Archive for September, 2010

Neck Surgery Can Reduce Stroke Risk

Sunday, September 26th, 2010

A surgical procedure to widen carotid arteries that have become narrowed and restrict blood flow to the brain reduces the risk of stroke over a 10-year period.

According to British researchers the carotid artery supplies blood carrying oxygen to the head, so a procedure to widen it helps restore blood flow to the brain. However, the operation, called a carotid endarterectomy, has about a 3 percent risk of causing an immediate stroke, the researchers cautioned.

For some elderly patients, this risk may outweigh any long-term benefit. But older, healthy patients will likely benefit from the procedure, the study authors noted.

Recent studies suggest that the rate of stroke in patients with [narrowed carotid arteries without symptoms] is lower than the rates found in this trial, according to the highlighted report posted by the American Association for Critical Illness Insurance, the trade group.

Although the study found the rate of stroke in patients without a carotid endarterectomy to be 1.8 percent a year over a 10-year period, the rates are thought to be about 1 percent a year, but may be as low as around 0.5 percent a year.

The lower rates of stroke, medical reserachers report, are thought to be due to advances in medical treatment such as blood pressure control, antiplatelet drugs and more widespread use of statins.

The report is published in the Sept. 25 issue of The Lancet.

In the Asymptomatic Carotid Surgery Trial, a research team led by Dr. Alison Halliday of the John Radcliffe Hospital, the University of Oxford, randomly assigned 3,120 patients with narrowed carotid arteries to surgery or to no surgery until their condition required it.

Some of the patients originally assigned to the “no surgery” group did undergo the operation during the study, the researchers noted.

A total of 1,979 operations were performed. Among these the risk of stroke within 30 days was 3 percent, including 26 minor and 34 disabling or fatal strokes, Halliday’s team reported.

Over an average of five years of follow-up, 4.1 percent of those who underwent the procedure suffered a stroke, compared with 10 percent of those who did not have the operation.

At 10 years, 10.8 percent of those who had the operation had suffered a stroke, compared with 16.9 percent of those who were not operated on, the researchers found.

In addition, over the years of the study, patients in both groups were also taking cholesterol-lowering drugs. Even these medications did not affect the benefit of the surgery, the researchers said.

“This trial took more than 15 years to complete, because we wanted to know about the long-term effects of surgery,” Halliday said in a statement.

“The finding that successful carotid artery surgery can substantially reduce the stroke risk for many years is remarkable, because it means that most of the risk of stroke over the next five years in patients with a narrowed carotid artery is caused by that single carotid lesion. The definite benefits that we have found will be of practical value to doctors and patients deciding in the future whether to take the immediate risk of having such surgery,” she said.

The rates of stroke were reduced from about 2.2 percent a year to 1.4 percent a year over five years and from 1.8 percent a year to 1.3 percent a year over 10 years, he said.

Blood Test Can Predict Prostate Cancer Death

Thursday, September 16th, 2010

September 16, 2010.  A blood test at the age of 60 can accurately predict the risk that a man will die from prostate cancer within the next 25 years.

According to researchers at Memorial Sloan-Kettering Cancer Center, in New York, and Lund University, in Sweden the test findings are quite significant for men. 

The research findings could have important implications for determining which men should be screened after the age of 60 and which may not benefit substantially from continued prostate cancer screening. 

Prostate cancer is one of the primary critical illnesses impacting men explains Jesse Slome, executive director of the American Association for Critical Illness Insurance.  The national trade organization educates consumers regarding important health issues. 

The study analyzed blood samples from 1,167 men born in 1921 that were collected between 1981 and 1982. All men were carefully followed until they had reached age 85 or had died. 

After studying various biomarkers, the researchers found that the PSA level was a highly accurate predictor of long-term risk. PSA testing has been recommended for the early detection of prostate cancer for many years; however this new data suggests a baseline PSA could determine who should and should not continue to be screened for prostate cancer. 

According to the study, 126 men were diagnosed with prostate cancer, and of those, 90 percent of deaths occurred in men in the top 25 percent of PSA levels at age 60. The researchers concluded that men with a PSA level above 2 ng/ml at age 60 should be considered at increased risk of aggressive prostate cancer and should continue to be screened regularly. 

Men with a PSA level below 1 ng / ml had a 0.2 percent chance of death from prostate cancer. The researchers concluded that men with PSA levels in this range, which is about half of all men, should be considered at low risk of prostate cancer death and may not need to be screened in the future. The study also indicated that some men found to be at low risk may actually have prostate cancer; however it is not likely to cause symptoms or shorten their life by the age of 85.