April 21, 2015

Dogs Detect Prostate Cancer By Smelling Urine

My prostate cancer diagnosis came over 20 years ago, but not like this.

As reported in the April 2015 issue of the Journal of Urology, two specially trained female German shepherds – formerly bomb-sniffing dogs – detected the presence of prostate cancer with remarkable accuracy simply by smelling men’s urine.

The study is particularly significant because the current diagnostic process – screening the blood for the presence for the prostate-specific antigen (PSA) – leads to many false positives, and subjects healthy men to unnecessary stress and additional tests.

Researchers from the Humanitas Clinical and Research Center in Milan, Italy, collected urine samples from 362 men at different stages of prostate cancer, and from 540 healthy controls.

Zoe and Liu
The two German shepherds bomb sniffers – Zoe and Liu – were retrained to detect the specific volatile organic compounds in urine associated with prostate cancer.

Once their training was completed, Zoe and Liu were presented with batch after batch of urine samples from the prostate cancer patients, placed at random among among samples from the control group.

One dog correctly identified all of the prostate cancer urine samples and misidentified only seven of the non-prostate cancer samples, or 1.3%.

The second dog correctly identified 98.6% of the prostate cancer urine samples and misidentified 13 of the non-prostate cancer samples, or 3.6%

Dr. Gianluigi Taverna, chief of the prostatic diseases unit at the Humanitas Research Hospital, summarized the importance of his organization’s work:

April 17, 2015

Michael J. Fox Discusses Accepting Parkinson's Disease with David Letterman

Michael J Fox appeared on the Late Show with David Letterman last night to discuss Parkinson's Awareness Month (April), his own diagnosis, and steps his foundation is taking to find a cure. It's been 22 years since his diagnosis, and Michael looks and sounds great.

Here's the remark I liked best:
To be kind of corny about it, once you accept it, and you learn about it... and realize you're in a position to do something about it, and to make a difference, and to help, well then just, like, quit your bitching and get on with it.
Since 2000, the Michael J Fox Foundation for Parkinson's Research has funded more than $450 million to speed a cure. About 52% of that total has gone toward altering the disease (developing a treatment that could restore function to damaged dopamine neurons in the brains of people with PD), and 22% toward defining the disease (indentifying biomarkers). Fox explained to Letterman that identifying those biomarkers is a promising way to spot the disease before it develops.

April 16, 2015

To Live Longer, What Amount and Type of Exercise is Best?

Two just-released studies underscore the importance of exercise. Published last week in JAMA Internal Medicine, they define how much exercise might be enough, quantify the risks of getting too little, and suggest there’s no real harm in getting “too much” vigorous exercise.

How Much Exercise is Best?
The first study -- Leisure Time Physical Activity and Mortality: A Detailed Pooled Analysis of the Dose-Response Relationship -- assembled data about people’s exercise habits from six large health studies still in progress. Researchers from Harvard, the National Cancer Institute, and several other institutions placed over 661,000 adults – mostly middle aged – into categories based on the amount of time they spent exercising each week.

Those subgroups ranged from people who didn’t exercise at all to people who exercised moderately for 25 or more hours every week. Somewhere in between were those people who actually followed the 2008 Physical Activity Guidelines for Americans: a minimum of 75 minutes vigorous-intensity or 150 minutes of moderate-intensity exercise each week.

After stratifying all those people into their appropriate exercise categories, the researchers examined the death records for all groups. Here’s what they found:
  • Hardly a surprise: people who did not exercise carried the highest risk of early death.
  • People who exercised just a little – even well short of the recommended 150 minutes per week – reduced their risk of early death by 20%.
  • People who hit that recommended guideline exactly were 31% less likely to die early than those who didn’t exercise.
  • People who tripled the recommended guideline (3 x 150) – logging about 450 minutes of moderate exercise each week – showed the best results of all, reducing their risk of early death by 39%.
  • The super-exercisers – people who went at it for 25 or more hours each week – experienced early death rates similar to those who simply met the 150-minutes-each-week guideline. “More” wasn’t necessarily “better,” but “more” didn’t hurt, either… contrary to much of the conventional wisdom out there.

What Kind of Exercise is Best?

April 15, 2015

Saving on Drug Costs: Pros and Cons of Discount Programs

Surfing the web, I came across a link to "7 Tips for Saving Money on Prescription Drugs" featured on Next Avenue, the PBS website created for people 50+.

Author Bart Astor, an expert on life transitions for seniors, relayed a personal anecdote about his health insurer's refusal to pay for an expensive drug prescription. Why wouldn't his carrier pony up? He didn't have the specific disease the drug is supposed to treat.

Astor says his subsequent effort to resolve this issue uncovered a potential "happy ending for all of you who are stuck paying for an expensive drug without the benefit of having prescription drug coverage or if you're one of those with a prescription drug insurance doughnut hole."

Drug Discount Programs
A pharmacist at Costco suggested he check for coupons available online that offer discounts up to 70%. Astor then Googled his drug's name and the word "coupon" and got many links. He clicked on internetdrugcoupons.com and found that the company provided a free pharmacy discount card good for every FDA-approved drug. He ordered the card.

When he took it to his local CVS, the pharmacist told him that the drug would cost $432, about 70% less than the regular price of $1,600.

The pharmacist also said she often tells patients to check for coupons online, and to ask their doctors for free samples.

Astor then created his list of seven tips to save money on prescription drugs. Tip number two: "Ask your doctor for free samples." Tip number four? "COUPON!"

Others Advise Differently
I thought Astor's seven tips would make a helpful blog post. But first -- since I wasn't familiar with online coupons -- I wanted to do a little more research.

April 14, 2015

Novel Blood Signature Analysis May Enable Earlier Parkinson’s Diagnosis… and Treatment.

In recent weeks, we’ve heard promising news on several fronts in the battle against Parkinson’s disease.

Two weeks ago, we learned about apparent progress in the development of an anti-PD vaccine. Then last week, we heard that researchers had developed a novel process they felt could enable doctors to diagnose PD  much sooner by evaluating the way people typed on a keyboard.

It’s now axiomatic that the timing of diagnosis is paramount in the treatment of this disease. PD is often not diagnosed for ten years after the damage begins. Estimates suggest that up to 80% of the dopamine-producing neurons are already destroyed by the time someone receives a proper diagnosis of PD. For treatment to be truly meaningful, diagnoses must come much sooner than they do now.

A Novel Blood Signature Analysis
Now, in a study published in the journal Movement Disorders, we learn that PD might be identified earlier using a new blood signature analysis. This new research was conducted by the Mount Sinai Medical Center and – like so many others --- funded by the Michael J. Fox Foundation for Parkinson's Research.

The Mount Sinai team used a new approach to search for biomarkers – or at least “blood signatures” -- in the blood of PD patients who carry a known genetic risk factor for the disease, and in the blood of PD patients who do not.

At this point in the effort to ID the disease sooner, there’s only one blood feature that might signal an increased likelihood of developing PD: the presence of a mutation in a gene identified as leucine-rich repeat kinase 2, or LRRK2. (The mutation doesn’t carry a PD sentence; only some people with the mutation get the disease.)

Still, it’s a start. Less than two percent of all people with PD actually carry the LRRK2 mutation. It would be a big leap forward if science could find another similar bio-marker.