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This week in the medical journals

A new cancer drug and PMS prevention highlight reports

By Peggy Peck
Medpage Today Senior Editor

Editor's note: has a business partnership with, which provides custom health content. A medical journal roundup from MedPage Today appears each Thursday.



Food and Drug Administration (FDA)
Health Organizations

Getting it right

Amid a mixed bag of reports in the medical journals this week, there was a rare pat on the back for Food and Drug Administration for getting something right.

The FDA accelerated approval of the cancer drug Velcade, which is used to treat relapsed or treatment-resistant bone marrow cancer, known as multiple myeloma, without awaiting the results of the usually mandatory randomized trial.

Now those trial results have been published in the New England Journal of Medicine, and the research from the Dana Farber Cancer Institute in Boston, Massachusetts, provides evidence that validates the FDA decision.

Velcade worked in 38 percent of the difficult-to-treat myeloma patients. That response rate is 11 percent better than the response reported in the studies the FDA reviewed before it gave conditional early approval of the drug.

The researchers called their findings a vindication of the FDA decision. Velcade is the first of a new class of drugs called proteasome inhibitors. They directly attack cancer cells as well as the microenvironment that surrounds them.

Velcade trial validates early FDA approval

Not receiving enough care

In other cancer news in the medical journals this week, there was a disturbing report that obese women with breast cancer may be receiving too little chemotherapy to prevent a return of their tumor.

The quandary, researchers reported in Archives of Internal Medicine, is that chemotherapy drugs are dosed by body weight -- the larger the person, the more cancer-killing drugs needed.

But many oncologists reduce the indicated dose for obese women because the dose is so high that they are worried it will increase adverse reactions such as nausea, vomiting, fever and fatigue.

In the study, 37 percent of severely overweight women and 17 percent of obese women received chemotherapy regimens with reduced doses, which meant they were not receiving optimal care, the researchers concluded.

Heavy women shortchanged on chemotherapy

One cheer for the FDA

Tuna burgers, anyone?

Before you throw another burger on the grill, consider this: A study of 500,000 Europeans found that people who ate an average of six ounces of red meat daily increased the risk of colorectal cancer by 35 percent compared with people who ate just over a half-ounce of red meat daily.

A half-ounce? Barely a nibble of a Big Mac. Eating fish, on the other hand, could reduce colorectal cancer risk, and those who consumed an average of three ounces of fish daily reduced their risk by 31 percent.

Chicken, meanwhile, had no effect at all, according to the report in the Journal of the National Cancer Institute.

Memo to fast-fooders: Get with it.

Big study links red meat to colorectal cancer

Speaking of (go) fish ...

About 38 percent of stroke patients have trouble speaking immediately after stroke and more than half of them will still have communication problems, called aphasia, six months after stroke.

Now researchers in Germany report that an intensive language re-training program that compresses 30 hours of language training into two-weeks can improve speech in 85 percent of stroke patients with aphasia.

The training program, described in Stroke, Journal of the American Heart Association, has even better results if it is reinforced by friends and family at home.

The program involves a card game that uses decks of cards that can be paired by matching images and words. The patients are instructed to ask for cards using spoken language -- so the game is similar to the children's card game, Go Fish.

Stroke patients regain language skills after intense therapy

Preventing PMS?

Forget chocolate for PMS. Foods rich in calcium and vitamin D are just what the doctor ordered to prevent premenstrual syndrome, researchers report in Archives of Internal Medicine.

When they compared the diets of 1,057 women who said they regularly suffered from PMS and 1,968 women who had no PMS, a team of Harvard researchers discovered that the women with no PMS had the highest intake of vitamin D and calcium.

High vitamin D intake reduced risk of PMS by 41 percent compared with low levels of dietary vitamin D, while a diet rich in calcium was associated with a 30 percent reduction in PMS risk, compared with women who consumed little calcium.

Take home? Get milk, and get more milk.

Dietary calcium and vitamin D may help prevent PMS

Good news for mother and child

As many as 7 percent of pregnant women develop diabetes during pregnancy, which increases the risk of severe complications, including death, for their babies.

Until this week there was suspicion but no evidence that treating the diabetes in the mother could reduce the risk of complications for the baby.

A team a researchers in Australia reported in the New England Journal of Medicine that women who had aggressive treatment of their diabetes, which included diet restrictions, close monitoring of blood sugar levels, and insulin, when needed, gave birth to healthier babies.

An added bonus, the researchers said, was a trend toward less postpartum depression among the mothers in the treatment group.

Bottom line: Better babies with healthy living

ADA: Treating gestational diabetes helps mother and child

Adolescents and obesity

A report in this week's Journal of the American Medical Association found that the diet drug Xenical can help obese teens lose weight -- if they are willing to put up the gastrointestinal side effects of the drug.

More than 13 percent of obese teens taking Xenical three times a day for a year reduced their body mass index, or BMI, by 10 percent, and 26 percent of the teens reduced their BMI by at least 5 percent. At the same time, only 4 percent of teens taking dummy pills reduced their BMI by 10 percent, and 16 reduced BMI by 5 percent.

Teens in both treatment groups were also put on a reduced calorie diet that was 30 percent fat, 50 percent carbohydrate, and 20 percent protein. The downside to Xenical is that it causes diarrhea and cramping, symptoms reported by about half of the teens who took the drug.

Xenical: Not a panacea

Xenical helps adolescents lose weight

Pain relief can hurt

If you thought there was no more bad news on painkillers, you thought wrong.

Two studies reported in BMJ (British Medical Journal), link ibuprofen with increased risk of heart attack and Celebrex with increased risk of congestive heart failure. Both studies found heart disease risks for all nonsteroidal anti-inflammatory drugs, or NSAIDs, except for the old reliable aspirin.

Voltaren, a prescription NSAID, increased risk of heart attack by 55 percent, which was higher than the 32 percent higher risk reported for Vioxx, the arthritis drug taken off the market last September, or the 24 percent increased risk for Advil or Motrin (ibuprofen).

Research anew links NSAIDs to increased cardiovascular risk

Got a light? Pass the chips

Smoking and obesity are a well-known deadly duo, but this week researchers from St. Thomas Hospital in London, England, reported that at least for women sickness and death aren't the only downside to this combo. They also make your body age faster, effectively giving, for example, a 60-year-old the body of a 67-year-old.

The problem, researchers reported in The Lancet, is that both smoking and obesity shorten the body's chromosomes, and the shorter the chromosome, the older the body.

Endnote: You look like an ashtray, baby.

Smokers and the obese get old fast

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