Many Lung Cancer Tumors May Prove Harmless, Study Finds

Smokers who have a CT scan to check for lung cancer stand a nearly one-in-five chance that doctors will find and potentially treat a tumor that would not have caused illness or death, researchers report. Despite the finding, major medical groups indicated they are likely to stick by current recommendations that a select segment of long-time smokers undergo regular CT scans. Some researchers argue that many people receive painful and life-altering treatments for cancers that never would have harmed or killed them. The new study used data gathered during the National Lung Screening Trial, a major seven-year study to determine whether lung CT scans could help prevent cancer deaths. The trial found that 20 percent of lung cancer deaths could be prevented if doctors perform CT screening on people aged 55 to 79 who are current smokers or quit less than 15 years ago. To qualify for screening, the participants must have a smoking history of 30 pack-years or greater. In other words, they had to have smoked an average of one pack of cigarettes a day for 30 years. Based on the study findings, the American Lung Association, the American Cancer Society, the American College of Radiology and other medical associations recommended regular screenings for that specific segment of the smoking population. The latest projections from that same data, however, found that more than 18 percent of the cancers detected by the scans would be unlikely to do harm to the patient, said study co-author. He characterized his findings as "one piece of information they were waiting for just to understand the risks and limitations of the trial and of recommending mass screening." "When we tell patients we're going to do a test, you need to understand the risks and benefits," he said. "This is just part of the equation." A member of research team said, some of the over-diagnosis can be attributed to slow-growing tumors. In other cases, however, smokers will not die of cancer because they will succumb first to emphysema, heart disease or the myriad of other major health problems caused by smoking. "It could be that heavy smokers die of lots of other things before the cancer can kill them," he added. Study co-author said the results highlight the need for future research to uncover genetic markers that will allow doctors to better sort aggressive cancers from cancers that might not need to be treated.

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Irregular Heartbeat Tied To Depression

People with an irregular heartbeat may also be at increased risk of being depressed, a new study suggests. The added risk was small, researchers found, but it's in keeping with other studies linking heart disorders with depression. Atrial fibrillation (AF) is a type of rhythm disorder affecting the heart's upper chambers. It can be caused by a number of issues - including heart attacks, infections and heart valve problems. Obesity is a risk factor for AF, as are high blood pressure, high cholesterol and diabetes. Doctors have long known that patients' mental state can affect how well they take care of themselves, follow treatment instructions and how they perceive the burden of their illnesses. Lead researcher and her fellow wanted to see if depression might affect the course of atrial fibrillation and patients' feelings about their disease. Her team used data on 10,000 German adults for the new study. Most did not have AF, but 309 did. The researchers compared the average depression scores for people with AF to the scores of people without the condition. Depression was measured on a scale of zero to 27, with higher scores indicating more severe depression. On average, people with AF scored a four, compared to an average score of three among those without the irregular heartbeat. In either group's case, the score wouldn't be enough to warrant treatment for depression. Lead researcher and her colleagues did find that the difference in depression severity they saw was mostly driven by the physical symptoms of depression, such as aches and pains, being more common or intense in people with irregular heartbeats. Screening for and treating depression symptoms might help heart patients to feel better physically and potentially even improve their heart conditions, the researchers write.

SOURCE: Reuters Health, December  2013

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Snoring In Pregnancy Tied To More C-section & Small Baby

Pregnant women who snore three or more nights a week are more likely to have a cesarean section and smaller babies, a new study finds. The findings suggest that treating snoring in pregnant women may help reduce health problems among newborns and the associated medical costs, according to the researchers. They looked at 1,673 pregnant women, 35 percent of whom reported regular snoring. Compared to non-snorers, those who snored before and during pregnancy (chronic snorers) were two-thirds more likely to have a small baby and more than twice as likely to have an elective C-section. "There has been great interest in the implications of snoring during pregnancy and how it affects maternal health, but there is little data on how it may impact the health of the baby," lead author said. "We've found that chronic snoring is associated with both smaller babies and C-sections, even after we accounted for other risk factors. This suggests that we have a window of opportunity to screen pregnant women for breathing problems during sleep that may put them at risk of poor delivery outcomes," she explained. A previous study found that women who begin snoring during pregnancy are at high risk for high blood pressure and preeclampsia -- a condition in which a pregnant woman experiences sharp rises in blood pressure along with protein in her urine and other symptoms. Snoring is a key sign of obstructive sleep apnea, which can be treated using continuous positive airway pressure (CPAP). "Millions of health care dollars are spent on operative deliveries, taking care of babies who are admitted to the NICU and treating secondary health problems that smaller babies are at risk for when grown," she said. "If we can identify risks during pregnancy that can be treated, such as obstructive sleep apnea, we can reduce the incidence of small babies, C-sections and possibly NICU admission that not only improve long- term health benefits for newborns but also help keep costs down," she said. While the study found associations between snoring in pregnancy and an increased likelihood of C-section delivery and smaller babies, it did not establish a cause-and-effect relationship.

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