Radiation may help after prostate cancer setback

NEW YORK (Reuters Health) — Men whose prostate cancer recurs after they have undergone surgical removal of the prostate may benefit from early radiation therapy, according to study findings reported in this week's Journal of the American Medical Association.

"Our study provides the first evidence that salvage radiotherapy can improve survival," Dr. Bruce T. Trock commented to Reuters Health.

Trock, at Johns Hopkins School of Medicine in Baltimore, and colleagues analysed the outcomes of 635 men who underwent radical prostate surgery between 1982 and 2004 and subsequently relapsed. While 397 men were not given any salvage treatment, 160 received radiotherapy, and 78 received hormone therapy plus radiation therapy.

The mortality rates from prostate cancer in those three groups at six years after the recurrence of cancer were 22 percent, 11 percent, and 12 percent.

The survival advantage was confined to patients treated within two years of relapse and those whose PSA level was rising rapidly. Men whose PSA was rising more slowly "had a better prognosis already — their survival at ten years was 75 percent without any salvage treatment — so adding salvage radiation didn't improve their survival much," Trock explained.

AA helpful for teenagers too — study

NEW YORK (Reuters Health) — Teenagers who attend Alcoholics Anonymous meetings after being treated for alcohol abuse tend to fare better in the long run compared with those who don't, a new study suggests.

Alcoholics Anonymous, or AA, has existed for more than 70 years, but little is known about its usefulness for teenagers. The same is true for Narcotics Anonymous (NA).

In the new study, researchers followed 160 teenagers who had undergone inpatient treatment for alcohol or drug abuse for an average of 4 weeks and were referred to AA or NA at discharge. The researchers found that teenagers who went to meetings in the first 6 months after treatment were more likely to remain abstinent over time.

The best results were seen among those who kept attending meetings over the entire 8-year study period.

"In terms of a real-world recovery metric," each AA or NA meeting attended correlated with a gain of two days of abstinence, "independent of all other factors that were also associated with a better outcome," lead researcher Dr. John F. Kelly, of Harvard Medical School and Massachusetts General Hospital, said in a statement.

However, the teenagers did not have to attend meetings frequently to obtain some benefit, the researchers report in the journal Alcoholism: Clinical & Experimental Research.

During the first six months of recovery, study participants who went to one to two meetings a week fared better in the long run than those who passed on AA/NA altogether. A threshold of three meetings each week was associated with complete abstinence during the study period.

This stands in contrast to the general suggestion for adults to initially attend daily AA or NA meetings; "90 meetings in 90 days" is the typical recommendation.

Diabetes linked to depression risk

NEW YORK (Reuters Health) — People being treated for Type 2 diabetes are at increased risk for depression, according to a new report, and individuals with depression have a moderately increased risk of developing Type 2 diabetes.

To explore the relationship between diabetes and depression, Dr. Sherita Hill Golden at Johns Hopkins University School of Medicine in Baltimore and colleagues analysed data on 6814 subjects who underwent three examinations between 2000 and 2005.

Among 4847 participants without depression at the start of the study, the researchers report, rates of occurrence of depression symptoms during follow-up were similar for people without diabetes and those with untreated Type 2 diabetes, but about twice as high in people being treated for Type 2 diabetes.

"The psychological stress associated with diabetes management may lead to elevated depressive symptoms," Golden's team suggests in their report in Journal of the American Medical Association.

They also found that participants who had symptoms of depression were about 30 percent more likely to develop diabetes during the study than people without depression. The link between depression and diabetes onset was partially due to lifestyle factors, such as caloric intake and physical activity.

Episiotomy raises tear risk in next delivery

NEW YORK (Reuters Health) — Episiotomy, an incision of the perineum intended to prevent tearing during the delivery of baby, may cause problems when a woman has another baby, a new study shows.

Researchers found that women who undergo episiotomy during their first vaginal delivery have an increased likelihood of suffering a tear, or laceration, in subsequent deliveries.

"In the past, episiotomy was thought to be an innocuous procedure and possibly even protective against severe perineal lacerations," Dr. Marianna Alperin told Reuters Health. "It has since been clearly shown that episiotomy increases the risk of severe obstetrical lacerations in that delivery."

To investigate any possible impact on a second delivery, Alperin and her colleagues at the University of Pittsburgh studied a database containing information on more than 6000 women who had consecutive vaginal deliveries at Magee-Womens Hospital over a 10-year period.

Almost half — 47.8 percent — underwent an episiotomy during their first delivery.

New inhibitors of breast cancer cells identified

NEW YORK (Reuters Health) — A team of US scientists has identified a new family of compounds that block the ability of oestrogen to stimulate the growth of breast cancer cells.

"The lead inhibitor is quite effective in breast cancer cells that are resistant to tamoxifen," Dr. David J. Shapiro noted at the Endocrine Society's annual meeting underway in San Francisco.

"We are hopeful that as we proceed with further development that these compounds may ultimately lead to therapeutics that are clinically useful against some breast cancers that are resistant to current therapies," added Shapiro, a biochemist at the University of Illinois at Urbana-Champaign.

Currently available treatment for breast cancer driven by oestrogen either interfere with oestrogen production (e.g., aromatase inhibitors such as letrozole) or block oestrogen's ability to bind to oestrogen receptors on breast cancer cells (e.g., tamoxifen).