Radiation Seed Therapy Fights Prostate Cancer

(HealthDay News) -- prostate cancer patients who receive radiation seed implants, called brachytherapy, have high survival rates, a U.S. study finds.

The seeds, about the size of a grain of rice, are designed to deliver concentrated radiation to the prostate, while sparing surrounding organs and tissues. This approach has become a widely accepted treatment for early-stage prostate cancer, because it's effective, minimally invasive, and is less likely than other treatments to cause side effects such as impotence and incontinence.

The study of nearly 2,700 early-stage prostate cancer patients treated at 11 centers found that more than 90 percent of patients who received appropriate dose levels with permanent radiation seed implants were cured of their cancer eight years after diagnosis.

The patients did not receive any other form of cancer treatment.

"This study is exciting because it shows that brachytherapy alone, without additional surgery, radiation or drugs, can be effective at curing early-stage prostate cancer," study lead author Dr. Michael J. Zelefsky, chief of brachytherapy services at Memorial Sloan-Kettering Cancer Center in New York, said in a prepared statement.

"These results also confirm other findings that the quality of the seed implant is a critical ingredient for achieving a better outcome," he said.

The findings are published in the Feb. 1 issue of the International Journal for Radiation Oncology, Biology, Physics.

More information
The American Academy of Family Physicians explains prostate cancer treatments.

Brain Stents Might Help High-Risk Stroke Patients

(HealthDay News) -- People at high risk of stroke because of narrowed blood vessels in the brain benefit from having flexible tubes known as stents implanted to keep those arteries open, a Chinese study finds.

That might seem to be common sense, but an American expert said it is far from common practice, and he agreed with the Chinese neurologist who reported the finding in the Feb. 6 issue of the journal Neurology that further studies are needed to prove the point.

"At present, there still has been a debate about the value of stents for people with brain vessel blockage, because the procedure itself can lead to stroke, and a high rate of procedural complications can offset the potential benefits," said lead researcher Dr. Wei-Jian Jiang, a neurologist at the Capital University of Medical Sciences in Beijing.

But his study, comparing 121 people who had artery blockage of more than 70 percent with 92 others who had a more moderate blockage, found clear benefits of stent implants for those with more severe obstructions.

The risk of a stroke for patients given stents for severe artery narrowing was 7.2 percent after one year and 8.2 percent after two years. For the moderate-blockage group, the risk was 5.3 percent after one year and 8.3 percent after two years.

"These similar results suggest while patients with severe blockage benefit from stents, patients with moderate blockage may not, since our study shows the degree of artery blockage isn't a predictor of stroke risk after stent placement," Jiang said. In other words, the potential risk of stent placement may not be worth it for patients with less clogged arteries.

Because his study was relatively small, Jiang said a large-scale, carefully controlled trial is still needed to compare stent placement with other treatments, such as medication or surgery, for patients with severe blockages.

Jiang said his group is planning such a study, but it won't be easy to do, since the "brain vessel stent procedure is still a new therapeutic method." There may also not be enough experienced interventional neurologists to perform such multicenter trials, Jiang added.

The Chinese report is "very encouraging," said Dr. Edgar J. Kenton, clinical professor of neurology at Thomas Jefferson University Hospital in Philadelphia and chair of the practice committee of the American Academy of Neurology. But he added that, "what you want at the end of the day is a double-blind study" comparing stent implantment with other treatments for high-risk persons, such as those with severely narrowed arteries and conditions such as diabetes, high blood pressure and a prior stroke.

At this time, the treatment such people receive depends in large part on the resources available at the center where they are diagnosed, Kenton said.

"It depends on the hospital," he said, "where they are, the degree of experience dealing with such patients, if they have an interventional neurologist on staff."

There is increasing evidence that "stents work, and particularly in severe cases," Kenton said, and severely affected people "are apt to be considered for stenting." But the issue will not be completely settled until a carefully controlled study is done, he said.

"At present, these high-risk patients are the target population of stent procedure in our practice," Jiang said.

More information
There's more on stenting and other stroke-prevention methods at the Cleveland Clinic.

High Blood Pressure in Pregnancy Boosts Lifetime Heart Risk

(HealthDay News) -- High blood pressure during pregnancy is a warning sign of diabetes and heart disease later in life, a Dutch study indicates.

The study of 491 older, postmenopausal women found that those who had reported high blood pressure during a pregnancy had a 57 percent higher risk of developing calcium buildup in their arteries, compared with those whose blood pressure did not rise abnormally during pregnancy.

The findings were published online in the Feb. 5 issue of the journal Hypertension.

Calcification of the arteries is a marker of atherosclerosis or "hardening of the arteries," which is associated with an increased risk of cardiovascular disease.

"Our research and that of others may have important implications for the management of women who have high blood pressure in pregnancy," senior researcher Dr. Michiel L. Bots, associate professor of epidemiology at the Julius Center for Health Sciences and Primary Care in Utrecht, said in a statement.

The findings probably do not have implications for obstetric care, added Dr. Sharonne Hayes, director of the women's heart clinic at the Mayo Clinic in Rochester, Minn.

"We would still need to treat those women the same way as we now do during pregnancy," she said. "But now, those women have been marked as having an increased risk of heart disease. They have another marker of risk and need to be much more vigilant in looking for cardiovascular disease."

Previous studies have led to "a growing recognition that complications, and particularly cardiovascular complications, during pregnancy lead to an increased risk of heart disease later on," said Hayes, who is chair of the scientific advisory board of Women Heart: A National Coalition for Women With Heart Disease.

"As far as I know, this is the first to look at coronary calcification, which is a very good marker for the presence of cardiovascular disease," she said.

The U.S. National Heart, Lung and Blood Institute estimates that 6 percent to 8 percent of American women develop unusually high blood pressure during pregnancy. Some go on to develop a condition called preeclampsia, which can damage the placenta, kidney, liver and brain.

A more serious condition, called eclampsia, is a leading cause of pregnancy-related mortality.

The increase in calcification in the Dutch study was seen not only in women who developed preeclampsia but also those with high blood pressure, Hayes noted.

"It is a sign that you need to be more careful about your risk of heart disease down the road," she said.
The women themselves and their physicians should be aware of their increased risk, said Dr. Daniel Jones, dean of the University of Mississippi School of Medicine and president-elect of the American Heart Association.

"In women who have had hypertension during pregnancy, there needs to be careful monitoring of cardiovascular risk factors, to [help them] be prepared appropriately to manage those factors," Jones said. "These women should be doing what we all should be doing -- keeping their weight in a good range, exercising, not smoking, eating a diet high in fresh fruits and vegetables."

The study, he said, "is a new way of looking at an issue that we have long suspected is a problem: that women who have hypertension in pregnancy are more likely to develop hypertension later in life, and hypertension is a known risk of vascular disease."

More information
There's more on high blood pressure at the U.S. Heart, Lung and Blood Institute.

Certain Online Behaviors Put Teens at Risk

(HealthDay News) -- It's a brave new World Wide Web, and parents may not always be doing all they can to protect their kids from the Internet.

A new study has found that teens who converse with strangers online are more likely to fall prey to online harassment than teens who share their personal information on the Web.

And teens who behave aggressively are also at higher risk of online "interpersonal victimization."

"Sending and posting personal information online may not increase one's risk for Internet victimization as much as meeting people online in lots of different ways, talking about sex with people known only online, and harassing others (i.e., making rude or mean comments, intentionally embarrassing or harassing others) online," said study lead author, Michele Ybarra, president of Internet Solutions for Kids, in Irvine, Calif.

"In many cases, what we see to be most influential in explaining the likelihood of Internet victimization is a pattern of these 'risky' behaviors instead of individual behaviors alone," she said.

The study is published in the February issue of Archives of Pediatrics & Adolescent Medicine.
Dr. Dimitri Christakis, author of an editorial accompanying the study, added, "Because of the 'digital divide,' most parents tend to get really scared and feel powerless over how to protect their children.

"But there are many real things that parents can do to make sure technology serves their children's best interest," added Christakis, director of the Child Health Institutes at the University of Washington, Seattle.

According to the article, about 9 percent of children who use the Internet are targets of harassment, and 13 percent are targets of unwanted sexual solicitation every year. Harassment and unwanted sexual solicitation are considered forms of online interpersonal victimization.

An estimated 90 percent of American children go online, according to the researchers.

Internet safety guidelines often stress not sharing personal information or talking with strangers online. But these recommendations aren't based on empirical evidence.

The authors of the study analyzed data from a 2005 telephone survey involving 1,497 American children aged 10 to 17. All participants had used the Internet at least once a month for the past six months. About half of the respondents were female and slightly more than three-quarters identified themselves as white. Most came from well-educated households with high annual incomes.

"This is a very good snapshot of kids in that age group who are using the Internet and what their experience really is," Christakis said. "They [the researchers] used the best method for assessing, and they did a very good job. There hasn't actually been a study like this of this size."

At issue for the study were nine online behaviors believed to increase the risk of online victimization. The behaviors were: putting personal information online; sending personal information online; harassing or embarrassing someone; making rude or nasty comments; meeting someone online; having people known only online on a buddy list; talking about sex with someone known only online; purposely visiting an X-rated Web site; and downloading images from a file-sharing program.

Seventy-five percent of the respondents reported engaging in at least one of the nine online behaviors. More than one in four, or 28.2 percent, reported engaging in four or more of the behaviors.

Teens who engaged in four types of behavior were 11 times more likely to have been victimized than those reporting none of the behaviors, the study found.

Aggressive behavior in the form of making rude or nasty comments increased the odds of being victimized 2.3 times; frequently embarrassing others increased the risk almost 5 times; meeting people in multiple ways increased the odds 3.4 times; talking about sex online with strangers doubled the risk.

According to the study authors, most Internet safety messages are on target, but sharing personal information seems to be less of an issue than discouraging risky behaviors.

"Just as you need to know who your kids are with and where they are in the offline world, know who they are talking with and what they are doing in the online world," Ybarra recommended. "Take time to understand their world online and appreciate the importance that self-expressive behaviors online (e.g., having a profile on social networking sites) have for some youth. Our findings suggest that simply having a posting or sending personal information are not the types of behavior to be concerned about. On the other hand, talking about sex with people known only online is."

Christakis advised parents to know how their children are using the Internet -- including visiting a child's "MySpace" account and making sure computers are in a public place in the house.

"The Internet shouldn't be perceived as being all bad or all good. The real problem is that it's both," Christakis said. "It's an incredibly powerful tool and, if it's used appropriately, it can be a very good thing for children. But, if it's misused, it's potentially dangerous."

More information
The U.S. Federal Communications Commission has more on the Children's Internet Protection Act.