In this week's RFE/RL Health Report, a leading cancer researcher says great strides have been made in detecting and treating the disease but adds that much more can and should be done. Correspondent K.P. Foley also filed reports on a new global anti-infectious disease strategy developed by the U.S., new guidelines for diagnosing Alzheimer's disease, and other stories making medical news.
Washington, 11 May 2001 (RFE/RL) -- The director of the U.S. National Cancer Institute (NCI) says more women than ever are avoiding breast cancer but he also says more intensive research could improve cancer detection as well as lead to more effective treatments.
In both Europe and the United States, breast cancer is the second leading cause of death among women, after heart disease. The World Health Association says that at birth, a woman has a one in nine chance of developing breast cancer, the most common form of cancer affecting women.
NCI Director Richard Klausner told a U.S. Senate budget panel this week that death rate from breast cancer began dropping each year in the United States starting in 1991, and that it is likely to continue dropping indefinitely. Doctors attribute the decrease to heightened awareness among women about breast cancer, the use of mammography -- a type of x-ray of the breast -- to find cancer early, and improved treatments.
However, Klausner says improvements could be even greater with more focused research.
"To really affect early detection we need new, really new approaches. We've incrementally improved survival, but with relatively toxic, and with a few exceptions, non-specific treatment. It's likely that we can continue to make these incremental improvements, and we must make sure that all women have access to prompt and state of the art treatment, but if we're going to do better, and we can and must, we must switch our treatment approach."
In his appeal for more research funds, Klausner noted that just within the past five years, scientists have learned that there are several different types of breast cancer, each calling for different treatment approaches.
"We must now develop new treatments based upon the molecular machinery of each type of breast cancer."
Cancer experts agree that mammography is probably the best tool doctors have for finding cancer in its earliest stages, when treatments should be most effective. However, James Marks, a disease prevention expert at the U.S. Centers for Disease Control, says even mammography is not fool proof.
"We know that mammography is not perfect. It misses some cancers and it finds lumps that are benign, that cause women to undergo further tests and needless anxiety."
U.S. Senator Arlen Specter (R-Pennsylvania), the chairman of the Senate budget sub-committee that oversees spending on health, says he will support additional funds for research and an easing of restrictions on research methods for U.S. government scientists.
Specter says he will argue for an end to the ban on the use of U.S. government funds to obtain a type of human cell, called a pluripotent stem cell, for research. Scientists say these particular cells are capable of giving rise to almost all of the cell types in a human body and offer tremendous potential for research into the origin of diseases, or for the cultivation of new tissues to replace damaged organisms.
There are objections to the use of pluripotent stem cells because they can only be obtained from human embryos used in fertility clinics, or from fetal tissue taken from terminated pregnancies. Anti-abortion advocates in the U.S. Congress oppose spending federal money for research on fetal cells and have enacted a prohibition on the use of federal funds to grow the stem cells.
U.S. Announces Global Anti-disease Campaign
The U.S. has announced its strategy to assist the World Health Organization and other international institutions in the effort to control three of the world's worst infectious diseases -- HIV, malaria, and tuberculosis.
The WHO says these three illnesses together cause more than five million deaths around the world each year. The Group of Seven plus Russia -- the world's leading industrialized democracies and Russia -- signed a joint pledge last July to reduce the devastating toll taken by these diseases worldwide, particularly in developing countries.
In the 20 years since its first reported appearance, AIDS has become the world's second leading cause of infectious disease deaths. The United Nations says 57 million people have become infected with the AIDS virus and more than 21 million people have died.
Experts say malaria affects up to 500 million people across the globe and kills one person every 10 to 15 seconds. Tuberculosis (TB), a disease once thought eliminated, is now said to be at epidemic proportions in large parts of Africa, Asia, and the former Soviet Union, and causes about two million deaths a year.
Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, outlined the U.S. approach to the effort this week. He said the Institute's plan highlights four research areas common to all three illnesses: vaccine and prevention studies, drug development, diagnostics, and enhancements to research capacity.
Fauci said vaccine research remains a top priority of the plan. He said no vaccine is available for HIV or malaria. There is a vaccine for tuberculosis (TB). However, it does not prevent the adult lung disease. The U.S. official said that in addition to vaccines, new drugs are needed to combat drug-resistant microbe strains that have emerged for each.
He said improved diagnostics will allow for more rapid and accurate identification of disease, allow researchers to better assess the incidence of these diseases, and permit physicians to treat them faster.
Global Effort Urged To Treat Brain Disorders
A new report says 250 million people in the developing world are affected by brain disorders -- psychiatric and developmental problems, stroke, epilepsy, and other conditions -- but health programs in these nations cannot afford to pay attention to them.
The report, prepared by the U.S. National Institute of Medicine and released this week, says the world's poorer nations have so few resources available and must devote most of their health efforts to treating infectious diseases.
The panelists included experts from Britain, Ecuador, India, Nigeria, Tanzania, the U.S., and the World Health Organization. They concluded that a major international effort is called for to improve the recognition and treatment of brain disorders. The experts said substantial long-term funding will be essential in creating a worldwide network of national treatment centers.
EU Official Says Hoof And Mouth Danger Reduced
European Union Consumer Health Commissioner David Byrne says the danger from hoof and mouth disease has been reduced considerably. He told reporters in Cyprus earlier this week that the number of new infections in Britain has dropped significantly. However, he says restrictions on the export of British meat to the rest of Europe will likely remain in effect indefinitely.
Thousands of British cows, pigs, and sheep have been destroyed since the epidemic flared in February. Cases of the disease were also record in Ireland, France, and Holland. Hoof and mouth disease is an infection that spreads easily and rapidly among cloven-hooved animals. It causes painful ulcers around the mouth and other sensitive areas. Animals often waste away because feeding is too painful. The most effective method of suppressing outbreaks is destruction of infected animals.
New Guidelines For Diagnosing Alzheimer's
The American Academy of Neurology has issued new guidelines for the diagnosis of Alzheimer's Disease, the incurable dementia that affects a growing number of older adults.
The Academy reviewed more than 1,000 studies on Alzheimer's undertaken since 1994, and earlier this week it released three sets of recommendations for recognizing early signs of the disease, procedures for a more precise diagnosis, and a review of the most effective treatments known.
Dementia is the term scientists use to describe general deterioration of brain functions that can be brought on by head injuries or disease, or which manifests itself as a person ages. Alzheimer's is seen most often in people over the age of 65, but doctors now believe it may actually start developing decades earlier. One of its most devastating effects is the erosion of memory, often to the point where a patient forgets even how to care for himself. Not every older person develops Alzheimer's but advancing age increases the risk.
The Academy of Neurology warned in its new guidelines that people who are diagnosed with persistent, short-term memory loss have an increased risk of developing Alzheimer's and should be aggressively monitored by their doctors.
The Academy said occasional forgetfulness is normal. However, it advised physicians that they must not ignore more persistent, serious memory lapses -- such as forgetting appointments. Doctors should guard against the tendency to dismiss concerns about memory as part of the normal aging process.
In a statement, the Academy concluded that doctors can make a reliable diagnosis of Alzheimer's with existing tools, and that they can prescribe treatments to ease the affects of the illness.