Black Women Wait Longer for Breast Cancer Surgery

Black Women Wait Longer for Breast Cancer Surgery
THURSDAY, Dec. 6 (HealthDay News) -- A woman's age and race caninfluence how quickly she receives surgery after a breast cancerdiagnosis, U.S. researchers report.
A team at the Johns Hopkins Medical Institutions in Baltimore alsofound that a lengthy delay in surgery for breast cancer affects overallsurvival.
Factors such as socioeconomic status and the cumulative effects of apatient's other illnesses likely contribute to breast cancer surgerydelays, according to preliminary findings of the study, which looked at1,477 breast cancer patients who had either a lumpectomy or a mastectomyat Johns Hopkins between 2000 and 2005.
The team found that the average interval from breast cancer diagnosisto surgery was six days longer for black American women than for whitewomen (34 days vs. 28 days). Women older than age 70 had to wait anaverage of 12 more days for surgery than women younger than 40. Thoseyounger women were treated within 21 days, compared with: 28 days forpatients ages 40 to 50; 31 days for women in their 50s; 29.5 days forpatients ages 60 to 70; and more than 33 days for women older than 70.
Overall, the average time from diagnosis to surgery was 29 days.
Women who had to wait more than 60 days between breast cancer diagnosisand treatment were 1.8 times more likely to die from any cause compared towomen who had surgery within 60 days of diagnosis, the study found.
"We think that timely treatment could make a difference in patientcare," Dr. Hae Seong Park, a research coordinator in the oncologydepartment at the Sidney Kimmel Comprehensive Cancer Center at JohnsHopkins, said in a prepared statement.
The study also found the average length of time between diagnosis andsurgery varied year to year. It was 24 days in 2000-01, 34 days in2002-03, and about 30 days in 2004-05.
The stage of cancer at time of diagnosis did not seem to influence thelength of time a woman had to wait until surgery.
"Although this is one factor that one might expect a time differential,we did not observe much difference," Park said.
The researchers were especially concerned by a finding that almost 24percent of patients didn't receive adjuvant therapy, such as chemotherapyor hormone therapy, after they had their breast cancer surgery. Patientswho had surgery more than 60 days after their diagnosis seemed to be lesslikely to receive adjuvant therapy, which is known to improvesurvival.
"Most patients should have received such treatment, but it may be thatthe cancer registry data did not reflect all of this information," Parksaid.
The researchers also lacked information about patients' insurancestatus and other data that may help explain some of the time lags betweendiagnosis and surgery.
"We plan to review individual patient records and collect moreinformation to confirm what we observed and perhaps to think aboutinterventions to provide more timely and complete care," Park said.
The findings were expected to be presented Thursday at an AmericanAssociation for Cancer Research meeting in Philadelphia.
More information
Breastcancer.org has more about surgery for breast cancer.

Glaxo cancer drug Tykerb shows more brain benefits

A scientist works in GlaxoSmithKline's plant in Singapore December 16, 2005. The European Medicines Agency has recommended conditional approval of GlaxoSmithKline Plc's new breast cancer pill Tykerb, Europe's biggest drugmaker said on Friday. (Luis Enrique Ascui/Reuters)LONDON (Reuters) - GlaxoSmithKline Plc announced furtherclinical trial results on Sunday underlining the ability of adrug combination including its product Tykerb to fight breastcancer that has spread to the brain.
An extension to an earlier Phase II study involving 49patients showed 20 percent of those receiving a mix of Tykerband Roche's Xeloda experienced at least a 50 percent volumereduction in measurable brain metastases.
The finding is significant because up to a third of womenwith HER2-positive metastatic breast cancer may develop brainmetastases, which occur when cancer spreads from its originalsite.
The results were presented at the San Antonio Breast CancerSymposium in San Antonio, Texas.
Tykerb, a once-daily pill, was approved by U.S. regulatorsin March and won a conditional green light from the EuropeanMedicines Agency on Friday.
It is recommended as a treatment, in combination withXeloda, for patients with advanced or metastatic breast cancerwhose tumors over-express protein HER2.
(Reporting by Ben Hirschler, editing by Will Waterman)

698-pound man dies after stomach surgery

Doctors and nurses stand beside obesity patient Carlos Marroquin during a gastric bypass surgery in Guatemala City, Thursday, Dec. 20, 2007. Marroquin died hours after the surgery of a heart attack. (AP Photo//Herlindo Zet/Siglo 21)GUATEMALA CITY - A man who weighed 698 pounds died Friday of heart failure after undergoing an operation to remove 80 percent of his stomach in a desperate effort to reduce his weight.
Carlos Marroquin, 47, was so heavy at the time of Thursday's operation that hospital workers used a forklift to place him on the operating table, surgeon Isaias Sandigo, who participated in the procedure, told The Associated Press.
"He had two heart attacks in 20 minutes, there was nothing we could have done for him," Sandigo said. He said Marroquin's heart and kidneys had begun failing even before the procedure.
Marroquin's family checked him in to the San Juan de Dios Hospital's obesity clinic for treatment after they were told that nothing more could be done for him at a local hospital in his home town of Santa Lucia Cotzumalguapa, southwest of Guatemala City.

Weight Loss Surgery May Help Less Severely Obese

FRIDAY, Dec. 21 (HealthDay News) --The morbidly obese may not bethe only people who should be eligible for bariatric surgery to loseweight, U.S. researchers report.
People with a body-mass index (BMI) less than the required 40 couldstill reap heart health benefits from the surgery, they say.
BMI is calculated based on height and weight. A healthy BMI rangesbetween 18.5 and 25. A person with a BMI of 40 -- for example, someone 5feet 9 inches tall and 270 pounds -- is considered morbidly obese.According to the Centers for Disease Control and Prevention, one in threeadults is obese.
Bariatric surgery options include gastric bypass and lap bandsurgeries. Typically, a person must have a BMI of 40, or be at least 100pounds over their healthy weight, to qualify for these surgeries. Peoplewho have a BMI greater than 35 and suffer from a life-threatening illness,such as non-insulin dependent diabetes, sleep apnea or heart disease, canalso qualify.
However, researchers at University of Texas Southwestern Medical Centerat Dallas published data in the December issue of Surgery for Obesityand Related Diseases suggesting that some otherwise healthy overweightpeople with a BMI lower than 40 may benefit. And they may benefit morefrom the surgery than people who are morbidly obese, the team added.
The study is among the first to evaluate the risk-factor relationshipbetween BMI and cardiovascular disease as it relates to bariatric surgerycriteria, said study author Dr. Edward Livingston, chairman ofGI/endocrine surgery at UT Southwestern.
"Our results show that cardiovascular risk factors do not necessarilyworsen with increasing obesity," Livingston said in a prepared statement."They also support the concept that obesity, by itself, doesn't trigger anadverse cardiovascular risk profile or increased risk of death."
The research team analyzed health data from more than 17,200 adults whohad a BMI greater than 20 and had participated in the Third NationalHealth and Nutrition Examination. The researchers assessed their heartdisease risk factors with respect to their BMI. They found a subgroup ofpeople whose BMIs were lower than 40 but who had significant heart diseaserisk factors.
This suggests that some patients who are obese but not morbidly obesecould benefit from bariatric surgery, which can help reduce cardiovasculardisease, said Livingston.
The research team theorized that some morbidly obese people may be moreefficient than moderately overweight people at storing fat in their cells,so it does not have as great an effect on the cardiovascular system.