Surgical treatments and procedures Archive

Research we're watching

Women at high risk for breast cancer might benefit from taking medication to prevent the disease, says a new recommendation from the U.S. Preventive Services Task Force (USPSTF), a national group of experts. Medications such as tamoxifen (Nolvadex), raloxifene (Evista), and aromatase inhibitors have been shown to help prevent invasive, estrogen receptor-positive breast cancer, but they can cause serious side effects, such as other cancers and blood clots. For some women, the potential benefits of these drugs outweigh those risks. The USPSTF, however, recommends against routine use of these medications for women who are not at high risk for breast cancer, because the potential benefit is much smaller. Women who are over age 35 and are at high risk for breast cancer or who have had previous benign breast lesions (such as atypical ductal or lobular hyperplasia or lobular carcinoma in situ) might want to discuss this recommendation with their doctor. The USPSTF encouraged doctors to weigh the risk of breast cancer against potential drawbacks of the medications and the individual woman's risk for adverse effects.

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Over the past decade, research has revealed that the majority of patients treated for cancer experience difficulties with memory, attention, concentration, and thinking. There are several lifestyle actions that can help improve these symptoms, as well as certain medications.

New recommendations could affect millions of people.

You may remember a time when taking a daily baby aspirin was almost a rite of passage for generally healthy older adults. The idea was that, for people with a low to moderate risk for heart disease, aspirin therapy was a simple and cost-effective way to help prevent a heart attack or stroke.

But taking aspirin increases the risk for bleeding in the stomach and brain (see "How aspirin affects the body").

Ask the doctor

Q. For 25 years, my doctor has recommended low-dose aspirin to reduce my risk of a heart attack. Recently, he told me that new studies indicate that I can stop. What's changed?

A. Millions of people are asking the same question. I'm afraid some of them think that, when doctors change their recommendations, it means we really don't know what we're doing. To the contrary, the recommendation you got 25 years ago was based on sound scientific evidence, and so is the recommendation you received recently.

Research we're watching

To manage the painful joint disease known as osteoarthritis, people often take ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox). But these and related drugs — known as NSAIDs — may account for the higher rates of heart disease seen in people with osteoarthritis, a new study suggests.

Researchers matched 7,743 people with osteoarthritis with 23,229 healthy people who rarely or never took NSAIDs. People with osteoarthritis had a 42% higher risk of heart failure and a 17% higher risk of coronary artery disease compared with healthy people. After controlling for a range of factors that contribute to heart disease (including high body mass index, high blood pressure, and diabetes), they concluded that 41% of the increased risk of heart disease related to osteoarthritis was due to the use of NSAIDs.

Can you do anything about hand and finger joint pain?

Everyone experiences the occasional painful hands and sore fingers, but when osteoarthritis strikes, it can put a hold on many aspects of your life.

"As osteoarthritis progresses, you may lose some hand mobility, like the ability to grasp and hold objects," says Dr. Robert Shmerling, clinical chief of rheumatology at Harvard-affiliated Beth Israel Deaconess Medical Center and senior faculty editor at Harvard Health Publishing. "Over time, osteoarthritis can make the joints deformed, so it's harder to open and close your hands."

Simple organization and communication strategies can help you manage your medications and reduce health risks.

If your pillbox is overflowing, you're not alone. Some 60% of Americans have at least one chronic condition, and 40% have two or more, according to the CDC. Doctors often prescribe multiple drugs to manage them.

"Some studies have found that a large number of people are taking as many as 12 to 15 drugs at a time," says Dr. David Bates, a professor of medicine at Harvard Medical School.

Antidepressants and opioids are common offenders.

It's frustrating when you feel the urge to move your bowels but can't seem to go. Before blaming your diet, consider whether medication side effects are causing your constipation.

Possible suspects

Many medications can contribute to constipation, including the following:

It may be as simple as adjusting the dose, avoiding alcohol, or taking the drug at a different time of day.

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One of the most commonly reported side effects of some medications is drowsiness. "Many people report tiredness or fatigue as a side effect from their medicines. However, there are things you can do to minimize the feelings of daytime sleepiness," says Laura Carr, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Typical offenders

Common culprits that cause sleepiness include antidepressants; antihistamines, found in sleep aids or medicines that treat allergies; anti-emetics, which are used to control nausea and vomiting; antipsychotics and anticonvulsants, which can be used to treat seizures or depression; drugs to treat high blood pressure, including alpha blockers and beta blockers; benzodiazepines and other sedatives, which are commonly used for anxiety or insomnia; drugs for Parkinson's disease; muscle relaxants; and opioids and other prescription pain medications. Many over-the-counter medicines may also make you drowsy, such as remedies for insomnia, allergies, nausea, vomiting, or diarrhea.

Doctors say three recently approved migraine prevention drugs are helping people have fewer headaches.

For people with frequent, debilitating migraine headaches, 2018 brought encouraging news. The FDA approved three new medications — erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) — the first drugs designed specifically to prevent migraines and reduce their frequency, intensity, and duration.

It was a big development, since other medications used to stop migraines were created to control other conditions, such as seizures, depression, high blood pressure, or an irregular heartbeat. But their side effects (such as weight gain, dizziness, or fuzzy thinking) often cause people to skip treatment.