research

Chemotherapy no longer required in 70 percent of breast cancer cases

New study says no chemotherapy needed to treat common breast cancer

A 21-gene test performed on tumors could enable most patients with the most common type of early breast cancer to safely forgo chemotherapy, according to a landmark study published in the New England Journal of Medicine.

Loyola Medicine oncologist Kathy Albain, MD, is among the main co-authors of the study and a member of the clinical trial's steering committee. First author is Joseph Sparano, MD, of Montefiore Medical Center in Bronx, N.Y. The study was published in conjunction with its Sunday, June 3 presentation at the plenary session of the American Society of Clinical Oncology 2018 meeting in Chicago.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer," Dr. Albain said. "For countless women and their doctors, the days of uncertainty are over."

Dr. Albain, the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine, has conducted research with the 21-gene test and also used it in her practice for years.

The test examines 21 genes from a patient's breast cancer biopsy sample to determine how active they are. The tumor is assigned a "recurrence score" from 0 to 100; the higher the score, the greater the chance the cancer will recur in distant organs and decrease survival. If patients with higher scores receive chemotherapy, this risk of recurrence will be significantly reduced, enabling more patients to be cured.

Previously, the challenge doctors and patients have faced is what to do if a patient has a mid-range score. It was uncertain whether the benefit of chemotherapy was great enough to justify the added risks and toxicity. Previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, while women with high scores (above 25) did require and benefit from chemotherapy.The new study examined the majority of women who fall in the intermediate range of 11 to 25.

The study enrolled 10,273 women who had the most common type of breast cancer (hormone-receptor positive, HER-2 negative) that had not spread to lymph nodes. Researchers examined outcomes of the 69 percent of patients who had intermediate scores on the 21-gene test.

Patients were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone. Researchers examined the chemotherapy and non-chemotherapy groups for several outcomes, including being cancer free, having cancer recur locally or to distant sites in the body and overall survival.

For the entire study population with gene test scores between 11 and 25 — and especially among women aged 50 to 75 — there was no significant difference between the chemotherapy and no chemotherapy groups. Among women younger than 50, outcomes were similar when gene test scores were 15 or lower. Among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group.

"The study should have a huge impact on doctors and patients," Dr. Albain said. "Its findings will greatly expand the number of patients who can forgo chemotherapy without compromising their outcomes. We are de-escalating toxic therapy."


Story Source: See this article on Science Daily: "More breast cancer patients can safely forgo chemotherapy: Study." ScienceDaily. ScienceDaily, 3 June 2018. www.sciencedaily.com/releases/2018/06/180603193614.htm. Materials provided by Loyola University Health System. Study published in the New England Journal of Medicine.

Research addresses concern over hormonal contraceptive side effects

The vast majority of women will use some method of contraception during their lifetime. Despite there being 37 million in the United States who are currently on birth control, many still worry about potential side effects. Women face several options when it comes to birth control, so potential side effects often factor into their decision. Depression is a common concern for many women, but a new study by researchers at The Ohio State University Wexner Medical Center is putting patients at ease. It found there’s no evidence to support a link between hormonal birth control and depression.

“Depression is a concern for a lot of women when they’re starting hormonal contraception, particularly when they’re using specific types that have progesterone,” said Dr. Brett Worly, lead author of the study and OB/GYN at Ohio State Wexner Medical Center. “Based on our findings, this side effect shouldn’t be a concern for most women, and they should feel comfortable knowing they’re making a safe choice.”

Worly and his team reviewed thousands of studies on the mental health effects of contraceptives. They included data tied to various contraception methods, including injections, implants and pills. Similarly, researchers reviewed studies examining the effects of hormonal birth control on postpartum women, adolescents and women with a history of depression, all with the same conclusion: there is insufficient evidence to prove a link between birth control and depression.

“Adolescents and pregnant moms will sometimes have a higher risk of depression, not necessarily because of the medicine they’re taking, but because they have that risk to start with,” said Worly. “For those patients, it’s important that they have a good relationship with their healthcare provider so they can get the appropriate screening done — regardless of the medications they’re on.”

Worly said patient concerns are valid, and he wants women to continue having open and honest discussions with their doctor about which options work for them.

“We live in a media-savvy age where if one or a few people have severe side effects, all of a sudden, that gets amplified to every single person,” he said. “The biggest misconception is that birth control leads to depression. For most patients that’s just not the case.”

Most women have tried at least one method of contraception in their lives, with nearly 37 million women in the United States currently using birth control. Sixty-seven percent of current users have opted for a non-permanent hormonal method such as an oral pill, but among those, 30 percent have discontinued their use due to dissatisfaction with potential side effects.


Story Source: Read this article on Science Daily: The Ohio State University Wexner Medical Center. “No link between hormonal birth control and depression: Research eases fear around hormonal contraceptive side effects.” ScienceDaily. ScienceDaily, 26 February 2018. www.sciencedaily.com/releases/2018/02/180226085756.htm.

Study reveals no increase in risks for women who eat and drink during labor

At most US maternity units, women in labor are put on nil per os (NPO) status -- they're not allowed to eat or drink anything, except ice chips. But new nursing research questions that policy, showing no increase in risks for women who are allowed to eat and drink during labor.

At most US maternity units, women in labor are put on nil per os (NPO) status — they’re not allowed to eat or drink anything, except ice chips. But new nursing research questions that policy, showing no increase in risks for women who are allowed to eat and drink during labor. The study appears in the March issue of the American Journal of Nursing, published by Wolters Kluwer.

“The findings of this study support relaxing the restrictions on oral intake in cases of uncomplicated labor,” write Anne Shea-Lewis, BSN, RN, of St. Charles Hospital, Port Jefferson, N.Y., and colleagues. Adding to the findings of previous reports, these results suggest that allowing laboring women to eat and drink “ad lib” doesn’t adversely affect maternal and neonatal outcomes.

No Increase in Complications with ‘Ad lib’ Oral Intake During Labor

The researchers analyzed the medical records of nearly 2,800 women in labor admitted to one hospital from 2008 through 2012. At the study hospital, one practice group of nurses and doctors had a policy of allowing laboring women to eat and drink ad lib (ad libitum, or “as they please”). Another four practice groups kept all patients NPO (nil per os, or “nothing by mouth”).

Recommendations to restrict oral intake during labor reflect concerns over the risk of vomiting and aspiration (inhalation) in case general anesthesia and surgery are needed. However, with advances in epidural and spinal anesthesia, the use of general anesthesia during labor has become rare (and, if needed, much safer than before).

The study compared maternal and child outcomes in about 1,600 women who were kept NPO (except for ice chips) with 1,200 who were allowed to eat and drink ad lib during labor. The two groups were “sufficiently equivalent” for comparison. The women’s average age was 31 years. Before delivery, a “preexisting medical condition” complicating pregnancy was identified in 14 percent of the NPO group compared with 20 percent of the ad lib group.

Even though the women in the NPO group started out with fewer medical problems, they had a significantly higher incidence of complications during labor and birth, compared with the ad lib group. The women in the NPO group were also significantly more likely to give birth via unplanned cesarean section.

Other outcomes — including requiring a higher level of care after delivery and the newborns’ condition as measured by Apgar score — were not significantly different between groups. Analysis using a technique called propensity score matching, comparing groups of women with similar risk factors, yielded similar results.

The findings add to those of previous studies suggesting that restrictions on eating and drinking during labor could be safely relaxed in uncomplicated cases. “Yet in keeping with current guidelines, most obstetricians and anesthesiologists in the United States continue to recommend restrictions on oral intake for laboring women,” Anne Shea-Lewis and colleagues write.

“Our findings support permitting women who are at low risk for an operative birth to self-regulate their intake of both solid food and liquids during labor,” the researchers add. They note some limitations of their study, especially the fact that the women weren’t randomly assigned to NPO or ad lib groups.

The authors hope their study will lead to reconsideration of current recommendations to keep women NPO during the “often long and grueling” process of labor and delivery. “Restricting oral intake to a laboring woman who is hungry or thirsty may intensify her stress,” Anne Shea-Lewis and colleagues conclude. “Conversely, allowing her to eat and drink ad lib during labor can contribute to both her comfort and her sense of autonomy.”

Story Source:

Read this article on Science Daily: Wolters Kluwer Health. “Ice chips only? Study questions restrictions on oral intake for women in labor.” ScienceDaily. ScienceDaily, 23 February 2018. www.sciencedaily.com/releases/2018/02/180223151852.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

Risk of heart disease goes up with breast cancer treatment

Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.

Breast cancer patients may be at an increased risk of cardiovascular diseases including heart failure and may benefit from a treatment approach that weighs the benefits of specific therapies against potential damage to the heart, according to a new scientific statement from the American Heart Association published in its journal Circulation.

The statement is an overview of what we currently know about risk factors common to both heart disease and breast cancer, the potential heart damage from some breast cancer treatments, and suggested strategies to prevent or minimize the damage. Breast cancer survivors, especially older women over the age of 65, are more likely to die from cardiovascular disease than breast cancer, underscoring the importance of effectively managing heart disease risk factors during and following cancer treatment.

“Any patient who is going to undergo breast cancer treatment, whether they have heart disease at the beginning or not, should be aware of the potential effects of the treatments on their heart,” said Laxmi Mehta, M.D., chair of the writing group for the new scientific statement. “This should not deter or scare patients from undergoing breast cancer treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

During cancer treatments, patients should pay attention not only to their breast health, but also to their general health, including their heart, said Dr. Mehta, who is director of the Women’s Cardiovascular Health Program and an associate professor of medicine at The Ohio State University in Columbus, Ohio.

For example, some cancer treatments, such as HER-2 targeted therapies, can cause weakening of the heart muscle, a condition known as heart failure. HER-2 is a specific type of breast cancer. In some cases, the reduction in heart function is temporary and cessation of the treatment and/or the addition of heart medicines can improve function. But in some breast cancer patients, heart failure can be permanent. Because of this, the early development of heart failure can signal a need to slow down and/or alter a patient’s breast cancer treatment because of the risk for worsening the condition or the development of permanent heart failure.

Some small studies suggest that administering common chemotherapy agents in new ways may reduce heart disease risks. Doxorubicin is a chemotherapy drug used in breast cancer therapy that can lead to the damage of heart cells. Studies have shown that when doxorubicin is administered slowly, rather than all at once, patients may have a lower risk of heart failure.

In addition, a drug called dexrazoxane that could reduce cell damage has recently been approved for patients with metastatic breast cancer who receive high doses of doxorubicin. More studies will need to be done to confirm whether the results of the smaller studies are seen in larger groups of patients.

Other treatments, such as radiation, can affect the heart arteries and cause the development of coronary artery disease or blockages. Some breast cancer treatment agents, such as anthracyclines, can result in abnormal heart rhythms that in some patients are benign but in others can lead to life-threatening heart rhythms. And, some treatments — like antimetabolites — can cause spasm of the heart arteries, which can cause chest pain symptoms but could lead to heart attacks as well.

Heart disease and breast cancer share a number of risk factors, including advanced age, poor diet, family history, physical inactivity and tobacco use. The fact that these diseases share some risk factors suggests that there are lifestyle choices, primarily diet and exercise, that could help decrease the risks of developing both diseases. Healthcare providers should monitor a woman’s heart health before, during and after breast cancer treatment.

Adherence to a number of ideal heart health behaviors or factors from the American Heart Association’s’ Life’s Simple 7 is associated with a trend towards a lower incidence of breast cancer. Life’s Simple 7 includes being physically active, achieving and maintaining a healthy body weight, eating a healthy diet, avoiding tobacco, maintaining healthy levels of blood pressure, cholesterol and blood sugar.

“Fortunately, with the advances in breast cancer treatment, there has been a growing number of survivors. However, during and after the treatment of breast cancer, having optimal control of heart disease risk factors is important, because older breast cancer survivors are more likely to die of heart disease than breast cancer,” Dr. Mehta said. “And that’s why Life’s Simple 7 is important for all patients with and without breast cancer.”

Although there are an estimated 47.8 million women in the U.S. who are living with cardiovascular diseases and approximately 3 million breast cancer survivors, many people regard breast cancer as the primary threat to women’s health. It is important to recognize the overlap of heart disease and breast cancer as both entities impact survival.

Story Source: Read this article on Science Daily: American Heart Association. “Breast cancer treatments may increase the risk of heart disease: American Heart Association scientific statement.” ScienceDaily. ScienceDaily, 1 February 2018. www.sciencedaily.com/releases/2018/02/180201085812.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

Mothers over 40 more at risk of preterm birth

Maternal age over 40 is associated with an increased risk of preterm birth Mothers aged 30-34 years old may have the lowest risk of preterm birth
Pregnant mothers aged 40 and over may have an increased risk for preterm birth, regardless of confounding factors, according to a new study.
Pregnant mothers aged 40 and over may have an increased risk for preterm birth, regardless of confounding factors, according to a study published January 31, 2018 in the open-access journal PLOS ONE by Florent Fuchs from CHU Sainte Justine, Canada and colleagues.

Maternal age at pregnancy has been increasing worldwide and so has the risk for preterm birth. However, the association between maternal age and preterm birth remains a topic of ongoing research.

Fuchs and colleagues sought to investigate the impact of maternal age on preterm birth in a large cohort. The researchers analyzed the previously-collected data from the QUARISMA randomized controlled trial, which had taken place in 32 hospitals in Quebec, Canada, from 2008 to 2011.

The researchers identified five different age groups among the 165,282 pregnancies included in the study, and compared them based on maternal characteristics, gestational and obstetric complications, and risk factors for prematurity. Some of the known risk factors identified more commonly in older mothers (40 and over) included placental praevia, gestational diabetes, medical history, use of assisted reproduction technologies and occurrence of an invasive procedure. On the other hand, nulliparity, past drug use and smoking were more prevalent in younger mothers (30 and under).

Even after adjusting for confounding factors, the researchers found that advanced maternal age (40 or over) was associated with preterm birth. Meanwhile, a maternal age of 30-34 years was associated with the lowest risk of prematurity.


Read this article on Science Daily:  “Maternal age over 40 is associated with an increased risk of preterm birth: Mothers aged 30-34 years old may have the lowest risk of preterm birth.” ScienceDaily. ScienceDaily, 31 January 2018. www.sciencedaily.com/releases/2018/01/180131160346.htm.


About Women’s OB/GYN Medical Group

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

Recent study reveals reproductive risk factors of heart disease and stroke for women

Dr. Lela Emad of the Women’s OB/GYN Medical Group talks about a new study while emphasizing that healthcare providers need to be vigilant about screening women for cardiovascular disease.

Dr. Lela Emad of the Women’s OB/GYN Medical Group talks about a new study while emphasizing that healthcare providers need to be vigilant about screening women for cardiovascular disease.

Research containing new data on risk factors for heart attack and stroke comes from a very large study of more than half a million men and women of up to the age of 69 who were recruited between 2006 and 2010. Ultimately the health of 267,440 women and 215,088 men was tracked over the course of the study, or until participants had their first heart attack or stroke, whichever came first. None of the participants had cardiovascular disease when they entered the study. From this, more than 9,000 cases of cardiovascular disease were recorded, a third of which were in women.

Highlights of the study found higher risk factors for women who experienced:

  • periods starting before age 12 (10% increased risk)
  • early menopause (33% increased risk of cardiovascular disease, 42% of stroke)
  • pregnancy complications (up to 44% higher risk depending on factor)
  • Hysterectomy (12% cardiovascular disease, heart disease 20%)

This study was large, and the researchers determined a range of potentially influential factors (see full results here).

“This study is particularly important for healthcare providers,” explains Dr. Lela Emad of the Women’s OB/GYN Medical Group of Santa Rosa. “Routine screening for cardiovascular issues is something we do for our patients and something we might be able to target better now, given this new information. This is something every healthcare provider needs to be aware of.”

Heart Disease: a serious health factor for women

The American Heart Association says cardiovascular diseases and stroke cause one out of three deaths in women every year, killing approximately one woman every 80 seconds. An estimated 44 million women in the U.S. are affected by cardiovascular diseases. A whopping ninety percent of women have one or more risk factors for heart disease or stroke and fewer women survive heart attacks then do men.

More than 5 million people in the United States suffer from heart failure, less than 50 percent of those with heart failure live a full five years following diagnosis. The deadly duo of heart disease and stroke are among the most prevalent and costly health complications today. Heart disease or stroke wreak havoc on people’s lives measured in increased medical bills, lost wages and decreased quality of living.

  • 5 million heart attacks and strokes occur every year in the United States
  • 800,000 deaths occur from heart disease each year, a total of 1 in every 3 deaths – about the same number as die from cancer, respiratory disease and accidents – combined
  • 150,000 of deaths from heart disease occur in people under age 65
  • $320 billion in health care costs and lost productivity were attributed to heart disease and stroke in 2011

The top five ways to manage heart disease include; controlling high blood pressure (with the help of a healthcare provider), a daily routine of physical activity (at least 20 minutes per day), eat whole foods (avoid processed alternatives), avoid excess salt and quit smoking.

“Fitness is a factor for women of all ages, and even more significant for those who have known risk factors for heart disease and stroke,” says Dr. Emad.  “Lifestyle changes such as exercising, dieting, quitting smoking and cutting back on caffeine are all examples of the most effective ways to maintain a healthy heart.”

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit our website.

 

Can working nights increase a woman’s cancer risk?

Among female nurses alone, those who worked the night shift had an increased risk of breast (58 percent), gastrointestinal (35 percent), and lung cancer (28 percent) compared with those that did not work night shifts. Of all the occupations analyzed, nurses had the highest risk of developing breast cancer if they worked the night shift.

Researchers performed a meta-analysis using data from 61 articles comprising 114,628 cancer cases and 3,909,152 participants from North America, Europe, Australia, and Asia. The articles consisted of 26 cohort studies, 24 case-control studies, and 11 nested case-control studies. These studies were analyzed for an association between long-term night shift work and risk of 11 types of cancer. A further analysis was conducted, which looked specifically at long-term night shift work and risk of six types of cancer among female nurses.

Overall, long-term night shift work among women increased the risk of cancer by 19 percent. When analyzing specific cancers, the researchers found that this population had an increased risk of skin (41 percent), breast (32 percent), and gastrointestinal cancer (18 percent) compared with women who did not perform long-term night shift work. After stratifying the participants by location, researcher Xuelei Ma found that an increased risk of breast cancer was only found among female night shift workers in North America and Europe.

“We were surprised to see the association between night shift work and breast cancer risk only among women in North America and Europe,” said Ma. “It is possible that women in these locations have higher sex hormone levels, which have been positively associated with hormone-related cancers such as breast cancer.”

Among female nurses alone, those who worked the night shift had an increased risk of breast (58 percent), gastrointestinal (35 percent), and lung cancer (28 percent) compared with those that did not work night shifts. Of all the occupations analyzed, nurses had the highest risk of developing breast cancer if they worked the night shift.

“Nurses that worked the night shift were of a medical background and may have been more likely to undergo screening examinations,” noted Ma. “Another possible explanation for the increased cancer risk in this population may relate to the job requirements of night shift nursing, such as more intensive shifts.”

The researchers also performed a dose-response meta-analysis among breast cancer studies that involved three or more levels of exposure. They found that the risk of breast cancer increased by 3.3 percent for every five years of night shift work.

“By systematically integrating a multitude of previous data, we found that night shift work was positively associated with several common cancers in women,” said Ma. “The results of this research suggest the need for health protection programs for long-term female night shift workers.

“Our study indicates that night shift work serves as a risk factor for common cancers in women,” said Ma. “These results might help establish and implement effective measures to protect female night shifters. Long-term night shift workers should have regular physical examinations and cancer screenings.

“Given the expanding prevalence of shift work worldwide and the heavy public burden of cancers, we initiated this study to draw public attention to this issue so that more large cohort studies will be conducted to confirm these associations,” he added.

A limitation of this work is a lack of consistency between studies regarding the definition of “long-term” night shift work, with definitions including “working during the night” and “working at least three nights per month.” Additional limitations include significant between-study heterogeneity and publication bias.


Read this article on ScienceDaily: American Association for Cancer Research. “Female night shift workers may have increased risk of common cancers.” ScienceDaily. ScienceDaily, 8 January 2018. www.sciencedaily.com/releases/2018/01/180108090118.htm.

New study reveals: Women Really are Better Survivors

Women survive crises better than men Newborn girls are hardier than newborn boys during famines, epidemics
Women today tend to live longer than men almost everywhere worldwide — in some countries by more than a decade. Now, three centuries of historical records show that women don’t just outlive men in normal times: They’re also more likely to survive even in the worst of circumstances, such as famines and epidemics.
Women today tend to live longer than men almost everywhere worldwide — in some countries by more than a decade.

Now, three centuries of historical records show that women don’t just outlive men in normal times: They’re more likely to survive even in the worst of circumstances, such as famines and epidemics, researchers report.

Most of the life expectancy gender gap was due to a female survival advantage in infancy rather than adulthood, the researchers found. In times of adversity, newborn girls are more likely to survive.

The fact that women have an edge in infancy, when behavioral differences between the sexes are minimal, supports the idea that explanation is at least partly biological, the researchers say.

Led by Virginia Zarulli, an assistant professor at the University of Southern Denmark, and James Vaupel, a research professor at Duke University, the team analyzed mortality data going back roughly 250 years for people whose lives were cut short by famine, disease or other misfortunes.

The data spanned seven populations in which the life expectancy for one or both sexes was a dismal 20 years or less. Among them were working and former slaves in Trinidad and the United States in the early 1800s, famine victims in Sweden, Ireland and the Ukraine in the 18th, 19th and 20th centuries, and Icelanders affected by the 1846 and 1882 measles epidemics.

In Liberia, for example, freed American slaves who relocated to the West African country in the 1800s experienced the highest mortality rates ever recorded. More than 40 percent died during their first year, presumably wiped out by tropical diseases they had little resistance to. Babies born during that time rarely made it past their second birthday.

Another group of people living in Ireland in the 1840s famously starved when a potato blight caused widespread crop failure. Life expectancy plummeted by more than 15 years.

Overall the researchers discovered that, even when mortality was very high for both sexes, women still lived longer than men by six months to almost four years on average.

Girls born during the famine that struck Ukraine in 1933, for example, lived to 10.85, and boys to 7.3 — a 50 percent difference.

When the researchers broke the results down by age group, they found that most of the female survival advantage comes from differences in infant mortality. Newborn girls are hardier than newborn boys.

The results suggest that the life expectancy gender gap can’t be fully explained by behavioral and social differences between the sexes, such as risk-taking or violence.

Instead, the female advantage in times of crisis may be largely due to biological factors such as genetics or hormones. Estrogens, for example, have been shown to enhance the body’s immune defenses against infectious disease.

“Our results add another piece to the puzzle of gender differences in survival,” the researchers said.

The findings were published Jan. 8, 2018, in the early online edition of Proceedings of the National Academy of Sciences.


Read this article on Science Daily:

Duke University. “Women survive crises better than men: Newborn girls are hardier than newborn boys during famines, epidemics.” ScienceDaily. ScienceDaily, 9 January 2018. <www.sciencedaily.com/releases/2018/01/180109105941.htm>.

Start the New Year Right: Quit the nicotine habit using the latest research model for success

In addition to lowering the effects of nicotine withdrawal, exercise is by far the best thing women can do to improve health.The Women’s OB/GYN Medical Group shares insight into how women who have a nicotine habit can take advantage of the latest research trends for quitting that might just guarantee success; starting an exercise routine.

Smoking is a bad habit for anyone and for women it poses very specific problems, particularly for pregnant women and women who are considering pregnancy. “Now is the perfect time for women of all ages to make a commitment to stop smoking,” says Dr. Lela Emad Obstetrician & Gynecologist. “In light of the latest research, we’re asking all of our patients who smoke or use nicotine products, to make the commitment to change this one lifestyle habit, and start the New Year on a better track toward health.”

The Study 

Experts at St George’s University of London set out to understand the underlying mechanism that seems to be exercise’s way of supporting the body against nicotine dependence and withdrawal. The study revealed that even moderate exercise noticeably reduces the severity of nicotine withdrawal symptoms. The findings help to validate the protective effect of exercise during smoking cessation; against the development of physical dependence, which may help smokers in giving up the habit by reducing the severity of withdrawal symptoms.

The Impact of Smoking

According to the Center of Disease Control and Prevention cigarette smoking remains the leading cause of preventable death and disability in the United States, despite a significant decline in the number of people who smoke. More than 16 million Americans have at least one disease caused by smoking.

“If exercise works to decrease the symptoms associated with nicotine withdrawal, then taking up an exercise routine and quitting the habit go hand in hand,” Dr. Emad says. “Statistics show that only 30 percent of women quit smoking when they find out they are pregnant, if we could make a dent in that number, it will have a positive impact on the well-being of both mothers and their children.”

Cigarette smoking alone kills more than 480,000 Americans each year. It causes direct damage to the body, which can lead to long-term health problems. We’ve all heard that smoking causes cancer, lung and heart disease, and stroke, but smoking also causes specific problems for women’s health including:

  • Decreased bone density
  • Rheumatoid arthritis
  • Cataracts
  • Gum disease
  • Ulcers
  • Depression
  • Menstrual problems
  • Low birth-weight
  • Pre-term delivery

In addition to lowering the effects of nicotine withdrawal, exercise is by far the best thing women can do to improve health. Exercise has been found to increase a person’s overall energy level and it releases endorphins—which in turn increases a person’s happiness quotient. Ongoing research suggests that as little as 2.5 hours weekly (about 20 minutes a day) of moderate aerobic exercise such as walking provides all the major health benefits a body needs to stay healthy.

“What a great resolution for women of all ages to make for this New Year; stop smoking, start exercising,” Dr. Emad said.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit the Women’s OB/GYN website.

Discontinuance of Hormone Therapy May Be Hazardous to the Heart

A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT.
Hormone therapy (HT) continues to be a hotly debated topic. The benefits of estrogen to the heart, however, appear to be universally accepted. A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Since publication of the Women’s Health Initiative (WHI) clinical trial data, there has been significant disagreement over the various risks and benefits of HT. What remains relatively unchallenged is the fact that estrogen has rapid beneficial vascular effects and that shorter periods between the onset of menopause and the initiation of HT provide greater protection against cardiovascular disease. This beneficial relationship between HT and protection against heart disease has led to the speculation that withdrawal from HT could result in clinically significant changes in arterial function. Although previous studies have shown that termination of estradiol-based HT led to significant increases in the risk of cardiac and stroke deaths, particularly during the first year, these results were questioned because women with documented heart problems had not been excluded from the study.

This study, however, involving more than 400,000 Finnish women excluded women with prior cardiac or stroke events. The results of the study, published in the article “Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy,” showed that discontinuation of HT was associated with an increased risk of cardiac and stroke death during the first posttreatment year, especially in women who discontinued HT aged younger than 60 years. This increased risk was not observed in women aged 60 years or older at the time of discontinuation.

“Since the initial Women’s Health Initiative reports, studies have shown that hormone therapy has many benefits and is safer than originally thought. This is especially true for symptomatic menopausal women younger than age 60 and within 10 years of menopause, as these women had fewer heart events and less risk of mortality,” says Dr. JoAnn Pinkerton, NAMS executive director. “This new study suggests that younger women may have a higher risk of heart disease and stroke during the first year of discontinuation. Thus, women and their healthcare providers need to consider the benefits and risks of starting and stopping hormone therapy before making any decisions.”


Story Source:

Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Read this article on ScienceDaily.com: The North American Menopause Society (NAMS). “Risk of cardiac and stroke death increases after discontinuing hormone therapy: Highest risk occurs in first year after discontinuation, especially in women aged younger than 60 years.” ScienceDaily. ScienceDaily, 8 November 2017. www.sciencedaily.com/releases/2017/11/171108124156.htm.