More American women under age 65 have been diagnosed sooner and treated earlier for ovarian cancer since the Affordable Care Act went into effect in 2010, new research shows. And, more women received treatment within 30 days of diagnosis, improving their survival odds, the researchers said. For the study, the investigators analyzed data from the U.S. National Cancer Database. They compared nearly 36,000 women who were diagnosed and treated between 2004 and 2009, with more than 37,000 women diagnosed and treated between 2011 and 2014. Women in both groups were between 21 and 64 years of age. A similar number of seniors with ovarian cancer was used as a control group, because those women had access to Medicare and were much less likely to be uninsured before or after introduction of the Affordable Care Act, also known as Obamacare. Compared with the control group, there was a 1.7% gain in early-stage diagnosis and a 1.6% improvement in treatment within 30 days of diagnosis among younger women since 2010, the findings showed. The greatest gains were among women who got public insurance after the Affordable Care Act was introduced. These women had a 2.5% gain in early-stage diagnosis and timely treatment compared with the control group. The improvements were seen regardless of race, income or level of education. While a 1.7% improvement in early diagnosis may…  read on >

Cutting-edge prostate cancer drugs that help extend life in the toughest cases might also be useful in fighting less aggressive tumors, two new clinical trials suggest. Two drugs that interfere with cancer’s ability to use testosterone for fuel, apalutamide (Erleada) and enzalutamide (Xtandi), are already approved for use against more advanced prostate tumors that don’t respond to regular therapy. But these trials show that the drugs also can improve survival and slow progression in prostate cancers that do respond to regular therapy, which typically involves medication that halts production of testosterone. Both clinical trials involved patients with prostate cancer that had spread to other parts of their body but who still responded to androgen-deprivation therapy. “We’re slowly starting to see a migration of drugs traditionally saved for advanced stages of disease, where we’re incorporating them into earlier stages of disease,” said Dr. Bobby Liaw, medical director of the Blavatnik Family Chelsea Medical Center at Mount Sinai, in New York City. He was not involved in the trials. Apalutamide combined with androgen-deprivation therapy caused a 33% reduction in overall risk of death, compared against patients who received a placebo alongside their androgen-deprivation therapy, said the lead researcher of that clinical trial, Dr. Kim Chi. Apalutamide also delayed progression of the cancer by 52%, and the length of time before patients required chemotherapy by 61%, said Chi,…  read on >

Adding a newer drug to standard hormone therapy lengthens the lives of younger women with advanced breast cancer, a new trial has found. The drug, called Kisqali (ribociclib), is already approved for treating such patients — based on earlier results showing it can delay the progression of their cancer. This is the first evidence it can also extend their lives, said senior researcher Dr. Debu Tripathy, chair of the breast medical oncology department at M.D. Anderson Cancer Center in Houston. After 3.5 years, 70% of patients given hormone therapy plus Kisqali were still alive. That compared with 46% of those given hormone therapy alone. That proof of a survival advantage hits “a pretty big milestone,” Tripathy said. And, he added, it argues for giving the drug as a “first-line or second-line” treatment to these patients. The findings were to be presented Tuesday at the American Society of Clinical Oncology annual meeting, in Chicago, and they will also be published in the New England Journal of Medicine. Kisqali is one of three newer drugs on the market called CDK4/6 inhibitors; the others are Verzenio (abemaciclib) and Ibrance (palbociclib). They work by blocking two proteins that help cancer cells grow and divide. Kisqali, taken as a tablet, was originally approved as a first-line treatment for postmenopausal women with advanced breast cancer that is hormone receptor-positive — which…  read on >

When a heart attack occurs, delaying treatment by even a few minutes could be deadly. But many people wait hours after symptoms set in to get care — either because they feel mentally “frozen” and unable to act, or because they’re slow to recognize the seriousness of the situation, a new survey reveals. The finding stems from a look at how 300 Swedish patients reacted while having a heart attack. “The patients who waited more than 12 hours seeking medical care when having symptoms perceived an inability to act,” said study lead author Carolin Nymark. These patients often described feeling as if they had “lost control over themselves.” Others said they felt unable to take any action because they didn’t know how to react or what to do. Nymark works in the department of neurobiology at Karolinska University Hospital in Stockholm. She and her colleagues reported their findings online May 27 in the European Journal of Cardiovascular Nursing. The researchers said that heart attack symptoms can show up as several forms of moderate-to-severe discomfort, including chest pain, or pain affecting the throat, neck, back, stomach and/or shoulders for 15 minutes or more. Nausea, cold sweat, weakness and shortness of breath may also set in, along with a sense of foreboding, fear or powerlessness. “Another red flag is feeling you have no power to act on…  read on >

Heart failure is a common ailment afflicting older Americans, and many take drugs called diuretics to rid the body of excess fluid buildup that can impede breathing. Now, a team of Brazilian researchers say that, in some cases, it’s safe for patients with stable heart failure to stop taking diuretic drugs. “Patients don’t like using diuretics because they feel they have to stay at home to use the bathroom and they get cramps,” noted study principal investigator Dr. Luis Rohde, of the Federal University of Rio Grande do Sul in Porto Alegre, Brazil. “Patients would welcome being able to stop this medication,” he said, and the new study suggests it can often be done safely. One U.S. expert who reviewed the new findings stressed that diuretics are key to heart failure care. “Congestive heart failure is one of the most common chronic ailments in the United States, characterized primarily by volume (fluid) overload,” explained Dr. Mohammed Imam. In heart failure, a damaged or weakened heart fails to pump blood as efficiently as it should. “The mainstay of treatment for decades have been diuretics,” said Imam, who directs cardiothoracic surgery at The Heart Institute at Staten Island University Hospital in New York City. Diuretics help patients with heart failure reduce excess fluids that can cause shortness of breath, swollen legs, coughing and weight gain. However, the…  read on >