in Manhasset, N.Y., said coffee alone might not account for the reduced diabetes risk.

"It is unclear if the extra cup of coffee may cause these patients to eat less, as they may become full faster," she said.

Noting that the study consisted of health care professionals, Myers said the results might not reflect the entire population. Also, the study doesn't address physical activity. "Perhaps those who drank caffeinated coffee had the energy to work out more," she said.

Low Blood Sugar May Affect Heartbeat in People With Diabetes

By Serena Gordon
HealthDay Reporter

TUESDAY, April 22, 2014 (HealthDay News) -- Low blood sugar levels -- known as hypoglycemia -- in people with diabetes may cause potentially dangerous changes in heart rate, according to a small new study.

This study's findings may help explain why a large-scale study found that very tight control of blood sugar levels in people with type 2 diabetes led to higher-than-expected death rates. It may also help explain why some otherwise healthy people with type 1 diabetes die during their sleep -- sometimes called "dead-in-bed syndrome" -- without an apparent cause, researchers say.

"We found that hypoglycemia was fairly common and that nocturnal episodes in particular were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept," said Dr. Simon Heller, senior study author and a professor of clinical diabetes and honorary consultant physician at the University of Sheffield, in England.

"These periods of hypoglycemia were associated with a high risk of marked slow heart rates [bradycardia] accompanied by [abnormal] beats. We have therefore identified a mechanism which might contribute to increased mortality in individuals with type 2 diabetes and high cardiovascular risk during intensive insulin therapy," Heller said.

Low blood sugar levels are not uncommon in people with diabetes, a disease that can produce dangerously high blood sugar levels. That's because the very treatments that can help prevent high blood sugar levels -- and the serious complications that accompany long-term high blood sugar levels -- can cause blood sugar levels to drop too low.

Although some oral diabetes medications can cause low blood sugar levels, the most common treatment to drop blood sugar levels too low is insulin. Insulin is a naturally occurring hormone that helps usher sugar into cells to be used as fuel.

"Your body needs fuel to survive and run properly," said Dr. Simon Fisher, an associate professor of medicine, cell biology and physiology at Washington University in St. Louis. "During hypoglycemia, the body is low on energy. When hypoglycemia is more severe, the brain [which runs on sugar] can get confused and stop functioning. If the blood sugar gets low enough, hypoglycemia can be fatal."

Fisher is also a co-author of an editorial accompanying the study in the May issue of Diabetes.

Low blood sugar is a well-recognized problem for people with type 1 diabetes, who must take multiple daily injections of insulin because their bodies no longer produce the hormone, according to study author Heller. But, low blood sugar generally isn't considered to be as significant a problem in type 2 diabetes, noted Heller, who added that the researchers were somewhat surprised to see that people with type 2 diabetes had low blood sugar levels about 10 percent of the time.

The study included 25 people with type 2 diabetes who had a known risk of heart disease. Their average age was 64 years. They were all being treated with insulin, and had been on insulin therapy for at least four years.

All of the study volunteers were monitored with a continuous glucose monitor for five days, as well as a 12-lead Holter monitor that captured heart activity. Both of these devices are portable, which allowed the study volunteers to carry on with normal daily activities.

Overall, the researchers recorded 1,258 hours of time with normal blood sugar levels, 65 hours with high blood sugar levels and 134 hours of low blood sugar levels. Low blood sugar was defined as a blood sugar of less than 63 milligrams per deciliter. These low blood sugar levels often went unrecognized, according to the study.

The risk of a slow heart rate was eight times higher when blood sugar was low at night compared to when it was normal. Slow heart rates didn't occur during the day, according to the study. Other types of abnormal heartbeats (arrhythmias) were also significantly higher at night when blood sugar was low compared to when blood sugar was normal. No irregular heartbeats occurred when low blood sugar symptoms were felt by the study participants.

"This study noted that spontaneous insulin-induced episodes of hypoglycemia were associated with asymptomatic mild heart arrhythmias. We have performed similar studies in animals, and noted similar arrhythmias during insulin-induced hypoglycemia," Fisher said.

"However, in animal studies, when blood sugar became severely low, more severe abnormal cardiac rhythms -- in other words, fatal heart rhythms -- were noted. So, based on existing animal and human data, we speculate that severe hypoglycemia-induced arrhythmias may contribute to sudden death in patients with insulin-treated diabetes," Fisher said.

He continued, "Nocturnal hypoglycemia is a major problem. People are less likely to wake up and treat their hypoglycemia at night. They're less likely to appreciate the normal warning symptoms of hypoglycemia because the entire sympathetic response is relatively blunted at night."

While the study found an association between low blood sugar levels and abnormal heart rhythms in people with type 2 diabetes, it did not prove a cause-and-effect relationship.

Another expert said the new findings highlight the dangers of hypoglycemia.

"This study suggests that the deeper the hypoglycemia, the more abnormal the heart rhythms. There seems to be some real scientific plausibility that recurrent episodes of hypoglycemia can cause abnormal disturbances of the heart. Each episode of hypoglycemia may have some element of risk," said Dr. John Anderson, the immediate past president of the American Diabetes Association.

"It may be that tight control of blood sugar might not be as important as safe control of blood sugar. Avoiding severe hypoglycemia should be a primary goal of therapy, especially for those who have a lot of risk for heart disease. That's why the American Diabetes Association said in 2012 that glycemic goals should be individualized. And, if you have to use insulin, avoiding those 3 a.m. hypoglycemias may be even more important," Anderson said.

In addition to changing target blood sugar goals, Anderson and Fisher both said that the use of a continuous glucose monitor with alarms could also help people avoid low blood sugar levels in the middle of the night. "[Continuous glucose monitoring] isn't thought of as much for the type 2 population. But, there are a lot of people with type 2 diabetes on insulin who have cardiovascular disease. This might be a prudent use of [continuous glucose monitoring]," Anderson said.

Fisher agreed, noting, "Technology -- like [continuous glucose monitors] and insulin pumps -- may be able to decrease the number of hypoglycemic episodes while still allowing patients to maintain tight glycemic control."

Intensive Insulin Therapy Might Aid Diabetics After Heart Attack

 TUESDAY, May 13, 2014 (HealthDay News) -- Intensive insulin therapy may boost survival in people with type 2 diabetes who've suffered a heart attack, a new study suggests.

Swedish researchers tracked outcomes for up to 20 years for 620 people with diabetes who were treated in hospital after a heart attack.

Some patients received intensive insulin treatment, which involved insulin-glucose infusion for at least 24 hours, followed by insulin injections four times a day for at least three months. Others received standard blood sugar-lowering therapy in which they were given occasional insulin shots for a year.

Those who got the intensive insulin treatment survived an average of two to three years longer than those who received standard care, and the survival advantage lasted for at least eight years after treatment and then leveled off, according to the research team, which was led by Dr. Viveca Ritsinger of the Karolinska Institute in Stockholm.

Those who benefited the most from intensive insulin treatment included patients younger than 70 who had no previous heart attack or history of congestive heart failure. Those who had not previously had insulin therapy also tended to fare better when placed on the regimen, according the researchers, who reporter their findings May 12 in The Lancet Diabetes & Endocrinology.

But Ritsinger's team stressed that the study began in 1990, and while the findings show that intensive insulin treatment boosts survival in type 2 diabetes patients who have suffered a heart attack, the benefits might not be so significant if the trial was conducted now.

That's because of the many recent advances in the treatment of type 2 diabetes patients with heart problems, including medications that help lower cholesterol and blood pressure, the researchers noted.

Two experts in the United States agreed with that caveat.

"More recent trials have been less impressive in this regard, possibly due to the patients receiving therapy for high cholesterol and hypertension; both of which are standard therapy today but were less recognized and use at the time the [Swedish] study was begun," said Dr. Derek LeRoith, a professor of medicine endocrinology, diabetes and bone disease at Icahn School of Medicine in New York City.

Dr. Alyson Myers, an endocrinologist at North Shore University Hospital in Manhasset, N.Y., agreed that today's means of controlling high blood pressure and high cholesterol may have dampened the findings' importance.

And, she added, there are risks with intensive insulin treatment. "Although intensive control may prolong survival, it also increases the risk for hypoglycemia," she said.

Diabetes Complication Rates Drop Among U.S. Adults

By Serena Gordon
HealthDay Reporter

WEDNESDAY, April 16, 2014 (HealthDay News) -- The rates of five serious complications from diabetes -- heart disease, stroke, kidney disease, amputations and death -- have all dropped dramatically since 1990, a new U.S. government study shows.

Heart attack rates have decreased nearly 70 percent in people with diabetes. Stroke rates have dropped by more than 50 percent, as have lower extremity amputations. Deaths from high blood sugar crises have fallen nearly 65 percent, and the risk of end-stage kidney disease is down 28 percent, according to the study.

The biggest declines in diabetes-related complications have occurred for heart attack and stroke, especially among people aged 75 and older.

But, the news isn't all good.

During the same time frame that diabetes complications were dropping, the rates of diabetes diagnoses were soaring. In 1990, 6.5 million Americans had diabetes. By 2010, that number was 20.7 million, according to the study authors.

Health experts point to the obesity epidemic as a leading contributor to the rise in cases of type 2 diabetes.

And, although the rates of diabetes complications are significantly lower than they used to be, they're still far greater than for those without diabetes. For example, someone with diabetes has a six times greater risk of developing kidney failure than does someone without the disease. The risk of amputation is 10 times higher, while the risk of a heart attack is twice as high, according to the study.

"In general, this study is good news. Rates of diabetes complications have declined, and that's a testament to what good care and self-management can do," said study author Edward Gregg, chief of the U.S. Centers for Disease Control and Prevention's epidemiology and statistics branch in the division of diabetes translation.

"For the average person with diabetes, the complication risk is far less than it was. But, we wouldn't want to send the message that this battle is won," Gregg added. "The baby boom generation is moving into the high-risk years for diabetes. Even if we make continued improvements, the fact that the baby boom generation is moving into high-incidence years means a lot of cases in the future."

Results of the study are published in the April 17 issue of the New England Journal of Medicine. Data for the research came from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System.

In 1990, just over 140,000 Americans with diabetes had a heart attack. In 2000, that number had jumped to 191,000. By 2010, it was down to almost 136,000, according to the study.

A closer look at those heart disease numbers, to see how many people per 10,000 with diabetes had a heart attack, shows a much steadier decline. In 1990, 141 people per 10,000 with diabetes had a heart attack. In 2000, it was 106 people per 10,000, and by 2010 that number had dropped to a low of 45.5 per 10,000 people with diabetes, according to the study.

The only category of complication that didn't see a drop of more than 50 percent was end-stage kidney disease, although there was nearly a 30 percent decline in this complication. Gregg said it's possible that the large drops in the other categories may be slowing down the rates of improvement in kidney disease. People with diabetes may now be living long enough to get end-stage kidney disease, he explained.

Dr. Joel Zonszein is director of the clinical diabetes center at Montefiore Medical Center in New York City. He said the new study "shows us we have an opportunity. Good treatment can prevent diabetes complications. When we treat early and aggressively, people with diabetes -- either type 1 or type 2 -- can do quite well."

Zonszein said he thinks "medical therapy is making a big difference in complications." That includes blood-sugar lowering medications, drugs for high blood pressure and drugs to lower cholesterol levels, he said.

Gregg agreed that better tools to manage risk factors for complications -- such as medications -- along with better ways to identify people with diabetes may have contributed to the improvement in the complication rates. He said diabetes education has also likely played a big role in the drop in complications.

"We need to continue to work on improving care, but we also need to turn more attention to preventing diabetes in the first place," Gregg said.

Type 2 Diabetes May Shrink the Brain, Study Suggests

By Steven Reinberg
HealthDay Reporter

TUESDAY, April 29, 2014 (HealthDay News) -- People with type 2 diabetes may lose more brain volume than is expected as they age, new research indicates.

Surprisingly, this shrinkage doesn't appear to be linked to the damaging effect of diabetes on tiny blood vessels in the brain, but instead by how the brain handles excess sugar, the researchers noted.

"We have known for a long time that diabetes is not good for the brain," said lead researcher Dr. R. Nick Bryan, a professor of radiology at the University of Pennsylvania's Perleman School of Medicine in Philadelphia.

Diabetes is associated with an increased risk for stroke and dementia, he said. Until now, doctors have thought these risks were likely related to blood vessel damage related to diabetes.

"But our study suggests that there is additional damage to the brain which may be more like a brain disorder such as Alzheimer's disease," Bryan said. "So there may be two ways diabetes affects the brain, damage to blood vessels and brain-cell degeneration."

The brain shrinkage seen in this study may be linked with how sugar is used by the brain, Bryan said.

"It is important that patients understand the adverse effect of their disease on their brains and cooperate with their doctors who are trying to treat their diabetes and prevent the effects of diabetes on the brain and other organs," he said.

Bryan cautioned, however, that what isn't known from this study is if treating diabetes will prevent or slow brain shrinkage.

Nearly 26 million people in the United States have diabetes, according to the American Diabetes Association. In type 2 diabetes, the body often doesn't use insulin efficiently, leading to an excess of both insulin and blood sugar, according to the association.

For the study, Bryan and his colleagues used MRI scans to look at the brains of 614 people with type 2 diabetes. The volunteers had diabetes for an average of about 10 years.

They found that the longer a patient had the disease, the more brain volume loss occurred, particularly in the gray matter. Gray matter includes areas of the brain involved in muscle control, seeing and hearing, memory, emotions, speech, decision-making and self-control.

In fact, for every 10 years someone had diabetes, it looked as if the brain was about two years older than the brain of someone without diabetes, according to Bryan.

It's important to note that this study only found an association between type 2 diabetes and greater and faster brain volume loss, and it wasn't able to prove that type 2 diabetes was the cause of the brain shrinkage.

The report was published in the April 29 online edition of Radiology.

Dr. Souhel Najjar, director of neuroscience and stroke at Staten Island University Hospital in New York City said, "Given the increasing public health burden of type 2 diabetes, the findings of this research are very important as they link diabetes directly to brain atrophy, underscoring the importance of primary prevention and early management of diabetes in reducing the burden of dementia, particularly in older population."

This brain loss may lead to an earlier onset of dementia, another expert noted.

Dr. Sam Gandy, director of the Center for Cognitive Health at Mount Sinai Hospital in New York City, said, "This is a very timely paper. There is a lot of interest and a lot of confusion about the mental impairment that accompanies type 2 diabetes."

This study suggests that chronic high levels of insulin and sugar may be directly toxic to brain cells, he said. "This would definitely be a potential cause of dementia."

Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, said that the brain shrinkage also might be due to low blood sugar, which is a common problem for people with diabetes and can be as damaging as high blood sugar.

"Diabetes over time also affects the brain, and can lead to thinking and memory problems like Alzheimer's disease. We need to control diabetes as soon as possible so that patients don't have brain problems," Mezitis said.

Kids' Diabetes Rates Up Dramatically in 8 Years, Study Finds

By Steven Reinberg
HealthDay Reporter

SATURDAY, May 3, 2014 (HealthDay News) -- Rates of diabetes in U.S. children have jumped sharply in just eight years, according to new research.

The prevalence of type 1 diabetes increased 21 percent between 2001 and 2009. At the same time, rates of type 2 diabetes rose 30.5 percent, the study found.

These increases affected both boys and girls, and nearly all racial groups, the researchers noted.

The reasons behind the increases aren't entirely clear, said lead researcher Dr. Dana Dabelea, the associate dean for faculty at the Colorado School of Public Health in Aurora.

"While we do not completely understand the reasons for this increase, since the causes of type 1 diabetes are still unclear, it is likely that something has changed in our environment, both in the U.S. and elsewhere in the world, causing more youth to develop the disease, maybe at increasingly younger ages," she said.

Several reasons for the increase in type 2 diabetes are possible, Dabelea said. "Most likely is the obesity epidemic, but also the long-term effects of diabetes and obesity during pregnancy, which have also increased over time," she noted.

This report shows the increasingly important public health burden that pediatric diabetes represents, Dabelea pointed out. "It also highlights the facts that all racial/ethnic groups are affected by both major forms of diabetes," she said.

The report was scheduled to be published May 7 in the Journal of the American Medical Association to coincide with the May 3 presentation of the study findings at the Pediatric Academic Societies annual meeting in Vancouver, Canada.

In type 1 diabetes, the body does not produce insulin, the hormone needed to convert sugar, starches and other food into energy. In type 2 diabetes, the body does not use insulin properly. This is called insulin resistance. At first, the pancreas makes extra insulin to make up for it. But over time, it isn't able to keep up and can't make enough insulin to keep blood sugar at normal levels.

For the study, Dabelea's team collected data on more than 3 million children and adolescents. When looking for type 1 diabetes, the researchers included people aged 19 years and younger. For type 2, the researchers limited the age range to 10 through 19 years. The incidence of type 2 in children younger than 10 was too low to provide statistically significant numbers, according to the report.

The data came from five centers located in California, Colorado, Ohio, South Carolina, and Washington state, as well as from some American Indian reservations in Arizona and New Mexico.

In 2001, type 1 diabetes had been diagnosed in just under 5,000 youngsters from a group of more than 3 million youth. By 2009, that number rose to almost 6,700, an increase of 21 percent, according to the study authors. The only groups that didn't see an increase in type 1 diabetes were children from 0 to 4 years old, and American Indian children, the study revealed.

For type 2, the researchers looked at a group of almost 2 million children. In 2001, 588 children and teens had been diagnosed with type 2 diabetes. By 2009, 819 kids and teens had type 2, a jump of 30.5 percent, the researchers found. The only ethnic groups that didn't see an increase in type 2 were American Indians and Asian Pacific Islanders.

"Historically, type 1 diabetes has been considered a disease that affects primarily white youth; however, our findings highlight the increasing burden of type 1 diabetes experienced by youth of minority racial/ethnic groups as well," the authors wrote.

The increase for both types of diabetes was seen among boys and girls and among whites, blacks and Hispanics. The biggest increase in both types of diabetes was among those 15 through 19 years of age, the researchers noted.

Of the study, Dr. Robert Ratner, chief medical and scientific officer for the American Diabetes Association, said, "The overall prevalence of diabetes is going to grow progressively, because we've done so much better in keeping these people alive, they are going to live longer. We also know they are going to continue to incur costs for complications."

Diabetes will be a major health care problem over the next two decades, he predicted. "There is a need to pay more attention to the prevention of diabetes, because we are not going to be able to care for all of these people," Ratner said.

Ratner was perplexed by the increase in type 1 diabetes. "Whether it's an interaction between genetics and environment that's increasing autoimmunity -- we really don't know," he said. "It's a major question that needs to be answered."

Dr. Luis Gonzalez-Mendoza, director of pediatric endocrinology at Miami Children's Hospital, was also concerned by the increase in type 1 diabetes.

"Type 1 diabetes seems to be on the rise among teens, almost double what it used to be," he said. "There is something that is acting as a trigger for the immune system to go crazy, because type 1 diabetes is an autoimmune disorder."

Mouse Study Raises Possibility of New Treatment for Diabetes

 WEDNESDAY, May 21, 2014 (HealthDay News) -- The discovery of a molecule that can help insulin last longer in the body and work more efficiently at lowering blood sugar could lead to a new treatment for diabetes, a new study in mice suggests.

Giving the animals the molecule lowered levels of insulin-degrading enzyme (IDE), which then raised insulin levels, the Harvard University researchers report.

Much more investigation is needed, but the compound may one day help people with diabetes control their disease more effectively, according to the authors of the study published May 21 in the journal Nature.

"This work validates a new potential target for the treatment of diabetes," study co-author David Liu, a professor of chemistry and chemical biology at Harvard, said in a university news release. "What we show is that inhibiting IDE in an animal can improve glucose tolerance under conditions that mimic the intake of a meal if you administer this compound beforehand."

Insulin-based diabetes treatments include insulin injection, drugs that stimulate insulin production or drugs that make the body more sensitive to insulin.

"What's been missing has been the ability to regulate the degradation [breakdown] of insulin," study co-author Alan Saghatelian, an associate professor of chemistry and chemical biology at Harvard, said in the news release. "The technological leap we've made was in identifying a molecule that allows that to happen."

Promising research with animals often fails to provide similar results in humans.

Diabetes: 2 Large Meals Better Than 6 Small?

By Nicky Broyd
WebMD Health News

Reviewed by Farah Ahmed, MD

May 16, 2014 -- Eating two large meals may be better than eating six small ones with the same amount of calories to control weight and blood sugar in people with type 2 diabetes.

The results of the new study, conducted in the Czech Republic, have been published in Diabetologia, the journal of the European Association for the Study of Diabetes.

The study looked at 54 patients, 29 men and 25 women. All were taking oral medications for diabetes. The patients were between 30 and 70 years old and were divided into two groups of 27. They were asked to follow one of two restricted-calorie diets for 12 weeks. After completing one diet, they switched to the other, again for 12 weeks.

Each diet contained 500 calories fewer than the recommended daily amount. One included six small meals: breakfast, lunch, dinner, and three small snacks. The other included two large meals: breakfast eaten between 6 and 10 a.m., and lunch between noon and 4 p.m.

The diets had the same calories and nutrients.

The researchers found that people lost weight in both diets, but there was more weight loss in the group that ate two large meals. People in that group lost 8.2 pounds on average, while the people who ate six small meals lost 5 pounds on average.

Blood sugar levels went down in both diets, more for people eating the two-meal diet.

No side effects were noted for either diet.

The authors acknowledge that their data contradicts a widely held opinion that eating more frequently is healthier.

Richard Elliott, research communications officer at Diabetes UK, says in a statement that more research is needed before people with diabetes change their eating habits.

"What we do know is that eating a healthy balanced diet, taking regular physical activity and maintaining a healthy weight, together with taking any medication prescribed by your doctor, is vital for effective management of type 2 diabetes," Elliott says.

SOURCES: Kahleova, H. Diabetologia, May 16, 2014. Diabetes UK.

©2014 WebMD, LLC. All Rights Reserved.

Diabetics Fare Well After Kidney Transplants, Study Finds

 FRIDAY, May 9, 2014 (HealthDay News) -- Survival rates for people with diabetes who have a kidney transplant are similar to those of people without diabetes, a new study finds.

Researchers looked at nearly 1,700 people who received new kidneys between 1996 and 2007, including about 400 with diabetes. Before 2004, kidney transplant patients with diabetes were more than twice as likely to die within five years as those without diabetes.

But after 2004, the five-year survival rate for people with diabetes was similar to that of people without diabetes, according to the study published online recently in the journal Kidney International.

The findings show that there have been major improvements in the management of kidney transplant patients with diabetes, the Mayo Clinic researchers said. Specifically, the improvements in patient care led to significant declines in heart problems and infections.

"We were really encouraged to see this gap improve so dramatically," study leader Dr. Fernando Cosio, medical director of kidney and pancreas transplantation, said in a Mayo news release.

"Diabetic patients who undergo kidney transplantation can expect outcomes equally as successful as nondiabetics, provided that they are diligent in their management of blood pressure, glucose, healthy weight, and other factors that influence their kidney function and overall well-being," he added.

Health Tip: Minimizing Seasonal Allergy Symptoms

(HealthDay News) -- Pollen and mold are common culprits of seasonal allergies, but there are things you can do to help minimize symptoms.

The American Academy of Allergy Asthma and Immunology offers these suggestions:

At home and in the car, close the windows and run the air conditioning if needed.When pollen and mold levels are high, stay indoors. Wear a pollen mask during a prolonged stay outdoors.When you come inside, wash your hair and change your clothes.Ask someone else to mow the lawn and rake leaves.Don't hang clothing or linens outside to dry.Take allergy medication as prescribed.

Ragwitek Approved for Adult Ragweed Allergy

FRIDAY, April 18, 2014 (HealthDay News) -- Ragwitek has been approved by the U.S. Food and Drug Administration to treat allergy to short ragweed among adults aged 18 to 65.

The once-daily tablet contains an extract from short ragweed (Ambrosia artemisiifolia) pollen, the agency said in a news release. Treatment should begin 12 weeks before the start of ragweed season -- which in the United States includes late summer and early fall -- and continue through the season.

The product is placed under the tongue, where it rapidly dissolves. The first dose should be given by a doctor, who can monitor the user for any adverse reaction, the FDA said. Subsequent doses can be taken at home.

Ragwitek's safety and effectiveness were evaluated in clinical studies involving some 1,700 adults. The most common side effects included throat irritation and itching of the mouth and ears.

The product's label will include a boxed warning that it could cause a life-threatening reaction among people who are severely allergic to the pollen of short ragweed, one of the most common seasonal allergens.

Ragwitek is produced for New Jersey-based Merck and Co. by Catalent Pharma Solutions, based in the United Kingdom.

FDA Panel Says No to Over-the-Counter Allergy Drug Singulair

 FRIDAY, May 2, 2014 (HealthDay News) -- A panel of expert advisors to the U.S. Food and Drug Administration on Friday voted overwhelmingly against moving the allergy drug Singulair from prescription to over-the-counter status.

The panel voted 11-to-4 against the sale of the popular medication without a doctor's approval, the Associated Press reported.

According to the AP, many on the FDA panel felt there were still questions over the safety of making Singulair available without a prescription, especially because some patients would be using it for "off-label" treatment of conditions such as asthma.

The FDA does not have to follow the advice of its expert panels, but it usually does.

Two experts in the care of respiratory illness were happy with the panel's vote.

"My discomfort about Singulair being sold over the counter mirrors the FDA's concern that it may be used inappropriately for the treatment of asthma," said Dr. Andrew Ting, an assistant professor of pediatrics, pulmonary and critical care at The Mount Sinai Hospital in New York City.

"The selection of Singulair over an inhaled corticosteroid for asthma prevention is a decision that should only be made by trained medical professionals," he said. "The risk of asthmatics using Singulair as a rescue medication or in place of an oral corticosteroid such as prednisone could lead to a significant delay in appropriate treatment for exacerbations."

Ting also noted that "Singulair has possible side effects such as headache, bed wetting and behavioral changes that should be addressed with the patient before beginning the medication."

Dr. Harlan Weinberg is director of pulmonary medicine and pulmonary rehabilitation at Northern Westchester Hospital in Mt. Kisco, N.Y.

"A major concern would be for this medication's inappropriate use in children as well as patients self-medicating their asthma," he said. And Weinberg added that "medication interactions are always a concern and your use of Singulair with other prescription medications must be reviewed with your physician.

Finally, he said, "there are no well-controlled studies in pregnant women or with breast-feeding, for determining fetal or infant risk."

Health Tip: Getting Rid of Dust Mites

(HealthDay News) -- Dust mites can worsen allergies and asthma symptoms. But keeping your home clean can help keep dust mites at bay.

The U.S. Environmental Protection Agency offers these suggestions to help banish dust mites:

Wash all linens and bedding weekly in very hot water, and dry completely.Protect mattresses and pillows with dust-proof covers.Make sure all carpets and furniture are cleaned weekly with a vacuum equipped with a HEPA filter.Give children washable stuffed toys, and wash these items regularly in hot water.Dust your home frequently with a damp cloth.

Health Tip: Controlling Dust and Dust Mites

(HealthDay News) -- Many people are allergic to dust, and to the tiny mites that thrive inside it.

The American Academy of Allergy Asthma and Immunology suggests these tips to minimize dust and dust mites:

Since you probably spend at least eight hours in the bedroom, do your best to get rid of dust where you sleep.Place an allergen-proof cover on your mattress, box spring and pillows, as well as on any comforter that isn't washable.Wash bedding each week in hot water and dry it on the hot setting.Run air conditioning or use a dehumidifier to control humidity.Get rid of carpeting, if possible. Use washable throw rugs instead.

Stress Tied to Worse Allergy Symptoms

 FRIDAY, April 18, 2014 (HealthDay News) -- Stress may trigger symptom flare-ups in people with seasonal allergies, a new study suggests.

Researchers followed 179 people with hay fever for 12 weeks, and found that 39 percent of them had more than one flare-up. Those patients had higher levels of stress than those who didn't have allergy symptoms during the study period.

Sixty-four percent of the participants with higher stress levels had more than four flare-ups over two 14-day periods, according to the findings in the April issue of the Annals of Allergy, Asthma & Immunology.

There was no significant link between stress and flare-ups on the same day, but a number of people had flare-ups within days of experiencing increased daily stress, the researchers said.

"Stress can cause several negative effects on the body, including causing more symptoms for allergy sufferers," study author Dr. Amber Patterson, of Ohio State University, said in a journal news release. "Our study also found those with more frequent allergy flares also have a greater negative mood, which may be leading to these flares," she added.

"Symptoms, such as sneezing, runny nose and watery eyes can cause added stress for allergy sufferers, and may even be the root of stress for some," Patterson said. "While alleviating stress won't cure allergies, it may help decrease episodes of intense symptoms."

Although the study found an association between stress levels and severity of allergy symptoms, it did not prove a cause-and-effect relationship.

Ways to reduce and control stress include: meditation and deep breathing; making time for fun and relaxation; eating right, getting sufficient sleep and taking care of health issues; asking for help from a family member, co-worker or social worker; and eliminating things that cause stress and learning how to cope with it better.

Winter's Polar Vortex Ushers in Spring's 'Pollen Vortex'

By Serena Gordon
HealthDay Reporter

FRIDAY, April 25, 2014 (HealthDay News) -- You may have survived the worst this winter's polar vortex had to throw at you, but if you suffer from allergies, better brace yourself for its sibling -- the "pollen vortex."

Allergy experts say that the long, cold winter kept trees dormant for longer than usual, which means tree pollen season will overlap with grass pollen and mold seasons this year. And, for those with multiple environmental allergies, that likely means extra misery this year.

Plus, many people who start taking preventive allergy medications in late February or early March may have been lulled into thinking they could safely put off the use of these medications. Now they're being caught off-guard.

"People who take preventive medications ahead of time will be OK, but people who wait until they have their symptoms will have more problems. If you wait until you have symptoms, it takes at least a few days before you start feeling relief," said Dr. Joseph Leija, an allergist with Gottlieb Memorial Hospital, part of Loyola University Health System, in Chicago.

Leija, who has been personally measuring levels of pollen for the Midwest for the National Allergy Bureau for several decades now, said he normally starts measuring pollen counts in the Chicago area in February because that's when tree pollen usually starts.

"It was impossible in February this year, and even March. I finally started doing it this month, and there was even one day that I had to cancel the count because the machine was frozen," Leija said.

As soon as the weather starts warming, the tree pollen will come out in force at about the same time the grass pollen start to be an issue, Leija explained. And mold can be an issue, too.

The pollen vortex, he said, will be created by "the pollens all coming in at the same time. The season will probably be shorter, but people with allergies will be more miserable," he said.

Dr. Robert Valet, an allergist at Vanderbilt University in Nashville, Tenn., said the tree season started later there as well. "The trees are usually out at the beginning of March, and they did seem to get a late start this year," he said. "It will be interesting to see if the pollen season lasts as long. The grass season seems to be moving along normally, so the seasons are less discrete and might be harder to separate this year."

Like Leija, Valet recommends starting preventive allergy medications. He said nasal steroids take about two weeks to reach their peak. There's also a new nasal antihistamine available over the counter.

Both experts pointed out that new oral allergy immunotherapy for grass and ragweed pollens were approved by the U.S. Food and Drug Administration last week. These pills offer an alternative to allergy shots.

Valet said it's too late this season to get protection for grass pollen, but he said it's a great time to start immunotherapy for ragweed. The oral immunotherapy is taken once a day, with the first dose administered at the doctor's office to be sure you don't have a serious reaction to the pill.

Both allergy experts said while medications are important, controlling your environment is equally crucial. Use your air conditioner instead of opening windows to keep pollen out of your home and car, Valet recommended.

Leija also suggested taking a shower before bed to get the pollen out of your hair, especially if you've been working in your yard.

Valet said it's also a good idea to wipe down your dogs when they come in from outside because they can carry in pollen and mold on their coats. He also suggested bathing your pets at least once a week.

And, it's possible that sneezing fit you're having has nothing to do with pollen, Valet pointed out. "People who do a big spring cleanup in the house might not realize they're reacting to pet dander and dust mites more than pollen," he said.

If you have a forced air heating and cooling system, one of the best ways to clean your air is to install a higher-grade furnace filter, according to Valet. Room air filters with HEPA filters may also be helpful for people who don't have forced air heating and cooling, he said

FDA Panel Says No to Over-the-Counter Allergy Drug Singulair

 FRIDAY, May 2, 2014 (HealthDay News) -- A panel of expert advisors to the U.S. Food and Drug Administration on Friday voted overwhelmingly against moving the allergy drug Singulair from prescription to over-the-counter status.

The panel voted 11-to-4 against the sale of the popular medication without a doctor's approval, the Associated Press reported.

According to the AP, many on the FDA panel felt there were still questions over the safety of making Singulair available without a prescription, especially because some patients would be using it for "off-label" treatment of conditions such as asthma.

The FDA does not have to follow the advice of its expert panels, but it usually does.

Two experts in the care of respiratory illness were happy with the panel's vote.

"My discomfort about Singulair being sold over the counter mirrors the FDA's concern that it may be used inappropriately for the treatment of asthma," said Dr. Andrew Ting, an assistant professor of pediatrics, pulmonary and critical care at The Mount Sinai Hospital in New York City.

"The selection of Singulair over an inhaled corticosteroid for asthma prevention is a decision that should only be made by trained medical professionals," he said. "The risk of asthmatics using Singulair as a rescue medication or in place of an oral corticosteroid such as prednisone could lead to a significant delay in appropriate treatment for exacerbations."

Ting also noted that "Singulair has possible side effects such as headache, bed wetting and behavioral changes that should be addressed with the patient before beginning the medication."

Dr. Harlan Weinberg is director of pulmonary medicine and pulmonary rehabilitation at Northern Westchester Hospital in Mt. Kisco, N.Y.

"A major concern would be for this medication's inappropriate use in children as well as patients self-medicating their asthma," he said. And Weinberg added that "medication interactions are always a concern and your use of Singulair with other prescription medications must be reviewed with your physician.

Finally, he said, "there are no well-controlled studies in pregnant women or with breast-feeding, for determining fetal or infant risk."

Spring Cleaning Helps Stave Off Allergy Symptoms: Experts

 

FRIDAY, April 11, 2014 (HealthDay News) -- For allergy sufferers, spring cleaning does more than make their home look nice -- it can help prevent allergy symptoms.

"Thoroughly cleaning your home can help eliminate allergens and keep new ones from easily entering," Dr. James Sublett, president-elect of the American College of Allergy, Asthma and Immunology (ACAAI), said in a college news release.

"Allergy season can last all year for those sensitive to indoor allergens, but it can worsen in the spring months when pollen becomes an issue. It's important to remove allergens from the home so you can lead a healthy and active lifestyle," said Sublett, past chair of the college's indoor environment committee.

The ACAAI offered advice on how to remove allergens from your home and how to prevent more from getting in.

One way to reduce your spring-cleaning workload is to keep on top of things throughout the year. Change your air filters every three months and use filters with a MERV rating of 11 or 12. Vacuum regularly to get rid of dust mites, using a vacuum with a HEPA filter or a cyclonic vacuum, the ACAAI advises. Wash bedding and stuffed animals every week.

Moisture control helps reduce mold. Use bathroom fans and clean up any standing water immediately. Use detergent and water to scrub visible mold from surfaces and completely dry them. It also helps to keep your home humidity below 60 percent and clean gutters regularly, the experts noted in the news release.

If you have any pets, it's likely that after the winter your home has elevated levels of fur, saliva and dander, they added. Reduce levels of these allergens by vacuuming often and washing upholstery, including your pet's bed. Never let your pet in your bedroom.

You may be tempted to open your windows to allow fresh spring scents into your home, but doing so can allow pollen particles inside. You should also know that chemicals in air fresheners and candles can trigger asthma attacks, the experts warned.

Don't go outside at midday or in the afternoon, when pollen counts are highest, the ACAAI suggests. When gardening or mowing the lawn, wear gloves and an N95 particulate pollen mask. Take your allergy medication before you go outside and don't touch your eyes. Wash your hands, hair and clothing when you go back inside your home.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCE: American College of Allergy, Asthma and Immunology, news release, April 8, 2014

Got Hay Fever? New Tablets vs. Allergy Shots

By Rita Rubin
WebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

April 24, 2014 -- As many as 4 in 10 Americans have sneezing, runny nose, and watery eyes due to allergies. If you're one of them, allergy shots can help ease your reaction to the plants, insects, or animals that trigger your symptoms. But they require multiple doctor visits over years.

That's one reason only about 5% of Americans with allergies get the shots, even though they can provide long-lasting relief, says Linda Cox, MD, of the American Academy of Allergy, Asthma, and Immunology. The rest rely on avoiding whatever triggers their allergies, which isn't always easy. Or they use antihistamines and steroid nose sprays to temporarily ease symptoms.

But now allergic people have a new option: under-the-tongue tablets they can take at home. The prescription tablets, called Grastek, Ragwitek, and Oralair, are the first allergy treatments of their kind on the U.S. market, although they've been available in Canada and Europe. All three medications were approved by the FDA this month.

The tablets contain the same type of extracts used in allergy shots. As with the shots, the goal is to boost a patient's tolerance of allergy triggers.

"People still need to see an allergist," says Sandra Lin, MD, associate professor otolaryngology-head and neck surgery at Johns Hopkins. "The first thing to know is what you're allergic to."

Cox and Lin address common questions about the new tablets and other allergy treatments.

Q: What types of allergies do the tablets target?

A: Grastek contains an extract from Timothy grass, commonly known as cat's tail. It is found in all 50 states as well as most of Canada, according to the U.S. Department of Agriculture. Oralair contains extracts from Timothy grass plus sweet vernal, orchard, perennial rye, and Kentucky bluegrass. Ragwitek contains an extract from short ragweed.

Q. What are the advantages and disadvantages of the tablets compared to allergy shots?

A. One of the main advantages of the tablets is convenience, Lin and Cox say. Shots are given in a doctor's office. It starts with once or twice a week for 3 to 6 months, then once or twice a month for 3 to 5 years, according to the American Academy of Allergy, Asthma, and Immunology. Some people have fewer symptoms for years after they finish the shots, Lin says. Those who get symptoms again might need more shots.

One drawback of the tablets is that they might not cover everything people are allergic to, Lin says. Shots can be tailored to a person's needs. "In the United States, a lot of people are sensitive to more than one thing," she says.

Q. How long do you have to take these tablets?

A. Grastek's label says you should begin taking the tablets 8 to 12 weeks before and then during the pollen season. Grastek may be taken for up to 3 years.

Oralair's label says you should start taking the tablets 4 months prior to and through the pollen season. Ragwitek's label says you should begin treatment 12 weeks before and then during the pollen season.

Some studies suggest that people with allergies who take the tablets only during pollen season still benefit, Cox says.

With all three pills, you're supposed to take the first tablet in your doctor's office in case you have a severe reaction. Such a reaction, called anaphylaxis, is thought to be less likely with the tablets than with the shots. But because anaphylaxis can happen later with the tablets, the labels call for patients to have injectable epinephrine at home to treat it. Epinephrine can slow down or stop the reaction.

Q: What about other side effects?

A. For Grastek and Oralair, the most common side effects are an itchy mouth, throat irritation, and mouth swelling. Side effects for Ragwitek include mouth itching, and ear and throat irritation.

Q. Can children take Oralair, Grastek or Ragwitek?

A. Oralair is approved for ages 10 to 65, while Grastek is approved for ages 5 to 65. Ragwitek is approved only for adults ages 18 to 65.

Q. How much do the tablets cost?

A. The wholesale price of both Grastek and Ragwitek will be $8.25 per pill, or $247.50 for a 30-day supply, says Merck spokeswoman Pamela Eisele. The wholesale price of Oralair will be $10 per pill, or $300 for a 30-day supply, says Andrea Moody, a spokeswoman for Greer Laboratories, which is marketing the drug in the United States.

Both Eisele and Moody note that actual costs will vary, depending on your insurance coverage. Allergy shots cost about $25 each.

Q. Even before Oralair, Ragwitek, and Grastek became available, weren't some U.S. doctors using similar treatments for allergies?

A. Doctors have been using under-the-tongue drops for "off-label" use. Off-label means a medication is being used in a way not specified in the FDA's approved packaging label.

A 2011 survey by the American College of Allergy, Asthma, and Immunology found that more than 11% of those polled said they used under-the-tongue drops, nearly double the percentage from a 2007 survey. The drops have the same extracts used in allergy shots.

Lin says she mixes the extracts according to patients' allergy test results. She sends them home with a metered vial so they know how much to take each day. There is no standard dose; Lin says she bases the size of the doses on research published by European doctors. Cox says she hasn't prescribed the drops because "we don't know what the effective dose would be."

Q. What if you don't like to get a bunch of shots or have to remember to take medicine every day? What's on the horizon?

A. How about four monthly shots? Period. That's all it took for an experimental treatment for cat allergies to protect against symptoms 2 years after the first shot. The treatment, developed by researchers at McMaster University in Canada, is in its final stage of pre-market testing. The scientists are also working on a similar approach to treat ragweed and dust mite allergies.

Cox has served as a consultant for Stallergenes, the French company that markets Oralair.

SOURCES: Linda Cox, MD, American Academy of Allergy, Asthma and Immunology. Sandra Lin, MD, associate professor otolaryngology-head and neck surgery, Johns Hopkins. Jeanne Bariller, spokeswoman, Stallergenes. Robert Consalvo, spokesman, Merck. Pamela Eisele, spokeswoman, Merck.Veronica McGuire, spokeswoman, McMaster University.FDA.gov, Package Insert, Oralair.FDA.gov, Package Insert, RagwitekFDA.gov, Package Insert, Grastek.News release, Merck.News release, Stallergenes.

©2014 WebMD, LLC. All Rights Reserved.

Could a Blood Test Predict Breast Cancer's Return?

By Barbara Bronson Gray
HealthDay Reporter

THURSDAY, May 15, 2014 (HealthDay News) -- Imagine using a blood test to give you the odds your breast cancer will return. A new German study brings that possibility a step closer.

Researchers have found it may be possible to look for "markers" of cancer cells in routine blood samples and use them to better gauge whether early breast cancer will progress.

The blood test looks for circulating tumor cells (CTCs) in patients with breast cancer. While conclusive data about their relevance has been established for breast cancer that has spread, the CTC test has not been proven to be predictive in early breast cancer, the researchers noted.

It's hoped the CTC blood test will function as a real-time biopsy, providing an early alert system to identify patients who aren't responding to treatment, said lead researcher Dr. Brigitte Rack, senior physician in the department of gynecology and obstetrics at Ludwig-Maximilians University, in Munich.

Besides noting the presence and number of tumor cells in the blood, researchers may be able to study their genetic characteristics, or phenotype, to personalize treatment, Rack said.

"Our data confirms the prognostic relevance of CTCs within a large prospective trial," said Rack. "CTCs could help identify patients with increased risk for relapse who might benefit from additional systemic treatment approaches."

The idea is to prevent spread of the disease "by destroying these minimal residuals," she said.

While the CTC test is commercially available now, the researchers don't recommend its use yet to influence treatment decisions in early breast cancer. "CTC detection in early disease should be limited to patients within clinical trials," said Rack.

For the study, published May 15 in the Journal of the National Cancer Institute, the researchers analyzed the blood of over 2,000 patients after surgery but before chemotherapy, and about 1,500 patients after chemo.

The investigators identified four groups of patients: those who had CTCs before and after treatment; those with no CTCs before or after treatment; those who had CTCs before treatment but not afterwards; and those who only had CTCs after treatment. All participants were followed for about three years.

The results suggest these tumor cells may help predict the spread of breast cancer both before and after chemotherapy, the researchers concluded.

Patients with CTCs in their blood before and after treatment had the shortest disease-free survival time compared to the other three groups.

In general, the chance of being disease-free three years after surgery was lower for those with CTCs than for those without, the results indicated.

Among those who died during the follow-up period, about 41 percent had CTCs in their blood. Of those who survived, only about 21 percent had CTCs.

While the study is promising, it's too soon to know what to do when a patient has a positive CTC, said Dr. Arnold Schwartz, author of an editorial accompanying the study. "Should we change chemo, or give more chemo? Clearly we can tell the patient that this is something we need to follow. But the data is not definitive yet," he said.

The test might be informative in terms of prognosis and management, but the data isn't entirely clear, Schwartz wrote. "Many patients with [cancer that has spread] do not demonstrate expected CTCs, and several case patients with CTC positivity did not have recurrence within the three-year follow-up," he noted.

Schwartz, a professor of pathology and surgery at George Washington University in Washington, D.C., said he believes that as CTC technology improves, physicians will better understand the circulating cells' unique characteristics, such as their sensitivity to chemotherapy and the way they reproduce and disseminate.

For now, he is cautious about the implications of the study. "Science is a very plodding march. Everyone will say this is an important step in the understanding of how tumors spread and biomarkers of breast cancer," he said. "But what are you going to do with the data? Can a person with a negative CTC be relaxed? Life is a risk."

Diet, Lifestyle Affect Prostate Cancer Risk, Studies Find

By Dennis Thompson
HealthDay Reporter

TUESDAY, May 20, 2014 (HealthDay News) -- Diet and lifestyle can play a role in lowering a man's risk of prostate cancer, according to a trio of new studies.

A diet rich in complex carbohydrates and lower in protein and fat is associated with a 60 percent to 70 percent reduced risk of prostate cancer, said Adriana Vidal, a co-author of two of the studies and an assistant professor at Duke University School of Medicine in Durham, N.C.

In addition, a fiber-filled diet reduced the risk of aggressive prostate cancer by 70 percent to 80 percent, according to Vidal.

"Good carbs, high-quality carbs, and high fiber are definitely protective against prostate cancer," Vidal said.

The two other studies found that:

Drinking lots of milk could increase a man's risk of advanced prostate cancer.Men suffering from two or more health problems linked to metabolic syndrome also have an increased risk of aggressive prostate cancer.

Metabolic syndrome is a group of risk factors that increase a person's risk of heart disease, diabetes and stroke. They include obesity, high blood pressure, elevated blood sugar levels, elevated levels of triglycerides (blood fats) and reduced levels of "good" HDL cholesterol.

"When men have two metabolic syndrome components, their risk of high-grade prostate cancer goes up almost 35 percent," Vidal said. "With three to four components, their risk goes to almost 94 percent increased."

These studies shed more light on connections between diet, lifestyle and prostate cancer that up to now have been "tenuous," said Dr. Durado Brooks, director of prostate and colorectal cancers for the American Cancer Society.

"We don't have as good evidence regarding a link between diet and prostate cancer as we do with colorectal cancer or breast cancer, and there has been some conflicting data in previous studies," Brooks said.

The first study focused on a group of 430 veterans at the VA Hospital in Durham, N.C., including 156 men with confirmed prostate cancer. Researchers had the men fill out questionnaires to track the amount of carbohydrates, protein and fat in their daily diets.

The researchers found that when men received more of their energy from carbohydrates rather than protein or fat, their risk of prostate cancer declined. High fiber intake also appeared to reduce prostate cancer risk.

Additionally, they found that foods like simple carbohydrates that cause blood sugar to spike appear to increase prostate cancer risk in black men.

That finding, along with the results of the metabolic syndrome study, seem to indicate there could be an as-yet-unknown connection between blood sugar levels and male hormones like testosterone that increase prostate cancer risk, Vidal said.

In the second study, doctors reviewed the consumption of dairy products among nearly 3,000 people, including almost 1,900 men with either localized or advanced prostate cancer.

The investigators found that drinking milk was associated with advanced prostate cancer. However, total dairy consumption was not related to prostate cancer risk, nor were consumption of yogurt, ice cream and cheese.

The analysis also found that men with low overall calcium intake were at greater risk of prostate cancer when they ate more dairy products, compared with men with average or high levels of calcium in their diet.

The findings suggest that although calcium intake likely contributes to an increased risk of prostate cancer, "additional components in dairy may contribute to prostate cancer development," the authors concluded.

The final study focused on the effects of metabolic syndrome on a man's chances of prostate cancer, with researchers reviewing data gathered for almost 6,500 men in an unrelated clinical trial.

Researchers found that men with multiple metabolic syndrome risk factors had a progressively increased risk of prostate cancer.

"The more metabolic syndrome components, the more risk for high-grade prostate cancer," Vidal said.

The findings are in keeping with previous studies linking one of those risk factors, obesity, to a higher risk of aggressive prostate cancer, Brooks said.

"The question is whether because of their obesity these men are less likely to have their cancer identified and biopsied at an earlier stage," he said. "These researchers feel there's more than just delayed diagnosis, that there's something about these risk factors that contributes to prostate cancer."

Findings from these studies were scheduled for presentation Tuesday at the American Urological Association's annual meeting in Orlando, Fla. Results from studies presented at meetings are generally considered preliminary until they've been published in a peer-reviewed journal.

Blood Test May Spot Pancreatic Cancer Earlier

By Dennis Thompson
HealthDay Reporter

TUESDAY, May 20, 2014 (HealthDay News) -- Researchers report that a new blood test could help doctors find pancreatic cancer at an earlier stage, potentially improving a patient's chances of survival.

A set of four "markers" -- or signs -- in the blood identified cases of pancreatic cancer nine out of 10 times, sorting malignancies from other diseases like chronic pancreatitis or pancreatic cysts.

The blood test will be particularly helpful in ruling out suspected cases of pancreatic cancer, saving those patients from extremely invasive screening procedures, said study author Dr. Ayumu Taguchi, an assistant professor at the MD Anderson Cancer Center at the University of Texas, in Houston.

Pancreatic cancer is hard to detect early because it does not cause symptoms right away, and when symptoms do appear they are often vague and slight.

Other teams are also working on new treatments that could improve the survival chances of people diagnosed with pancreatic cancer, according to two other studies also presented Monday at an American Association for Cancer Research (AACR) special conference on pancreatic cancer, in New Orleans.

One study, done in mice, identified a protein that appears to keep immune cells from attacking pancreatic tumors. By blocking the protein, doctors hope to improve the immune system's ability to target and destroy the cancer.

The second study found that radioactive cancer-killing antibodies can more than double survival rates if patients receive repeat treatments combined with a drug that enhances the effects of radiation.

In the blood test study, doctors began with a known pancreatic cancer biomarker called CA 19-9. They then tested 20 other potential biomarkers, using blood samples taken from pancreatic cancer patients, healthy people and patients with chronic pancreatitis.

Once they had boiled down the potential biomarkers to a panel of four, they then tested them against blood samples from two other independent sets of people.

The blood test outperformed a test that solely relied on CA 19-9, researchers found. It accurately ruled out non-cancer cases between 91 percent and 94 percent of the time, while CA 19-9 alone could only rule out these cases 76 percent to 78 percent of the time.

While this test will be useful in helping sort out suspected cancer cases, it is not likely to become a screening tool used to regularly detect pancreatic cancer in the average patient, said Dr. Andrew Lowy, co-chair of the AACR special conference and chief of surgical oncology at the University of California, San Diego.

"It would be highly unlikely that a test could be developed that would be used as a mass screening tool, because the incidence of pancreatic cancer is not high enough. A test would have to be just about perfect, otherwise there would be too many false positive results," Lowy said. "It's much more likely a test like this would be applied to high-risk populations, which are being increasingly well-defined by genetic studies."

Taguchi plans to further test this panel using larger numbers of blood samples. He said research also continues into other potential biomarkers that could improve detection of pancreatic cancer.

The two treatment studies both involved ways to use parts of the body's immune response to target pancreatic cancer.

In the first study, doctors identified a protein called CD47 that appears to mask pancreatic cancer cells from detection by the immune system.

"CD47 is a widely expressed cell surface protein that functions as a 'don't eat me' signal," said lead researcher Dr. Geoffrey Krampitz, a doctoral candidate in the laboratory of Dr. Irving Weissman, director of the Institute for Stem Cell Biology and Regenerative Medicine at Stanford University School of Medicine and the Ludwig Center for Cancer Stem Cell Research at Stanford.

In mouse tests, doctors found they could cause dramatic tumor regression by blocking CD47 function, which allows immune cells to detect and attack the cancer, Krampitz reported. Although findings from animal trials often don't hold true in human studies, the researchers said they hope to begin clinical trials in the not-too-distant future.

The second study involved the use of antibodies to carry a radiation source directly to cancer cells, killing them in a more targeted way than conventional radiation beam therapy.

Researchers from the Digestive Disease Institute at Virginia Mason Medical Center found that antibodies designed to carry radiation to a cancer worked particularly well when combined with gemcitabine, a drug that enhances the effects of radiation therapy.

The combined therapy improved survival rates by about 40 percent in patients who received both the antibodies and gemcitabine. In addition, people survived more than twice as long if they received the combination therapy, compared to receiving the antibodies alone.

A larger trial is underway to confirm these results, those researchers said.

Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Ayumu Taguchi, M.D., assistant professor, MD Anderson Cancer Center, University of Texas, Houston; Andrew Lowy, M.D., chief, surgical oncology, University of California, San Diego; Geoffrey Krampitz, M.D., doctoral candidate, laboratory of Dr. Irving Weissman, director, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine and the Ludwig Center for Cancer Stem Cell Research at Stanford; May 19, 2014, presentations, American Association of Cancer Research special conference on pancreatic cancer, New Orleans

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Scientists Get Closer to the Stem Cells That May Drive Cancers

 THURSDAY, May 15, 2014 (HealthDay News) -- Although the very concept of cancer stem cells has been controversial, new research provides proof that these distinct types of cells exist in humans.

Using genetic tracking, researchers found that a gene mutation tied to cancer's development can be traced back to cancer stem cells. These cells are at the root of cancer and responsible for supporting the growth and progression of the disease, the scientists report.

Cancer stem cells are able to replenish themselves and produce other types of cancer cells, just as healthy cells produce other normal cells, the study's British and European authors explained.

"It's like having dandelions in your lawn. You can pull out as many as you want, but if you don't get the roots they'll come back," study first author Dr. Petter Woll, of the MRC Weatherall Institute for Molecular Medicine at the University of Oxford, said in a university news release.

The researchers, led by a team of scientists at Oxford and the Karolinska Institute in Sweden, said their findings could have significant implications for cancer treatment. They explained that by targeting cancer stem cells, doctors could not only get rid of a patient's cancer but also prevent any remaining cancer cells from sustaining the disease.

The study, published May 15 in Cancer Cell, involved 15 patients diagnosed with myelodysplastic syndromes (MDS), a type of cancer that often develops into acute myeloid leukemia, a form of blood cancer.

The researchers examined the cancer cells in the patients' bone marrow. Four of the patients were also monitored over time. One patient was followed for two years. Two patients were followed for 30 months and another patient was monitored for 10 years.

According to the researchers, in prior studies citing the existence of cancer stem cells, the lab tests that were used to identify these cells were considered by many to be unreliable.

However, "In our studies we avoided the problem of unreliable lab tests by tracking the origin and development of cancer-driving mutations in MDS patients," explained study leader Sten Eirik Jacobsen, of Oxford's MRC Molecular Haematology Unit and the Weatherall Institute for Molecular Medicine.

According to the research, a distinct group of MDS cells had all the characteristics of cancer stem cells, and only these particular cancer cells appeared able to cause tumor spread.

The researchers added that this subset of MDS stem cells was rare, but they could replenish other MDS cancer cells. They were also the root of all genetic mutations that caused the disease to progress.

"This is conclusive evidence for the existence of cancer stem cells in myelodysplastic syndromes," Woll concluded. "We have identified a subset of cancer cells, shown that these rare cells are invariably the cells in which the cancer originates, and also are the only cancer-propagating cells in the patients. It is a vitally important step because it suggests that if you want to cure patients, you would need to target and remove these cells at the root of the cancer -- but that would be sufficient, that would do it."

Although the findings do not offer up any new cancer treatment, the study authors believe they may help scientists develop more efficient treatments that specifically target cancer stem cells.

They stressed, however, that this particular study identified only MDS stem cells -- other forms of cancer likely have a unique set of stem cells that work differently, the team said.

"We need to understand more about what makes these cancer stem cells unique, what makes them different to all the other cancer cells," Woll said. "If we can find biological pathways that are specifically dysregulated in cancer stem cells, we might be able to target them with new drugs."

 

Dogs Join Fight Against Bone Cancer

By Dennis Thompson
HealthDay Reporter

THURSDAY, May 15, 2014 (HealthDay News) -- Man's best friend will be part of an effort to find better treatments for a type of bone cancer in children and young adults, researchers report.

Dogs who are suffering from osteosarcoma will be treated with drugs that are already approved by the U.S. Food and Drug Administration for other uses, to see how well these medications battle the bone cancer, said Dr. Joy Fulbright, a pediatric oncologist with Children's Mercy Hospital in Kansas City, Mo.

"This is one of the cancers that is the same type of cancer in both dogs and humans, and dogs tend to be able to process drugs similarly to how humans do," Fulbright said. "Ideally, we'd like to find an agent that's not as toxic as the chemotherapy we currently use."

Doctors are hoping that they'll find drugs that are effective against osteosarcoma in both dogs and humans. And, because these medications are already FDA-approved, they should be able to put them to use very quickly.

"It usually takes up to 15 years to get a drug from bench side to patient," Fulbright said. "We're hoping to decrease that time if we can find a drug that's already FDA-approved."

Finding new treatments for osteosarcoma has been a challenge because it's an uncommon cancer in humans. Only about 800 people are diagnosed with the disease each year, about 400 of those are in children and teens, according to the American Cancer Society.

The five-year survival rates for people diagnosed with osteosarcoma before it has spread can be as high as 80 percent. If the cancer has spread, five-year survival rates drop to between 15 percent and 40 percent, according to the cancer society.

"We haven't improved the survival rate in the last 20 years," Fulbright said.

However, osteosarcoma is far more common in dogs than it is in people. About 10,000 cases are diagnosed each year, according to the study authors.

Currently, the researchers are pre-testing drugs in the laboratory using osteosarcoma cells taken from both humans and canines.

The most promising drug candidates from this phase will then be tested in dogs that have been diagnosed with bone cancer, to see which work best with the least side effects. Vets at the Colorado State University College of Veterinary Medicine will identify canine candidates for the study and treat them with the drugs selected by researchers. No dogs will be given cancer for this study; the dogs must have naturally occurring osteosarcoma.

After identifying drugs that work for dogs, doctors hope to move on to human trials using the same medications.

Canines are commonly used in medical research, said Nicole Duffee, director of education and scientific affairs for the American Association for Laboratory Animal Science.

Their use in this study makes sense because osteosarcoma "is a naturally occurring condition in dogs, especially in large dogs," Duffee said.

Duffee noted that while the study is focused on a human treatment for osteosarcoma, it could also lead to improved bone cancer treatments for dogs.

The study is being funded with a $500,000 grant from the Midwest Cancer Alliance.

Exercise Linked to Improved Bladder Cancer Survival

 WEDNESDAY, May 21, 2014 (HealthDay News) -- Regular exercise may increase the odds of bladder cancer survival. But smoking and a delay in diagnosis are two factors that might increase the risk of dying from the disease, the findings from two new studies suggest.

The first study found that regular physical activity can reduce the risk of dying from bladder cancer. Meanwhile, the second study found that women are more likely to ignore blood in their urine -- a key warning sign for this type of cancer. By not visiting their doctor, women are more likely to be diagnosed after the disease has progressed, making it more difficult to treat, the researchers said.

"Bladder cancer is among the top 10 most common cancers in the United States, with an estimated 72,000 new cases occurring each year," Dr. Mirza Moben, an assistant professor of urology at the University of Kansas Medical Center, said in a news release from the American Urological Association.

"Understanding the myriad factors impacting effective diagnosis and treatment will ultimately lead to better outcomes -- underscoring the importance of this type of research," added Moben.

Both studies were presented at the American Urological Association annual meeting, which concluded Wednesday in Orlando, Fla.

The first study, from researchers at the University of California, San Diego, involved national survey data on more than 200,000 people. Of these, 48 percent were men, and 73 percent were white. The participants provided information on their level of physical activity and their body mass index -- a measurement that can help determine if someone is a normal weight for their height.

Although the investigators found no link between ethnicity or gender and survival rates for bladder cancer, they did find that exercise may prevent bladder cancer deaths. The participants who exercised were more likely to survive their disease than those who didn't exercise. Even light or moderate exercise might help, the study authors suggested.

A past history of smoking was also linked to a tripled likelihood of dying from bladder cancer compared to those who never smoked, the researchers added.

However, while the study found an association between exercise, smoking and survival rates, it did not prove a cause-and-effect relationship.

A separate study, conducted by researchers from Vanderbilt University in Nashville, involved more than 9,000 Medicare patients who were diagnosed with blood in their urine, or hematuria, during an office visit with their doctor between January 2009 and June 2010.

Although blood in the urine is the most prevalent indicator of bladder cancer, the researchers found that an evaluation for this problem was complete in just 14 percent of the patients analyzed. In addition, 21 percent had an incomplete evaluation and 65 percent had no evaluation for this symptom, according to the study.

The researchers found that racial differences in bladder cancer outcomes are not due to the quality of evaluations for blood in the urine. They did find, however, that women were less likely than men to visit their doctor for an evaluation after developing blood in their urine. This delay in seeking medical attention may prevent the detection of the disease at an early stage, leading to worse outcomes, the study authors cautioned.

Smokers in this study were also more than four times more likely to die of bladder cancer than non-smokers, the findings showed.

Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.