A recent study in the Archives of Internal Medicine indicates that the risk of having a heart attack is up to 31 times higher immediately following joint replacement surgery. Those relative risk numbers could be terrifying for someone who needs to have a knee or hip replaced. The absolute risk numbers offer some reassurance. In the six weeks following surgery, one in 200 people in the study who got a new hip and one in 500 who had a knee replaced suffered a heart attack. One new point the study underscored is that the elevated risk may last longer than previously thought. Though earlier research had suggested a danger zone lasting four to five days after joint replacement—coincidentally, the period in which many people are discharged from the hospital—the elevated heart attack risk may persist for two to six weeks.
Posts by Daniel Pendick
The FDA has approved a new kind of PSA test for prostate cancer that its maker claims can help doctors do a better job of telling the difference between prostate cancer and less worrisome conditions such as prostate infection or benign prostate enlargement. The test, called the Prostate Health Index (PHI), should become available in the U.S. later this summer. The PHI combines measurements of three kinds of prostate specific antigen (PSA), a protein produced by the prostate gland. In theory, the combination could help reduce the number of men who undergo prostate biopsies when their PSA levels are slightly above normal, in the 4 to 10 nanogram per milliliter range. But doctors must take care not to allow use of the PHI test to worsen the existing overdiagnosis and overtreatment of low-risk cancers, according to Dr. Marc B. Garnick, an expert in prostate cancer at Harvard Medical School and editor in chief of HarvardProstateKnowledge.org.
Why is it so incredibly hard to quit smoking—even when you are desperate to do so? For some people, the answer may be in their genes. In a report published online in the American Journal of Psychiatry, a team led by Dr Li-Shiun Chen of the Washington University School of Medicine identified a “high risk” version of a nicotine receptor gene that is more common in heavy smokers. Those with the high-risk gene took two years longer to quit smoking. But there was a silver lining: smokers with the high-risk gene were three times more likely to respond to smoking cessation therapies. The study provides hope for even hardcore smokers. However long it takes, quitting is beneficial. In a study published in the Archives of Internal Medicine, quitting smoking reduced the risk of dying—even in people in their 80s. “Even older people who smoked for a lifetime without negative health consequences should be encouraged and supported to quit,” the researchers wrote.
Red meat hasn’t been getting very good press lately. Meat-heavy diets have been linked to increased risks of developing heart disease, diabetes, and some cancers. New findings from two long-term studies now indicate that eating lots of meat, especially processed meat, may also shorten your life. The new research involved nearly 125,000 female nurses and male health professionals, whose diet and health have been followed by Harvard School of Public Health researchers for more than two decades. Compared to eating less than one serving a day of red meat, adding one daily serving increased the chances of dying during the study period by 13%. (A serving is three ounces, about the size of a deck of cards). Red meat meant beef, pork, lamb, and hamburger. For every extra serving of processed meat (foods like hot dogs, bacon, and cold cuts), the increase was 20%.
One sex-related problem that men are sometimes reluctant to talk about—and doctors are unlikely to ask about—is called anorgasmia. It’s the inability to reach a climax during usual sexual activity. Until now, there hasn’t been much in the way of medication that can help. Researchers from Baylor College of Medicine are reporting that a drug called cabergoline (Dostinex, generic) restored half of men with anorgasmia to normal orgasm. Cabergoline raises the amount of prolactin in the bloodstream. In the Baylor study, 50 of 72 men with anorgasmia said their orgasms improved after taking 0.5 milligrams of cabergoline twice a week for an average of 10 months.
Breast cancer isn’t just a woman’s disease. Men can get it, too—about 1% of breast cancer is diagnosed in men. Since few men know that, they often fail to recognize its earliest signs and end up seeing a doctor later in the process than women do. The result: Men face treatment for larger and more advanced tumors, and their cancer is more likely to have spread to other parts of the body. The largest study to date on outcomes in men with breast cancer indicates that the five-year survival rate for women with breast cancer was 83%, compared to 74% for men. Even men diagnosed with early stage breast cancer still fared worse than women, although the gap closed for men and women diagnosed with later-stage disease. Since breast cancer in men isn’t often on doctors’ radar screens, men should be aware and check themselves.
An experimental approach to virtual colonoscopy could eliminate the unpleasant day-before bowel prep that keeps many people from having this potentially life-saving test. Virtual colonoscopy uses computed tomography (CT) scanning with X-rays, instead of a scope, to check the colon for cancers and precancerous polyps. Earlier version have required bowel cleaning, just like regular colonoscopy. A Harvard-based team led by Dr. Michael Zalis uses sophisticated computer software to make stool in the colon disappear. It’s a little like Photoshopping blemishes from still photos. “Laxative-free CT colonography has the potential to reach some of the unscreened population and save lives,” says Dr. Zalis, an associate professor of radiology at MGH and director of CT colonography at MGH Imaging.
Surviving cancer was once a challenging achievement. Today, more than 12 million Americans are cancer survivors, and many live long after their diagnoses. New guidelines from the American Cancer Society (ACS) offer them science-based advice for eating better and staying active—two keys to healthy living for cancer survivors and everyone else. The report, called Nutrition and Physical Activity Guidelines for Cancer Survivors, is available for free from the ACS website. The guidelines provide specific advice for survivors of a variety of major cancers: prostate, colorectal, lung, breast, ovarian, endometrial, upper GI, head and neck, and hematologic. They urge cancer survivors to maintain a healthy weight, avoid inactivity and return to normal daily activities as soon as possible following diagnosis, eventually aim to exercise at least 150 minutes per week, and follow an eating pattern that is rich in vegetables, fruits, and whole grains.