Don’t Ignore the Snore

Think for a moment about the factors that influence health.  Chances are you thought about: smoking, obesity, high blood pressure, high cholesterol and insufficient exercise. Maybe you added in family history of disease, and stress. How about snoring?

What!?!  Well, according to researchers at Henry Ford Hospital in Detroit, snoring may put your health at a greater risk than any of the above.

Their study revealed that isolated snoring may not be as benign as first suspected.  The trauma and subsequent inflammation caused by the vibrations of snoring can lead to changes in the carotid arteries – the pair of blood vessels that deliver blood to your brain and head. Snoring can cause a build-up of plaque which can eventually block the blood supply to the brain and increases the risk of stroke.

“Snoring is more than a bedtime annoyance and it shouldn’t be ignored. Patients need to seek treatment in the same way they would if they had sleep apnea, high blood pressure or other risk factors for cardiovascular disease,” says lead author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

Obstructive sleep apnea– a sleep disorder that occurs due to the collapse of the airway in the throat during sleep and causes loud snoring and periodic pauses in breathing – has long been linked to cardiovascular disease, along with a host of other serious health issues.

But the risk for cardiovascular disease may actually begin with snoring, long before it develops into obstructive sleep apnea.

Investigators reviewed data for 913 patients aged 18-50, who had participated in a diagnostic sleep study, none of whom had sleep apnea.  54 patients completed a survey regarding their snoring habits, and underwent a carotid artery ultrasound to measure the thickness of the innermost two layers of the carotid arteries. This test is able to pick up the first signs of carotid artery disease.

What they found was that snorers were had significantly greater thickening of the carotid arteries, compared to non-snorers.  Interestingly, no statistically significant differences in carotid artery thickening could be found for patients with or without some of the traditional risk factors for cardiovascular disease – smoking, diabetes, hypertension or hypercholesterolemia.

“Snoring is generally regarded as a cosmetic issue by health insurance, requiring significant out-of-pocket expenses by patients. We’re hoping to change that thinking so patients can get the early treatment they need, before more serious health issues arise.”

The Henry Ford research team plans to conduct another long-term study on this topic, particularly to determine if there’s an increased incidence of cardiovascular events in patients who snore.

In the meantime, instead of kicking your snoring bed partner out of bed, seek out medical treatment for him…or her.

Out Pacing Alzheimer’s

Alzheimer’s disease is the most common form of degenerative dementia, afflicting about 5.5 million Americans and costing more than $100 billion per year. In terms of U.S. health care expenditure it now ranks as the third costliest disease.

Alzheimer’s disease is not easily managed. It becomes progressively disabling with loss of memory, cognition, worsening behavioral function and a gradual loss of independent functioning. Currently there is no cure.

But this may be all about to change. Last October, during a five-hour surgery at The Ohio State University Wexner Medical Center, Kathy Sanford became the first Alzheimer’s patient in the United States to have a pacemaker implanted in her brain.

Could this be the dramatic shift in the disappointing struggle to find something to slow the damage of this epidemic?  As yet, no one knows if it might work, and if it does, how long the effects might last.  Research is still in its infancy.

Dr. Douglas Scharre, neurologist and director of the division of cognitive neurology, and Dr. Ali Rezai, neurosurgeon and director of the neuroscience program are jointly conducting the study.

Sanford is the first of up to 10 patients who will be enrolled in the FDA-approved study to determine if using a brain pacemaker can improve cognitive and behavioral functioning in people with Alzheimer’s disease.

The study employs the use of deep brain stimulation (DBS), the same technology used to successfully treat patients with movement disorders such as Parkinson’s disease.

First, holes are drilled into the patient’s skull so tiny pacemaker wires can be implanted into just the right spot. A battery-powered generator near her collarbone then sends tiny shocks up her neck and into her brain.

It is hoped that zapping the brain with mild jolts of electricity will make the brain work better and stave off the cognitive, behavioral and functional effects of Alzheimer’s disease.

“If the early findings that we’re seeing continue to be robust and progressive, then I think that will be very promising and encouraging for us,” says Ali Rezai MD, “But so far we are cautiously optimistic.”

Kathy Sanford says she volunteered for the study to help others avoid the angst she has suffered as Alzheimer’s slowly disrupted her life.  The Ohio woman’s early stage Alzheimer’s was gradually getting worse. She still lived independently, posting reminders to herself, but no longer could work. The usual medicines weren’t helping.
Her father is proud that his daughter is participating in the study. “What’s our choice? To participate in a program or sit here and watch her slowly deteriorate?” asked Joe Jester, 78.  He drives his daughter to follow-up testing, hoping to spot improvement.

Since having the surgery last October Sanford has undertaken a number of problem-solving tests while neurologists adjusted the voltage and frequency and watched her reactions.

She was cheered to see her test scores climb a bit during those adjustments. While she knows there are no guarantees, she says “if we can beat some of this stuff, or at least get a leading edge on it, I’m in for the whole deal.”

Her optimism and hope is shared by her neurologist. “We’re getting tired of not having other things work” said Douglas Scharre MD.  Alzheimer’s doesn’t just steal memories. It eventually robs sufferers of the ability to do the simplest of tasks.

Here’s hoping these brain pacemakers can reconnect some of the circuits and diminish such losses.

Testing, Testing… $, $$, $$$

If doctors knew the exact price of expensive medical tests would they order fewer of them?

That’s exactly what Johns Hopkins researchers wanted to know.

The answer has just been published in the Journal of the American College of Radiology, and it’s a resounding: No!.  According to the investigators, revealing the costs of MRIs and other imaging tests up front had no impact on the number of tests doctors ordered for their hospitalized patients.

“Cost alone does not seem to be the determining factor in deciding to go ahead with an expensive radiographic test,” says the study’s senior author, Daniel J. Brotman, M.D., director of the hospitalist program at The Johns Hopkins Hospital. “There is definitely an over-ordering of tests in this country, and we can make better decisions about whether our patients truly need each test we order for them. But when it comes to big-ticket tests like MRI, it appears the doctors have already decided they need to know the information, regardless of the cost of the test.”

Some earlier studies have suggested that much of the expense of laboratory tests, medical imaging and prescription drugs is unknown or hidden from providers and patients at the time of ordering, leaving financial considerations largely out of the health care decision-making process and likely driving up costs. Other studies have shown that doctors ordered fewer laboratory tests in some cases when they were given the price up front.

But, imaging tests appear to be “a different animal.”

Although there are certain inherent disincentives, aside from cost, to ordering some major tests, such as the potential danger of radiation used, physicians also need to learn how to explain to patients why they may not need them.

For the six months of the study, Brotman and his colleagues identified the 10 imaging tests most frequently ordered for patients at The Johns Hopkins Hospital. Five of these were randomly assigned to the active cost display group and 5 to the control group. During a 6-month baseline period from November 10, 2008, to May 9, 2009, no costs were displayed. During a seasonally matched period from November 2009, to May  2010, costs were displayed only for tests in the active group. At the conclusion of the study, the radiology information system was queried to determine the number of orders executed for all tests during both periods.

And, when they compared the ordering rates to the rates from a six-month period a year earlier, when no costs were displayed at all, they found no significant difference in ordering patterns.

Is this a good or a bad thing?

Certainly there are many instances when expensive tests are justified. When a key diagnosis is needed there are limited options for comparison shopping.  For example, when a patient appears to have had a sub-acute stroke, an MRI is needed regardless of cost.

That is not to say there aren’t times when physicians need to look more closely at whether too many imaging tests are being ordered. Do ventilated intensive care unit patients really need a daily chest X-ray to look for potential lung problems?  Especially when there is good medical evidence that outcomes aren’t compromised if X-rays are ordered only when the patient’s condition appears to be worsening.

“For too long, there has not been enough attention paid to the bottom line in health care,” Brotman says. This isn’t about rationing care to hold down costs, he says, but about choosing tests a little more wisely.

Even though price transparency didn’t influence the way physicians ordered imaging tests in this study, financial considerations may play a role in other circumstances if tied to clinical evidence.

If you show a provider that he or she is ordering four times as many CT scans as a colleague whose patients have similar outcomes, it could change the decision-making calculus for the better.

“Cost transparency must be part of the solution to solving fiscal challenges in medicine,” Brotman says. “Providers have no idea how much they’re spending. Patients don’t know either. Having everyone understand more of the economics of health care is a great place to start cutting costs in medicine.”

Seems logical to us.

Don’t trust those Baby Blues

Trustworthiness is a trait we look for when determining whether someone is a friend or foe. It also helps with the social aspects of life, including social, economic, and reproductive success.

But how do we determine trust?

While character references might be a good idea, few of us screen potential friends and partners in this way. Most of us kind of go with gut feeling. Or at least that’s what I thought!

Now, according to new research, it seems that we may make the call based on eye color and face shape!

A team of Czech researchers have been exploring which facial markers spark feelings of trustworthiness during our mind’s subconscious profiling. The researchers used 80 photographs of brown- or blue-eyed college science students. The photos were rated based on attractiveness, trustworthiness, and dominance.

The faces in the photographs were also analyzed based on the distance between the lips and brow, between the left and right cheekbones, and by the width to height ratio of the faces. This was done to determine which facial features translate into trustworthiness and which, if any, facial features are common among blue- and brown-eyed people.

What they learned was that people with similar eye color tend to share the same face shape. Brown-eyed men tend to have face shapes that convey happiness, whereas blue-eyed men, typically have face shapes that convey anger. This is consistent with previous research that showed blue-eyed babies are typically more inhibited, shy, socially wary, and timid than brown-eyed babies.

For the record, the researchers say a brown-eyed trustworthy face contains:

• a rounder, broader chin
• a broader mouth with upward-pointing corners
• relatively large eyes
• eyebrows that are closer together

Compare this with the less trustworthy traits of blue-eyed people, which include:

• an angular and prominent lower face
• a longer chin
• a narrower mouth with downward pointing corners
•  relatively small eyes
• distant eyebrows

Interestingly, they also showed that women tend to vote more favorably for other women with the same eye color as themselves, however eye color played no role in men’s decisions.

And the most untrustworthy trait? According to the study having downward pointing corners is a sure give-away of a shady character.

Although the authors admit that much more research is needed, they propose several possible reasons why brown-eyed people are perceived as being more trustworthy than their blue-eyed brethren.  Apparently, brown-eyed people represent a “biosocial adaptation that has been established for millions of years. Additionally, brown eyes are one of the preferred evolutionary trait people seek in their mates.

So if you’ve ever been told that you have “one of those faces” maybe now you know why!

A Day of Celebration and Remembrance

Monday January 21, 2013.  A Day that will go down in history.

Millions of Americans will come together today in a national day of service, dialogue and observance to honor the memory of Dr. Martin Luther King Jr.

Dr. King had a dream that one day all people would be guaranteed the inalienable rights of life, liberty and the pursuit of happiness as called for in the Declaration of Independence. Dr. King called for social justice and opportunity. He asked that we bridge differences and come together in unity.  With the election over and in the aftermath of a year of significant weather events and senseless tragedies, today provides a unique opportunity to unite Americans in volunteer service. Let’s  do what we, as Americans, do best – lend a hand, help our neighbors and build better communities.

Millions more, in America and beyond will watch as America swears in its 57th President.  But before the pomp and ceremony begins, the Obama family’s will kick off with the President asking Americans across the country to organize and participate in service projects in their communities to honor our shared values and celebrate the legacy of Dr. King. The Obama’s are driven by the basic values that make our country great and will remind us that hard work pays off and responsibility is rewarded, and when everyone—from Main Street to Wall Street—does their fair share and plays by the same rules.

But while the Obama’s celebrate, a certain past president may want to forget all about Jan 21. For it was that day, in 1998  that news of the Lewinsky/Clinton affair was  published. Although President Clinton vigorously denied all allegations at the time, the history books will go on to tell a different story.

Four years earlier, history, of sorts, was also made when Lorena Bobbitt was found temporarily insane of chopping off her spouse, John Wayne Bobbitt‘s penis and tossing it into a field.  Incidentally, that particular field is less than one mile from my house and the surgeon who subsequently performed the reattachment is someone run into on a regular basis. Aside from that, the case gained worldwide notoriety for its shock value. But it also brought public attention to the subject of marital rape, domestic violence and the realization that men as well as women can be the victims of such violence.

Other notable January 21st events.

• In 1986, 100 brave souls participated in a Nude Olympics race in 38 degrees F in Indiana.
• In 1978, the Bee Gees “Saturday Night Fever” album went to #1, where it stayed for 24 weeks
• In 1970, the Boeing 747 made its first commercial flight
• In 1949, the first inaugural parade was televised
• In 1908, New York City made it illegal for a woman to smoke in public
• In 1903, the Wizard of Oz premiered, also in new York City
• In 1799, the smallpox vaccine was introduced, which is kind of ironic given that on Jan 21, 1677, the first ever medical publication in America was a pamphlet on smallpox

And finally, on this day in 2010, SRxA’s Word on Health was founded. In three short years our readership has grown from 7 views per day to close to 1,000; for which we thank you immensely.

Whatever, you are doing today, we wish you a happy and healthy one.

Putting the Hilarity in Charity

Residents and visitors to the nation’s capital prepare for a big surprise.  No, we’re not talking about the upcoming inauguration, but something altogether more fun. So what could be more captivating than the swearing in of the 57^th President you ask?

Well how about 1,000 scantily clad runners?  That’s right!  In less than a month, on Valentine’s day weekend to be exact, the streets of Washington, DC will be filled with belles in bras and boys in boxers.  All will be participating in the third annual Cupid’s Undie Run to raise donations for the Children’s Tumor Foundation (CTF).

The Children’s Tumor Foundation is dedicated to ending neurofibromatosis (NF) through research. NF is a genetic disorder that causes tumors to grow on nerves throughout the body, causing blindness, deafness, learning disabilities and severe chronic pain. NF affects roughly 1:3,000 births in the U.S. Currently, there is no cure and there are frighteningly few treatment options. The Foundation’s mission is to advance peer-reviewed research to develop treatments and cures for NF; support persons with NF and their families by making thorough and accurate information readily available; to assist in developing clinical centers and best practices to improve access to quality healthcare for those who live with NF; and expand public awareness of NF to improve diagnoses, increase understanding of the challenges that NF presents, and encourage support for NF research.

Cupid’s Undie Run founders Brendan Hanrahan, Chad Leathers, and Bobby Gill

Cupid’s Undie Run was born three years ago after Chad Leathers learned of his brother Drew’s diagnosis of neurofibromatosis.

Since then, the Cupid’s Undie Run has expanded into 17 cities across the US and to Sydney, Australia with the goal of raising more than one million dollars for neurofibromatosis research.  By 2012, they’d surpassed the $100k mark.  This year, their main is to spread Cupid’s love around the country and get folks in new cities excited about the event and the charity.

The Cupid’s Undie Run DC will take participants on a 1.5 mile run past the US Capitol and the Supreme Court.  Pre- and post-run festivities are held at Pour House and Capitol Lounge. Festivities start at noon on Saturday, February 9th 2013*, before runners strip down for the Undie Run at 2pm. Post-race, there will be numerous festivities and awards. Prizes include custom undies, VIP Open Bar, embroidered bathrobes, engraved iPod Nanos, and even romantic getaways.

Charitable cherubs can either fundraise as an individual or join a team.

In addition to the DC event, there will be Cupid’s undies runs in NYC, Atlanta, Seattle, Denver and Cincinnati, LA, San Fran, Chicago, Austin, Nashville, Orlando, Minneapolis, Philly, Cleveland, St. Louis and Detroit.  Get ready!

So if you’re ready to run 1.5 miles in your bedroom-best click here for more information.

See you in your skivvies!

 

Rehab for Ruined Reputations?

After 25+ years working in or for the pharmaceutical industry, I’m probably one of its greatest supporters. I’ve witnessed the impact that pharma R&D has on the lives of patients, the benefits that pharma supported education offers physicians and the global impact of the pharma industry on the economy.

Yet despite all the good it does, pharma has somehow ended up with a reputation that, to put it mildly, sucks. Rather than being hailed as responsible and innovative the public perception of the industry is more likely to be fat cat greed.

So how did pharma earn itself a place in the ‘damaged goods’ file?

According to a new survey pharma’s poor reputation  stems mainly from concerns over safety, pricing and transparency.

The global survey, conducted by Patient View, in November and December 2012, explored the views of 600 international, national, and regional patient groups on the corporate reputation of the pharma industry as a whole, and the top 29 companies in particular.

The results are in and they’re not good. The Pharma Industry’s reputation has taken a dive.

Only 34% of those surveyed said that multinational drugmakers had an ‘excellent’ or ‘good’ reputation last year- compared with 42% in the 2011 survey.

The survey also asked patient groups – many of which receive financial backing from the pharmaceutical industry – to rank drugmakers on six indicators that influence corporate reputation: patient-centeredness; patient information; patient safety; useful products; transparency; and integrity.

Overall when comparing 2012 with 2011, the industry’s reputation suffered the most in the following areas:

• managing bad news about drugs (29% decrease)
• having ethical marketing practices (23% decrease)
• having a good relationship with the media (19% decrease)

Other factors cited for the poor performance: a continuing failure to help patients in cash-strapped countries gain access to medicines; a preoccupation with drugs that offer short-term health benefits and not enough effort made to discover new drugs for neglected groups of patients.

Patient groups also pointed to inappropriate and off-label marketing; a perceived lack of transparency, especially when it comes to reporting disappointing trial results; and giving the impression that profits come before patient well being.

What else?

13% said that the industry does not provide high quality patient information; 11% believe that no drugmaker has a good patient safety while 9% think that the industry does not provide useful products.

Brand-name drugmakers, ranked poorly compared with other players in the healthcare sector. Patient groups graded retail pharmacists, medical device makers, generics companies and even “for-profit” health insurers, as having ‘excellent’ or ‘good’ reputations. Only non-profit health insurers fared worse.

Can the industry turn itself around? We sure hope so.

Stakeholders, especially those who receive money from the industry, should respect pharmaceutical companies as corporate citizens.  At the same time, Pharma needs to recognize that they have a  key opportunity to demonstrate leadership by addressing the growing problem of chronic disease. Policy-makers, health care providers and patients will all benefit if the industry plays a more prominent role in helping to better manage chronic disease and partner with the public health community in promoting disease prevention.

And Pharma needs to tackle the price complaints head on, rather than shying away.  Whatever happens with healthcare reforms, politics or the economy, affordability and pricing will remain perennial reputational challenges for the industry. Period. We are all consumers at heart. Consumers, looking for bargains. And while I don’t support price cuts, I would advocate greater transparency around drug pricing. Pharma could both help themselves and make a meaningful impact by educating policy-makers and the public on the cost of medicines and by demonstrating how medicines decrease health care costs overall.

Managing reputation by meeting stakeholders’ myriad expectations for pharmaceutical companies is more than merely ‘doing the right thing.’

Stiffness, Swelling and the Sticky Issue of Sugary Soda

Those of us of a certain age, probably know all about osteoarthritis, the “wear and tear” disease in which joint cartilage is lost. Losing cartilage from your knee is similar to having the shock absorbers go on your car.  It leads to pain, stiffness and other symptoms.

According to a large 2007 study, nearly 20% of women and 15% of men over the age of 45 have  symptoms of knee osteoarthritis.

Until now, many experts thought disease progression was inevitable. I’m pretty sure that’s what my knee surgeon thinks. One such clue: he always says “when I see you again” rather than “if I see you again” at the end of every visit.

Now, for men at least, this may be about to change. A new study of more than 2,000 with osteoarthritis of the knee showed that disease progression in men is linked to consumption of sugary soda.

Researchers reviewed the records of 2,149 men and women with confirmed osteoarthritis of the knee.

All filled out dietary questionnaires that asked how many soft drinks, not including sugar-free beverages, they drank on average each week.

Every year for four years, the researchers tracked their osteoarthritis progression by measuring the space between the joints. The more cartilage that is lost, the less the space. Body Mass Index (BMI) was also measured.

After taking into account BMI and other risk factors, men who drank five or more soft drinks a week had twice as much narrowing of joint space compared with men who did not drink sugary soda.

“Our main finding is that the more sugary soda men drink, the greater the risk that knee osteoarthritis will get worse,” says researcher Bing Lu, MD, DrPh. Lu is assistant professor of medicine at Harvard Medical School and associate biostatistician at Brigham and Women’s Hospital in Boston.

If you’re thinking something along the lines of ‘Duh! Tell me something new. Soda=calories=weight gain= risk factor for osteoarthritis, think again.

Much to the researchers’ surprise, the link between knee osteoarthritis progression and sugary soft drinks could not solely be explained by weight.  When the men were divided into obese and non-obese, the link between sugary drinks and worse knee damage held true only in the non-obese men, suggesting that soft drinks worsen knee osteoarthritis independently of the wear and tear on the joints caused by carrying around excess weight.

So what’s a man who enjoys soda to do?  According to Lu the answer is simple. “just don’t drink it!”

Another expert says that’s going too far. “As with everything, enjoy soda in moderation. If you are a man with knee osteoarthritis and are drinking a lot of soda, this might be a reason to curb back,” says American College of Rheumatology spokesman Scott Zashin, MD.

He argues that the study doesn’t prove cause and effect and needs to be repeated before any recommendations to patients can be made, he says.

Furthermore he advises, that in patients with osteoarthritis of the knee, every excess pound of weight is 4 extra pounds of dead weight on the knee joint.

And it’s not only Zashin who’s speaking out. The American Beverage Association (ABA), has also taken issue with the findings.

In a statement, the ABA writes: “The authors’ ‘novel  findings’ – as they call them – suggest only a possible association of soft drink consumption with osteoarthritis in knees, which they state cannot be proven without further testing. Consequently, this presentation fails to establish that drinking soft drinks causes any negative health outcomes or even that they are linked to negative health outcomes.”

Lu however is defending his work. He claims that certain ingredients in soda, including phosphoric acid, caffeine, as well as coloring and sweetening agents may affect absorption of calcium and overall bone health.

He even has an explanation as to why the link between soda and disease progression could not be established in women. “It could be due to sex hormones. For example, estrogen has been associated with cartilage degeneration. Further research is needed to understand the pathways.”

Although the jury is still out on this issue, it seems cutting back, or cutting out soda may not be a bad idea.

Could or would you give up your cola?  Let us know!

Vital Signs of Health

Roll up your sleeve for the blood pressure cuff. Stick out your wrist for the pulse-taking. Lift your tongue for the thermometer.Report how many minutes you are active or getting exercise.

Wait, what?

If the last item isn’t part of the usual drill at your doctor’s office, a movement is afoot to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation’s largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit. And the trend is spreading among other medical systems.

Here’s how it works: During any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it’s among the first things the doctor sees.

“All we ask our physicians to do is to make a comment on it, like, ‘Hey, good job,’ or ‘I noticed today that your blood pressure is too high and you’re not doing any exercise. There’s a connection there. We really need to start you walking 30 minutes a day,'” says Dr. Robert Sallis, the Kaiser family doctor who initially hatched the vital sign idea.

A study looking at the first year of Kaiser’s effort showed more than a third of patients said they never exercise.  Many patients were not aware that physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. Few know that those who routinely exercise live longer than others, even if they’re overweight.

Take Zendi Solano, 34, who works for Kaiser as a research assistant in Pasadena, CA. She always knew exercise was a good thing, but until about a year ago, when her Kaiser doctor started routinely measuring it, she “really didn’t take it seriously.”  She was obese, and had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenuous.

So she decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon, formed a running club with co-workers and started eating smaller portions and buying more fruits and vegetables.  She is still overweight but has lost 30 pounds and her blood sugar is normal. Her doctor praised the improvement at her last physical in June and Solano says the routine exercise checks are “a great reminder.”

Kaiser began the program after 2008 government guidelines recommended at least 2 1/2 hours of moderately vigorous exercise each week. That includes brisk walking, cycling, lawn-mowing — anything that gets you breathing a little harder than normal for at least 10 minutes at a time.

Now other health systems are following suite. Dr. Elizabeth Joy of Salt Lake City has created a nearly identical program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.  NorthShore University HealthSystem in plans to start an exercise vital sign program this month, eventually involving about 200 primary care doctors.

All of which is good news. Figuring out how to get people to be more active could have a big effect in reducing medical costs and improving health. Here at SRxA’s Word on Health we’ll be working on our Exercise Minutes.  Will You?

Putting the squeeze on breast cancer

UC Berkeley and the Lawrence Berkeley National Laboratory have literally put the squeeze on malignant breast cancer cells to guide them back into a normal growth pattern.

The findings, presented last month at the annual meeting of the American Society for Cell Biology, showed for the first time that mechanical forces alone can revert and stop the out-of-control growth of cancer cells.

And, it seems, this change happens even though the genetic mutations responsible for malignancy remain, setting up a nature-versus-nurture battle in determining a cell’s fate.

“We are showing that tissue organization is sensitive to mechanical inputs from the environment at the beginning stages of growth and development,” said principal investigator Daniel Fletcher, professor of bioengineering at Berkeley. “Compression, appears to get these malignant cells back on the right track.”

Throughout a woman’s life, breast tissue grows, shrinks and shifts in a highly organized way in response to changes in her reproductive cycle. For instance, when forming the berry-shaped structures that secrete milk during lactation, healthy breast cells rotate as they form an organized structure.

One of the early hallmarks of breast cancer is the breakdown of this normal growth pattern. Not only do cancer cells continue to grow irregularly when they shouldn’t, recent studies have shown that they do not rotate coherently.

While the traditional view of cancer focuses on genetic mutations within the cell, scientists at the Berkeley Lab showed that a malignant cell is not doomed to become a tumor. Instead, its fate is dependent on its interaction with the surrounding microenvironment. Better still, manipulation of this environment can tame mutated mammary cells into behaving normally.

“People have known for centuries that physical force can influence our bodies,” said researcher Gautham Venugopalan. “When we lift weights, our muscles get bigger. The force of gravity is essential to keeping our bones strong. Here we show that physical force can play a role in the growth and reversion of cancer cells.”

Venugopalan and collaborators grew malignant breast epithelial cells in a gelatin-like substance that had been injected into flexible silicone chambers. The flexible chambers allowed the researchers to apply a compressive force during the first stages of cell development. Over time, the compressed malignant cells grew into more organized, healthy-looking structures, compared with malignant cells that were not compressed.  Notably, those cells stopped growing once the breast tissue structure was formed, even though the compressive force had been removed.

“Malignant cells have not completely forgotten how to be healthy; they just need the right cues to guide them back into a healthy growth pattern,” said Venugopalan.

While researchers are not proposing compression bras as a treatment for breast cancer, they say their work provides new clues to track down the molecules and structures that could eventually be targeted for therapies.

All of which is good news for the girls!