In The News This Week … Mar 16–22, 2008: Overeating, Cancer, Blood, & Pain

Overeating, Genes, & Disease

An article published online on March 16 in Nature suggests that overeating disrupts entire networks of genes in a person's body, which causes conditions such as obesity, heart disease, and diabetes. They concluded, "(C)omplex traits such as obesity are emergent properties of molecular networks that are modulated by complex genetic loci and environmental factors."

Obesity & Breast Cancer

A paper published in the March 15 issue of Clinical Cancer Research has found that inflammatory breast cancer (IBC) is seen more frequently in obese patients (45%) than in overweight patients (30%) or normal weight patients (15%), and that the more obese a patient is, the more aggressive the disease. In a March 14 news release, the study's senior author said, "This is the first study to highlight the value of BMI at the time of diagnosis as a prognostic indicator in women with aggressive disease and at a high risk of recurrence and at the time of diagnosis in locally advanced disease, including its most aggressive form, inflammatory breast cancer. We embarked on this research because the vast majority of our newly-diagnosed inflammatory breast cancer patients were overweight or obese, and IBC is associated with a poor prognosis." Both overall survival and recurrence-free survival are significantly worse for overweight and obese patients, compared to those who were of normal weight or underweight. (IBC is extremely aggressive, yet rare, representing only 1% to 2% of breast cancer cases diagnosed in the USA.)

Breast Cancer & Radiation Therapy

An article published early online on March 19 in The Lancet and The Lancet Oncology reports that for women with early breast cancer, a lower total dose of radiation, delivered in fewer, larger treatments is as effective as the international standard of a higher total dose delivered over a longer time. Additionally, a March 19 news release said, "After an average follow-up of five to six years, the rate of recurrence in the breast remained very low for patients in each of the treatment groups studied. The rate of side-effects were low overall, and no higher in women receiving the revised treatment than those receiving the international standard of 25 treatments."

Lung Cancer Surgery Outcomes

A study published in the March issue of The Annals of Thoracic Surgery has found that people who are undergoing lung cancer surgery tend to do better in teaching hospitals. The study concluded: "In-hospital mortality is reduced for patients undergoing lung cancer resections at teaching hospitals, with results prominent at all but the highest volume institutions. Lower mortality rates persisted at [Accreditation Council for Graduate Medical Education-approved general surgery] and [Accreditation Council for Graduate Medical Education-approved thoracic surgery] residency programs." The findings were based on 46,951 lung resections occurring between 1998 and 2004.

"We Need Some New Blood Around Here …"

An article published in the March 20 issue of The New England Journal of Medicine has found that fresher blood makes for better survival in cardiac surgery patients. Researchers found that transfusion of red cells that had been stored for more than two weeks was associated with a significantly increased risk of postoperative complications as well as reduced short-term and long-term survival in cardiac surgery patients. The findings were based on 6,002 patients who had undergone CABG, heart-valve surgery, or both between June 30, 1998, and January 30, 2006 at the Cleveland Clinic Foundation.

Pain After Traumatic Injury

Research published in the March issue of Archives of Surgery looked at 3,047 patients between the ages of 18 to 84 years who were admitted to the hospital because of acute trauma and survived to 12 months after injury. Among these patients, 62.7% reported injury-related pain a year later, and most of these had pain in more than one area. Interestingly, the reported presence of pain varied with age and was more common in women and those who had untreated depression before injury, and lower pain severity was reported by patients with a college education and those with no previous functional limitations.

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