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Research notes
Hormone therapy linked
to increased breast cancers
There’s
more bad news for women seeking relief from the symptoms of menopause through
the use of hormone therapy. According to a new study published in the June 25
issue of The Journal of the American Medical Society, even short-term use of a
combination of estrogen and progestin may stimulate breast cancer growth.
The study –
co-authored by Michele G. Cyr,
M.D., associate professor of medicine and associate dean of graduate medical
education– also concluded the use of combined hormone therapy (CHT)
hindered the diagnosis of breast tumors to a more advanced stage of disease,
making them more difficult to treat.
One year ago the
Women’s Health Initiative (WHI), a multifaceted national study that
examined hormone replacement therapy and other issues, demonstrated that CHT
– long believed to help aging women maintain good health – actually
put them at an increased risk for heart disease, strokes, blood clots and
breast cancer. Nearly 17,000 women participated in the hormone therapy study;
half were randomly assigned to take CHT, the other half to take a placebo.
Further analyzing the data
collected in the WHI project, Cyr and her colleagues found that women taking
CHT developed more breast cancers (245 cases versus 185 cases) and more
invasive breast cancers (199 cases versus 150 cases) when compared to the
placebo group. The researchers also found that after just one year, women on
CHT were more likely to have abnormal mammograms than those taking placebos (9.4
percent compared to 5.4 percent), a pattern that continued throughout the
study.
Until now many physicians
believed women could safely use CHT for one or two years to control menopausal
symptoms such as hot flashes and night sweats.
“This study really tells women they have to be
concerned even about short-term use of CHT,” Cyr told ABC News last
month. “And what we now define as short term is truly in question.”
– Mary Jo Curtis
Treatment explored for
brain cancer
A Brown physician is
leading a study of an experimental drug to treat patients diagnosed with a
typically fatal form of brain tumor.
Lloyd M. Alderson, M.D., assistant professor of clinical
neurosciences, is the principal investigator of a study of the experimental
chemotherapy drug gimatecan. The study is in its early stages – designed
to determine the maximum tolerable dose and tumor response.
At the 39th
annual meeting of the American Society of Clinical Oncology last month,
Alderson reported that gimatecan was not only well tolerated by the 15 patients
in the study, “two patients experienced a durable decrease in tumor
volume and have remained clinically stable.” In addition, the drug shrank
tumors in four other patients, but those malignancies grew again.
Alderson and colleagues
also found that gimatecan showed up in significantly lower doses in the blood
of the six individuals in the study who were taking anti-seizure medications.
The tumor under study is
called a high-grade glioma. The standard care for patients with this type of
tumor is to remove as much of the malignancy as possible surgically, treat with
radiation and try experimental chemotherapy.
In general, however,
patients with high-grade gliomas don’t respond to experimental
chemotherapy, Alderson said. Moreover, experimental drugs often make the
patients sick in other ways.
It is
“encouraging” that gimatecan did not hurt patients and that it
produced responses in six of 15 individuals, Alderson said. The study will
continue to determine maximum tolerated dose and if those higher doses shrink
tumors, he said.
Gimatecan is related to
other approved chemotherapy drugs, but the FDA has not approved it for any use
at this time. Patients in the study had undergone tumor-removal surgery and
radiation treatments, but their tumors had started to regrow.
The patients received the
drug in pill form five times a month for six months. The firm Sigma-tau
produces gimatecan, and also funds the study.
Next month, Alderson will
leave Rhode Island Hospital. He will continue the study at Lahey Clinic in
Burlington, Mass. – Scott J. Turner
Partners in education
reform
Many school districts turn
to external reform partners to meet mounting pressures from federal and state
agencies and from their communities to improve student results, according to a new
study commissioned by the Annenberg Institute for School Reform.
The study looked at five
partnerships between districts and external organizations: Flint, Mich.;
Durham, N.C.; Kansas City, Kan.; Hamilton County in Chattanooga, Tenn.; and
Cleveland, Ohio. Researchers Robert Kronley and Claire Handley found that these partnerships are only effective if
districts – and school superintendents specifically – establish the
conditions that make them work for schools and communities.
"Many districts spend
hundreds of thousands, even millions, of dollars annually on contracts with
outside organizations," said Warren Simmons, executive director of the Annenberg Institute. This
report "is the first attempt to systematically understand these
relationships, provide a framework for analyzing them, and offer guidance to
district leaders in making them work."
The report,
"Reforming Relationships: School Districts, External Organizations, and
Systemic Change," is available at www.schoolcommunities.org.
– Kristen Cole
Teens’ Capitol Forum: Weapons proliferation is top concern
High school students from Connecticut, Illinois, Indiana,
Nebraska, Rhode Island and Utah identified the proliferation of nuclear,
biological, and chemical weapons as the greatest concern facing the global
community. The finding was based on a ballot taken this spring as part of the
annual Capitol Forum on America’s Future, designed by Brown
University’s Choices for the 21st Century Education Program at
the Watson Institute for International Studies. The response reveals a
significant shift: In previous ballots, students saw environmental degradation
and problems with immigration as the most severe problems confronting the
United States as a global actor.
The 2003 ballot is available as a .pdf.
The Capitol Forum is
a yearlong program that involves students both within the social studies
classroom and beyond the classroom at their state capitols.
In 2003, nearly 1,500 students
from the six participating states completed the Capitol Forum ballot. - Nancy Soukup
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