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Breast Cancer Study Could Change How Early Growths Are Treated

June 4th, 2011 at 07:36am Under Health report

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This is the VOA Special English Health Report.

Have you ever felt lumps under the skin on the sides of your neck when you were sick? Those might be lymph nodes. They can get swollen and painful but their job is to fight infection. Lymph nodes are part of the body’s defenses known as the lymphatic system.

This complex system throughout the body makes and transports a protective fluid called lymph. Lymph is made of white blood cells, proteins and fats.

In a patient with breast cancer, the cancer can spread to the large number of lymph nodes under the arm. Doctors have traditionally removed many of these lymph nodes in the hope of removing all the cancer.

But the latest research finds nothing to gain by removing so many lymph nodes.

Doctors have two choices when breast cancer starts to spread. They can do what is called a sentinel node biopsy. They remove the main growth and one or two lymph nodes nearest to it.

Or they can take more aggressive action and remove a lot of lymph nodes. But that can lead to shoulder pain and permanent swelling of the arm.

Dr. Armando Giuiliano at the John Wayne Cancer Institute in Santa Monica, California, was a leader of the study. He found that a sentinel node biopsy can be enough to eliminate all of the cancer. And the patient does not need to stay in a hospital to have it done.

Dr. Giuliano and researchers at other American cancer centers studied almost nine hundred breast cancer patients. In each case, the cancer had spread to no more than two lymph nodes.

Half of the women had the traditional surgery. Doctors removed an average of seventeen lymph nodes. The other half had the simpler operation with just one or two nodes removed. Then both groups received radiation treatment and chemotherapy drugs.

Doctor Giuliano says rates of survival five years later showed that the less invasive operation was just as successful as the more aggressive action.

ARMANDO GIULIANO: “The five-year survival was about ninety-two percent regardless of which operation. And, wonderfully, women who had the sentinel node biopsy alone did just as well as the women who had the more radical operation.”

The study appeared in the Journal of the American Medical Association. Some experts say the findings could change the way surgeons treat early breast cancers that have spread to the lymph nodes. But other doctors say they want more proof before they make a change.

And that’s the VOA Special English Health Report. You can get more health news along with transcripts and MP3s of our reports at voaspecialenglish.com. And we invite you to visit the all-new mobile version of our site on your phone or other device. I’m Pat Bodnar.

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Contributing: Carol Pearson

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Screening for Breast, Cervical Cancer: The New Advice

February 26th, 2010 at 09:16am Under Health report

This is the VOA Special English Health Report.

Sometimes new health advice conflicts with old advice. Yet new guidelines last week for breast cancer testing in the United States created a storm of debate. The advice came from experts who are appointed by the government to develop guidelines for preventive services, like mammograms.

Congresswoman Sue Myrick of North Carolina is joined by other lawmakers as she discusses new guidelines for mammograms on November 18

The experts advised most women to get fewer mammograms. They said the risk of needless treatment outweighs the good from more tests. The new advice is to get tested every two years, instead of yearly, and to start at age fifty instead of forty.

The task force must not consider medical costs. But critics accused the Obama administration of trying to limit mammograms to save money.

The administration pointed out that the current members of the group were appointed during the last administration. And officials said the study had begun long before the latest debate on health reform.

The House of Representatives passed health care legislation earlier this month. And the Senate agreed Saturday to begin full debate on its own bill.

The secretary of health and human services said the new advice would not affect government policies. Kathleen Sebelius advised women to “keep doing what you have been doing.”

Some say they worry that health plans might pay for fewer mammograms now. But every state except Utah requires insurance companies to pay for testing women in their forties.

There appeared to be less reaction later in the week when a different group released new guidelines for cervical cancer testing. The American College of Obstetricians and Gynecologists said the timing was just by chance.

The new guidelines say women age twenty-one to twenty-nine only need to get a Pap test every two years instead of yearly. Girls are advised to begin testing within three years of when they first have sex, or in any case no later than twenty-one.

A Pap test looks for abnormal cervical cells that could become cancer. Doctors may remove suspicious growths. But the experts say that in most cases in young women, these growths would go away by themselves. Removing them can lead to problems such as scarring and the need for Cesarean births later.

Cervical cancer is highly curable if it is found early. Pap tests have saved countless lives. Today most of the deaths are in countries with poor health care.

And that’s the VOA Special English Health Report, written by Caty Weaver. For more health news, go to voaspecialenglish.com. I’m Barbara Klein.

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