March 31, 2015

Another Success for Parkinson’s Vaccine Development

Just over a week ago, we learned some interesting news from the Irish biotech company Prothena: the vaccine they produced to slow the progress of Parkinson’s disease (PD) had passed its Phase I trial -- the initial testing of a drug on a small group of people to evaluate its safety, determine a safe dosage range, and identify side effects.

This new Prothena vaccine in development introduces an antibody (PRX002) directly into the body. That particular antibody works to unclump the build-up of alpha-synuclein protein in the brain, and those accumulations are now convincingly linked to Parkinson’s disease.

The vaccine also apparently prevents continuing protein clumping in the brain, thereby protecting it from further degradation of neurons, a breakdown associated with the development and progress of PD.

Positive Findings from Phase I Trial
To establish the vaccine’s Phase I success in the clinical trial, the Prothena researchers tested it on 40 healthy volunteers. Not only did those study subjects tolerate the drug without incident, their average levels of alpha-synuclein -- the suspect protein that clumps – was reduced.

Dr. Gene Kinney, Prothena’s chief scientific officer and head of research and development, said:
We look forward to building upon these data with results from the on-going, multiple ascending dose study in patients with Parkinson's disease expected in the first half of 2016, where we will also be measuring levels of PRX002 in the cerebrospinal fluid and assessing additional biochemical, imaging and clinical biomarker endpoints.

Having shown its vaccine’s safety generally, Prothena is now recruiting people with PD for another Phase I trial.

Earlier Positive Vaccine Results from Austria 
This recent report from Ireland adds punch to news last summer from Austria, where biotech company AFFiRiS had similar Phase I success with its vaccine PD01A. The Austrian researchers administered two different doses of its vaccine, both of which proved safe and tolerable.

March 27, 2015

Two Favorite Poems, Two Interesting Videos

It's been a busy week and I need to start preparing for a family reunion next week. So I'm taking it easy today.

I keep a folder where I store things I come across and I like. Here are a few of the items from that grab bag.

First, two poems: 


ON AGING

When you see me sitting quietly,
Like a sack left on the shelf,
Don’t think I need your chattering.
I’m listening to myself.
Hold! Stop! Don’t pity me!
Hold! Stop your sympathy!
Understanding if you got it,
Otherwise I’ll do without it!
When my bones are stiff and aching,
And my feet won’t climb the stair,
I will only ask one favor:
Don’t bring me no rocking chair.
When you see me walking, stumbling,
Don’t study and get it wrong.
‘Cause tired don’t mean lazy
And every goodbye ain’t gone.
I’m the same person I was back then,
A little less hair, a little less chin,
A lot less lungs and much less wind.

But ain’t I lucky I can still breathe in.


--from Maya Angelou's And I Still Rise, published in 2011 when she was 83.
Ms. Angelou died last year.

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WALKING TO SLEEP

As a queen sits down, knowing that a chair will be there,
Or a general raises his hand and is given the field-glasses,
Step off assuredly into the blank of your mind.
Something will come to you.
. . . 
As for what turn your travels then will take,
I cannot guess. Long errantry perhaps
Will arm you to be gentle, or the claws
Of nightmare flap you pathless God knows where,
As the crow flies, to meet your dearest horror.
Still, if you are in luck, you may be granted,
As, inland, one can sometimes smell the sea,
A moment’s perfect carelessness, in which
To stumble a few steps and sink to sleep
In the same clearing where, in the old story,
A holy man discovered Vishnu sleeping,
Wrapped in his maya, dreaming by a pool
On whose calm face all images whatever
Lay clear, unfathomed, taken as they came.


--beginning and end of Richard Wilbur's poem "Walking to Sleep" 

March 26, 2015

If Your Doctor Has Just Made an Alzheimer’s Diagnosis for You, There’s a Good Chance She Won’t Tell You

On March 24, 2015, the Alzheimer’s Association released its 2015 Alzheimer's Disease Facts and Figures report, which recaps some disturbing observations about the way doctors communicate – or don’t communicate -- with Alzheimer’s patients, their families, and caregivers.

Based on its review of Medicare patients, the association found that only 45% of patients diagnosed with Alzheimer's disease (AD) said that their doctors shared the diagnosis with them.

In case you’re wondering if perhaps the AD patients may have forgotten who said what, only 53% of those patients’ family members and caregivers said the doctor communicated any AD diagnosis.

Alzheimer’s as the New Cancer
Compare those low numbers with the percentage of cancer patients who said their doctors shared the cancer diagnosis with them – 90%.

Beth Kallmyer, vice president of constituent services for the Alzheimer's Association, put it this way: "What we found is really shocking. This is reminiscent of what happened in the 1960s and 1970s with cancer. But that's changed now, and it really needs to change for Alzheimer's as well."

Why are so many newly diagnosed AD patients not told by their doctors?

It’s a sad excuse, but Keith Fargo -- director of scientific programs at the Alzheimer's Association – said it’s often about time: "It's difficult to disclose a diagnosis of a fatal brain disease in just a few minutes.” 

I find those typical 15-minute appointments – during which the doctor’s attention is focused on his laptop screen, not me – inadequate even for the most routine matters. In cases involving AD disclosures, doctors should simply schedule more time.

March 25, 2015

Dealing with Insomnia Without Pills


                        

Last week, I wrote a post about anticholinergic drugs, medications that, according to a new study, can carry irreversible dementia risks. Many of them are popular with seniors and include most of the over-the-counter sleep aids, like the Tylenol PM that I used and abused for years. But since then I've learned to deal with insomnia without pills.

My Struggles with Insomnia:
I'm no stranger to insomnia. Here is my history:
My alcoholic years:  I was a very successful practicing alcoholic until age 49. During those years, I didn't worry about insomnia since I most always went to bed half drunk. My wife and I usually downed at least two martinis before dinner and then sipped vermouth later in the evening. But to be sure that I would be able to get back to sleep when I woke in the middle of the night to go to the bathroom, I kept a small glass of vermouth hidden under my side of the bed and would drink it before going back to bed.

In a classic example of alcoholic denial, I knew my wife was an alcoholic because she took a drink before going to work. I was convinced I was not an alcoholic because I did not do that. Taking a drink at 7am was alcoholic behavior; taking a drink at 3am was not.
Intermittent insomnia:  During the early years of my sobriety, I slept okay except when I traveled, which was often. In those days, jet lag meant constipation and constipation meant insomnia. My remedy was drinking lots of coffee and lots of water first thing in the morning. But it usually took a few days for that regimen to work.
Eight years of big-time insomnia;  My longest and worst spell of insomnia occurred when I was in my 60s, and it lasted about eight years. During that time, whenever I tried sleeping in my bedroom, my body would jerk just as I started to doze off, and I'd be awake until 4am or later. I finally discovered that I could get a good night's sleep if I bedded down on the living room couch. Every time I tried to return to the bedroom, the body-jerk insomnia recurred.

It finally occurred to me (d'uh!) that I had no trouble taking my afternoon nap in the bedroom. That led me to wonder if the nighttime culprit might be the streetlight on the other side of the road from my bedroom windows. I installed blackout curtains to replace the Venetian blinds and... what do you know? The body jerking stopped and I could sleep in the bedroom again. Yeah!
The "Summer from Hell":  Even when body-jerk insomnia ceased, I continued to have intermittent insomnia. I often used Tylenol PM to deal with the problem. When these pills began to lose their efficacy, I got a prescription for Ambien instead.
About 10 years ago, I returned from a trip to Nepal with a particularly bad case of jet-lag insomnia. For about a week, I took a half tablet of Ambien at bedtime along with a Tylenol PM.
By the end of that week, the sleeplessness was accompanied for the first time by major attacks of anxiety and depression. Over the next few months, I consulted with my regular internist, a sleep therapist, and a shrink who specialized in prescribing medication. We tried a variety of antidepressants and sleep aids over that summer. None of them worked, and several made things worse.
Finally, the pill shrink recommended a holistic approach since the usual meds weren't working. I tried a variety of things, including hypnosis and even a trip to New York City to see a therapist who's work had been featured on NBC's "Today Show." She recorded my brain waves and converted them into a customized CD of sleep music. It didn't work but I've still got the CD.
Continuing to try everything, I read The Insomnia Solution, a new book that recommended a variety of approaches, many of which combined meditation with body exercises. One turned out to be a winner.
My Recovery from Insomnia Began With Meditation
I'm a neophiliac -- someone with a strong affinity for novelty -- so I've tried various forms of meditation over the years. But none really worked on slowing down my grasshopper mind.

March 24, 2015

My Checkered Experience with Bridge, the Card Game

Last week, I saw an article in the March 2015 issue of the AARP Bulletin titled “Fringe Benefit of Bridge? Brainpower.”

The author cited the two benefits often mentioned in commentaries about the card game:
  • It enhances mental sharpness, especially in seniors, and 
  • It creates opportunities for life-giving socialization.
I’m aware of both benefits, especially the second. Mostly, the AARP piece made me think about my own curious history with the game… a game that brings four people -- two sets of partners sitting opposite one another -- together at a card table.

It All Began in Ithaca
I started playing bridge at Cornell Law School. At noon, I’d find a game in the “men’s lounge” while we waited for afternoon classes to begin. Yes, the men’s lounge. As I recall, we had three women in the class of over 100. 

During my 40 years with the Bureau of National Affairs (BNA) in Washington, DC, many of my colleagues there got bridge games going during the lunch break. I missed those games, because I used the time in what I thought a more productive way: taking a siesta on the couch in my office. I was ahead of the curve, I guess; only decades later did I hear about the benefits of “power-napping.”

There was no way we’d ever get a game going at home, because my wife hated bridge. For several years, she worked in a small office at BNA, and every Monday her boss and another editor would discuss ad nauseum the many fascinating bridge hands they’d played over the weekend. That was more than enough for her.

Then, the Make-Believe Games
For many years after those law school games, I didn’t play at all. In fact, the next games I played were actually “imaginary” games.

March 20, 2015

Two Doctor Appointments in One Day? My Reaction

This past Tuesday, I was scheduled to see my neurologist at 9:40am and my geriatrician at 2pm. They have offices in the same medical building.

My neurologist showed up at my examining cubicle (too small to call a room) at 10:35am, 55 minutes late! Right away I could tell she hoped to shave off a few of the 15 minutes she usually spends on my checkups.

Fortunately, it was the first 70° day in Washington since early December, and I enjoyed a long, lovely lunch in a park close by. I was in my geriatrician's waiting room fifteen minutes early for my 2pm appointment. At 2:30, my name was called, and I was ushered into an examining cell. Fifteen minutes after that, my doctor appeared... only 45 minutes late!

Both doctors noted that the blood pressure readings their assistants had taken were somewhat high.

 

I'm glad I switched from a standard-operating-procedure internist to a geriatrician. But the U.S. -- unlike many other developed countries -- has a scarcity of geriatric health specialists. Internists are also in short supply. (No surprise: primary care physicians appear at the bottom of this chart that shows compensation by specialty.)


March 19, 2015

Bad News: Many Anticholinergic Drugs Popular with Seniors Carry Irreversible Dementia Risks

Earlier this week, we discussed the risks that statins -- those cholesterol-lowering drugs -- pose for seniors. Today it's anticholinergics, agents that block the neurotransmitter acetylcholine in the central and peripheral nervous systems. Studies suggest that 37% of people 65+ take these anticholinergic medications.

Drugs that fall into this class include tricyclic antidepressants, antihistamines, meds used to treat overactive bladders, and -- of special concern to me -- over-the-counter (OTC) sleep aids. A new study published in January shows that all these drugs may increase the risk of dementia and Alzheimer's.

The neurotransmitter that these drugs block -- acetylcholine -- helps transmit messages in the nervous system. It's linked to learning and memory, and it also stimulates muscle contractions.

"We have known for some time that even single doses of these [anticholinergic] medications can cause impairment in cognition, slower reaction time, and reduced attention and ability to concentrate," said Shelley Gray, the study's principal author and pharmacy professor at the University of Washington in Seattle.

At first, "the thinking was that these cognitive effects were reversible when you stopped taking the medication," said Gray. But her study found a link between heavier use of these medications and dementia, "a non-reversible, severe form of cognitive impairment."

Gray's team tracked nearly 3,500 men and women 65+ who'd taken part in Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system. The researchers used Group Health's pharmacy records to determine all the drugs, prescription and OTC, that participants had taken during the previous ten years. On average, their health was monitored for about seven years.

March 18, 2015

Old Age (Even Very Old Age): Embracing the Idea, Enjoying the Reality

You can’t escape them -- all the books, commercials, and websites that make us think of aging as something to be “corrected.”

Happily, we also see efforts to help us think of aging as something to be embraced.

A site I visit often is Changing Aging (“Exploring Life Beyond Adulthood”). As the name suggests, it has a pro-aging philosophy, not an anti-aging one. Geriatrician Dr. Bill Thomas is the principal blog author, and his commentaries over the past several years have helped reset my own orientation as a pro-aging advocate.

Another site I love is Time Goes By, a blog -- thoughtful and often humorous  -- written with verve. Ronni Bennett creates the content, and I look forward to her daily posts popping into my inbox. She, too, has little patience for all the anti-aging foolishness.

If you’re not familiar with these sites, I heartily recommend a visit.

Growing Old with Grace
Not long ago, Ronni wrote a piece titled "Growing Old with Grace." In the excerpt below, she describes how we make old age a wonderful place:
What makes any- and everyone beautiful in old age is acceptance of their years, of themselves as they are. 
After about 60, it is a victory of sorts just to awaken in the morning. We can face each new day with sadness for our lost youth or with joy for our luck at reaching this time of life. It's a personal choice. 
We eagerly said farewell to childhood when adolescence beckoned and goodbye to that stage of life when adulthood was upon us. It is a mistake – one of monumental proportions, I believe – to cling to adulthood when age arrives. 
Instead, when we accept the losses age imposes on us – youth, physical power, our position in society – say yes to old age, open ourselves to its mysteries and live every day in the present tense with passion and an open heart, we can't help but experience this time as an opportunity for happiness, fulfillment, joy and in time, serenity. 
In moving on from adulthood, we allow ourselves to grow into new dimensions of life and we get a chance at completion.

It’s easy to like Ronni’s message, and easy to agree with it.

The Beauty of Very Old Age
As I reviewed some files recently, I came upon a story that appeared last year in The New York Times. Author Phyllis Korkki titled it “Get to 100 and Life Actually Doesn’t Feel So Bad.” In fact, the article suggests it can feel very good indeed.

March 17, 2015

Doctors, Please STOP Prescribing Statins to Seniors With No Heart Trouble!


Quarter of a million Irish people use statins to lower their cholesterol.


Back in July 2012, I ran a post titled "If you are over age 60, "stay away from statins at all costs"

That recommendation came directly from the book Are Your Prescriptions Killing You? by Armon Neel, a board-certified geriatric pharmacist and winner of the 2010 annual achievement award from the American Society of Consultant Pharmacists. Neel wrote that statins are "among the most ineffective and dangerous drugs on the market, largely because the doctors who prescribe them haven't done their homework, relying instead on information supplied by the manufacturers of statins and the studies they've underwritten."

It's bad enough that the medical profession has ignored Neel's advice. Then came last year's new guidelines, which unfortunately created millions of new statin users, many of them over age 60.

Here are some other recent developments regarding statins:
  • Contrary to earlier studies suggesting that statins might ward off Parkinson's, new research found that users of statins are more than twice as likely to develop Parkinson's later in life than those who don't.
  • Another new study indicates that statins increase the risk of diabetes by 46%.
Cholesterol and Statins
Statins, prescribed to combat high cholesterol, are the best-selling class of drugs in the United States. Estimates suggest that 25% of all Americans take statins.

The brand I took -- Lipitor (atorvastatin) -- is the best-selling prescription drug in history. I started using Lipitor when I was 60 and stopped when I was 83. Before a generic finally became available several years ago, it was one of the priciest drugs around. I was paying about $200 for a 30-day supply. That's $2,400 a year.

In the letters I received from my internist after each annual physical, he would rave about the splendid results I was getting from Lipitor. But I'm increasingly persuaded that the drug caused my serious memory problems. Those issues began long before my Parkinson's diagnosis, and -- aside from memory -- I haven't experienced any other cognitive problems.

If you don't have hardening of the arteries by the time you're 70 or 80, you most likely never will, Neel says. And if you DO have this problem, Neel thinks it's too late for statins to do any good.

March 16, 2015

Study Confirms: Even Seniors Already at Risk for Alzheimer’s Benefit from Lifestyle Changes

The first-ever properly randomized, controlled trial has shown that a comprehensive program -- diet, exercise, information -- over two years actually slowed cognitive decline in seniors already at risk for dementia. Results from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) were published in "The Lancet" on March 11.

Researchers from Sweden and Finland -- after screening 2,654 seniors over two years -- recruited 1,269 Finns, aged 60-77. All of them showed dementia risk, based on results of standardized tests. Half of them were assigned to the “intervention” group, and the rest were assigned to the control group.

What “Intervention” Included
For over two years, study participants in the “intervention” group – not the control group – met regularly with health professionals who provided advice about healthy eating, muscle and cardiovascular training, mental exercises, and using data – including blood test results – to mitigate metabolic and vascular risk factors.
  
After two years counseling and encouraging the seniors in the active half of the study, the Scandinavian researchers assessed the mental function of all the study participants.

Using the standardized Neuropsychological Test Battery, the scientists determined that – on average – the intervention group performed about 25% better than the control group.

Several areas of mental function improved dramatically after the two-year period of “comprehensive advice” for the intervention group. They scored 83% higher than their control-group counterparts on executive function -- ability to organize and regulate thought processes – and a whopping150% higher on processing speed.

March 13, 2015

This is My Blog Post No. 1,000!

That's the number assigned to this post by the blogging service I use. So I decided to celebrate that achievement here.

Checking further, I discovered it's been 1,000 posts since the day back in November 2010 when I changed the blog's name from "Parkinson's and 5-HTP and Me" to its current title. I began the blog a few months after my September 2009 PD diagnosis, because I thought I'd found in 5-HTP a supplement that alleviated the disease's three most common non-motor side effects -- depression, insomnia and constipation. I wanted to share the good news with others in my situation.

I devoted most of my early posts to this subject. But I soon realized that other people with PD were not getting the same benefits from 5-HTP. I also was learning how difficult it was to tell whether my ailments were a function of my Parkinson's or my advancing age. After all, I was already 80 when my doctor first said "Parkinson's."

Hence the name change -- to "Aging and Parkinson's and Me" -- and the blog's new, more general direction. It continues to evolve. I'm a confirmed neophiliac, and the posts reflect my obsession with the new and different. 

Getting back to this post No. 1.000.... I have two observations:

1.  I'm Still Standing


"I'm Still Standing" from Elton John's 1983 album Too Low for Zero

and

March 12, 2015

New Electronic Gizmos to Improve Exercise and Meditation

The 2015 Consumer Electronics Show unveiled the latest stuff in Las Vegas earlier this year.

Michael Gorman, editor-in-chief of Engadget magazine, identified two particularly big trends:
  • For fitness: clothing loaded with sensors, and
  • For meditation: EEG headbands.

It’s unlikely I’ll be using Amazon “one click” (my favorite way to shop) for any of the exercise-related sensor-laden clothing. My biking days are over, and my exercycle is sitting behind me now waiting for the one or two times a month I use it.

Meditation Headbands
But those headbands for meditation? I might eventually take the plunge (especially because I'm a neophiliac), even though my own idiosyncratic meditation routine works very well for me, and I wouldn’t want to mess it up. It’s become a key part of my joy of quiet hour, a favorite time of day.

We've known for a long time that meditation is good for mind and body. Studies have confirmed its ability to reduce blood pressure, anxiety, depression, and pain. We’ve also learned that meditation can improve balance, stress management skills, and sleep.

So... what are these new headbands, and what do they do?

March 11, 2015

Major Breakthrough in Medical Care: Doctors Are Being Advised To Ask Patients What THEY Want

Last November, I posted a report about the best-selling book Being Mortal in which surgeon/author Atul Gawande discusses how doctors (himself included) are afraid to talk with patients about the two things medicine can't fix -- aging and dying.

His book is a thoughtful meditation on the evolution of medicine -- from the paternal doctor-patient model of the past to the current "informative" model, where doctors give aging and dying patients all the information they need to make their own decisions about treatments. But Gawande argues for a third model; here, doctors take the time to talk with their patients to determine what's most important to them. Then, doctors help patients make the best decisions so they can achieve their goals.

This morning, I picked up my Washington Post, which on Tuesday's has a special "Health & Science" section. Today, the front page of this section had two stories about doctors learning to lecture patients less and question them more about what they want.

Asking "How Can I Help?"
The first story was written by primary care doctor Mitch Kaminski about the lesson he learned when he met a patient suffering from congestive heart failure and renal failure. The patient had endured an endless cycle of medication adjustments prescribed by dueling specialists... punctuated by emergency room visits and hospitalizations.

After 30 years in practice, Kaminski knew that he couldn't possibly solve this man's medical problems. But he remembered a recent meeting at which a visiting palliative-care physician had said that in caring for the fragile elderly, "We forget to ask patients what they want from their care. What are their goals?"

March 10, 2015

Using Tweaked, Implanted DNA, Harvard Team Successfully Treats Primate Parkinson’s Symptoms

According to an article published on March 3 in the Harvard Gazette, scientists have had success treating an ape’s Parkinson’s symptoms using the animal’s own genetic material.

The therapeutic process seems clear, but not simple. Researchers first took skin cells from the Parkinson’s-afflicted primate, then created stem cells (induced pluripotent stem cells, or iPS cells) from that tissue, then extracted dopamine-producing neurons from the stem cells, and finally implanted those neurons into the ape’s brain.

Beating the Tissue-Rejection Conundrum
Because those newly implanted neurons were produced from the ape’s own genetic material, there was no problem with tissue rejection. Earlier experiments had used dopamine-producing neurons harvested from embryonic stems cells. When those neurons were implanted, rejection became an issue, and the animals therefore required immunosuppressive drugs. As a result, the outcome was not especially positive.

Dr. Ole Isacson -- principal faculty member at the Harvard Stem Cell Institute, neurology professor at Harvard Medical School, and director of the Center for Neuroregeneration Research/ Neuroregeneration Laboratories at McLean Hospital – said, “It’s very difficult to get cell survival in primates. This is a very high bar to clear.”

After Surgery: As Agile as Any Ape
Those new neurons survived in the ape’s body for over two years, and dramatically reduced its PD-associated motor symptoms. After implantation, the animal could move around its cage as quickly as a healthy ape and showed normal agility.

According to Isacson, this particular experiment marked “the first time that an animal has recovered to the same activity level as before.”

As a kind of built-in control, Isacson’s team implanted the fresh dopamine-producing neurons into only one side of the animal’s brain. As they expected, motor improvements manifested only in the opposite side of the animal’s body. This “half a fix” explained why the disease continued to show some effect on the animal’s movements.

March 9, 2015

Blogger Ronni Bennett on "Elder High Achievers: Inspiration or Reverse Ageism?"

Ronni Bennett writes the blog "Time Goes By." Her posts land automatically in my inbox, and I always look forward to reading them.

Here's a recent piece I liked... and wanted to share.

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Elder High Achievers: Inspiration or Reverse Ageism?

The media keep us well supplied with tales of derring-do by high achieving elders. Former President George H.W. Bush skydives every five years, most recently on his 90th birthday. An 80-year-old Japanese man becomes the oldest to climb Mt. Everest.

Other elders are hailed for bungee jumping, finishing marathons, deep sea diving, snow boarding, weight lifting and so on, all at great ages.

Occasionally, some are extolled for writing a book or earning a degree or recording a music album but nothing gets media attention like old people taking on the physical challenges usually reserved for 20- or 30-somethings.

This week's chapter comes to us from Australia, a country that is a lot like the United States except they have a much better sense of humor about themselves than Americans who actually have zero sense of humor about themselves. But that's a story for another day.

March 6, 2015

My Story from Start to Finish in One Photo


For those whose eyesight is as bad as mine, the sweatshirt logo reads:

It's where my story begins -- Ithaca, New York

Actually, I was born in Hudson, New York, in the spring of 1929. My dad lost his job there after the October, 1929 stock market crash. The family -- my dad, my mom, and me -- spent the next few years bouncing around from locations around New York City to Philadelphia and back again as my dad worked several short-term jobs.

I remember none of this. My first memories are of living in Ithaca, the family's home since 1932. I lived there until April 1955, when I moved to Washington DC to take a job at BNA, where I'd remain until I retired at the end of 1994. I intend to remain here at my DC home until my final departure.

I spent my formative years in Ithaca. I've done a lot of traveling since then, but I've seldom found a place more beautiful.

March 5, 2015

Revolutionary, Mutation-Driven "Basket" Studies Give Cancer Patients Quicker Access to Experimental Drugs

In its effort through the years to find cures for cancer, the medical community quite naturally focused on cancer types. There were trials for drugs to treat lung cancer, different trials for drugs to treat breast cancer, still others for colon cancer. The approach made sense, especially in the absence of other research options.

Now, because science has advanced so dramatically, and as “individualized” medicine therefore becomes more and more possible, researchers are testing drugs that specifically attack cancer-causing cell mutations. Their work has already identified about 60 different cancer-causing mutations in various tumor types.

The very same mutations in particular genes might appear in different types of cancer, which means test subjects for the very same experimental drugs might be battling stomach cancer, or esophagheal cancer, lung cancer, skin cancer, etc.

This spring, a federally funded national program will screen tumors in thousands of cancer patients to determine which might be attacked by any of the new drugs. If their tumors show mutations that might be targeted, patients eager for experimental treatment will get it.

New "Basket" Studies
These revolutionary trials are called “basket studies” because they lump together various cancers. They’re smaller than more typical studies, and they don’t include control groups of people who would receive standard treatments to make comparisons possible.

In the older trial model, researchers looked for small differences between an older treatment and a newer one. Now, with these basket studies, researchers are gambling to find very dramatic results… results so impressive that control groups might be superfluous.

March 4, 2015

Enhanced Curcumin Supplements Might Pack Too Hefty a Punch for Some

In yesterday's post, I mentioned recent warnings about dietary supplements. Today I'll take a closer look at curcumin, the supplement I've been touting for several years.

A recent article on NutricianFacts.org (a subscription site that offers non-commercial, science-based reports on the latest nutrition research) raised the latest cautions about curcumin.

Click here for the five-minute video on the report. Here's the summary:

Curcumin is a natural plant product extracted from the turmeric root. It's commonly used as a food additive, popular for its pleasant mild aroma and exotic yellow color. It enlivens curries and other dishes popular in India and elsewhere in Southeast Asia, like Nepal -- for years, my home away from home. When curcumin is used for culinary purposes, it is very unlikely to cause side effects.

Traditional Indian diets may include as much as a teaspoon of turmeric a day. But the curcumin supplements I've been discussing (and using) could provide the equivalent of 29 CUPS of turmeric a day. That's a lot of turmeric.

Extensive research confirms curcumin's efficacy as an anti-inflammatory agent with the potential for treating many diseases. Typically, experts suggest combining high-dose curcumin with black pepper or other substances designed to boost the botanical's bioavailability as much as 2000%.

A Warning about Supplements in General
Before addressing the specifics of curcumin, NutritionFacts debunks the widely accepted notion that complementary, alternative medicines offer safer therapies than prescribed meds:
Just because something is natural doesn't mean it's not toxic. Strychnine is natural; cyanide is natural. Lead, mercury, and plutonium are all elements -- can't get more natural than that! But turmeric is just a plant. Surely plants can't be dangerous? Tell that to Socrates.
We must remind ourselves and our patients that a therapy that exerts a biologic effect is, by definition, a drug and can have toxicity. It cannot be assumed that diet-derived agents will be innocuous when administered as pharmaceutical formulations at doses likely to exceed those consumed in the diet.
Cautions about Curcumin
Following flax and wheatgrass, turmeric is the third bestselling botanical dietary supplement, racking up $12 million in sales. Currently, sales are increasing at a rate of 20% annually.

March 3, 2015

Herbal Supplements: "Caveat Emptor," Continued

I apply my “Less is More” mantra whenever I can, especially when it comes to pills and medications.

While I used to pop about a dozen dietary supplements every day, I’m now down to three. I’ve carefully researched the products I take, and feel confident that those supplements are helping me. I also think I’m taking the best version of the products now available on the market.

New York State Takes a Big Step
On February 2, 2015, the New York State attorney general’s office advised four of the country’s largest retailers -- Walmart, Target, Walgreens, and GNC -- to stop selling certain dietary supplements.

Using DNA bar coding that produces a kind of genetic fingerprint, the AG’s office determined that a whopping 80% of all tested samples of several top-selling products contained no trace of the key, advertised ingredient. Other products contained substances -- not shown on the label – that could prove harmful, even fatal.

AG Eric Schneiderman said: “Mislabeling, contamination and false advertising are illegal. They also pose unacceptable risks to New York families — especially those with allergies to hidden ingredients.”

Big Pharma Reacts
Not surprisingly, the $13-billion-a-year industry struck back, calling into question New York State’s testing methodology. The objections have an especially hollow ring, particularly since there’s no scientific evidence to support the wild promises from supplement manufacturers’ marketing departments.

Now, an article from Consumer Reports published last month reiterates the often-bogus nature of these products. There are so many millions of Americans getting schnookered – even having their health endangered -- that I wanted to share these latest cautionary comments.

Marvin M. Lipman, M.D., chief medical adviser for Consumer Reports, said “The idea that dietary supplements cure the common cold, restore prostate health, sharpen your mind, or have any other health benefit is dubious at best.”

Processing Removes DNA from Herbs
The most suspect products are those that have been “highly processed,” which describes many of the most popular supplements.
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