Families happier with less aggressive end-of-life cancer care

Families may be more satisfied with end-of-life care for loved ones dying of cancer when treatment is focused on comfort rather than aggressive treatment and provided outside of a hospital, a U.S. study suggests.

When patients received at least three days of hospice care focused on comfort and quality of life, 59 percent of their loved ones thought their treatment was excellent, compared with just 43 percent when patients received little or no hospice care, the study found.

At the same time, family members of cancer patients admitted to an intensive care unit (ICU) in the last month of life reported excellent care just 45 percent of the time, compared with 52 percent when patients didn’t receive this type of aggressive treatment.

“Interventions should focus more on increasing early hospice enrollment and decreasing ICU admissions and hospital deaths,” said lead study author Dr. Alexi Wright of Harvard Medical School and Dana-Farber Cancer Institute in Boston.

“The best way to do this is to encourage patients, physicians and family members to talk about their end-of-life wishes,” Wright added by email.

Many patients with advanced cancer receive aggressive medical care during their dying days even though growing evidence suggests that high-intensity treatments may not be associated with better quality of life or outcomes for patients, or an easier bereavement for the loved ones they leave behind, Wright and colleagues report in JAMA.

For the current study, researchers interviewed family members and close friends of 1,146 patients aged 65 and older who died of lung or colorectal cancers.

In most patients, the cancer had spread beyond the original location to other tissue and organs.

Overall, 51 percent of relatives and friends rated their loved ones’ end-of-life care as excellent, and another 29 percent said the quality of care was very good.

When patients had received at least three days of hospice care, most family members – 73 percent – said their loved ones had died where they wanted to. But when patients got little or no hospice care, only 40 percent of participants said the death happened in the location of the patient’s choice.

When patients died in the hospital, just 42 percent of their loved ones reported excellent care, compared with 57 percent when patients didn’t die in a hospital.

It’s possible that hospitalized patients didn’t get good pain or symptom management or emotional and spiritual support, said Dr. David Casarett, director of palliative care for Penn Medicine in Philadelphia.

“Hospice is very good at providing that sort of support and is designed to help people remain in their homes,” Casarett, who wasn’t involved in the study, said by email.

It’s also possible that families with loved ones in the ICU didn’t have a chance to come to terms with the patient’s death, and were more surprised by the course that events took, Casarett added.

The findings underscore the importance of having family discussions about wishes for end-of-life care and communicating clearly with healthcare providers about these preferences, Casarett said.

If hospice is preferable to more aggressive treatment, it’s crucial to communicate that as early as possible.
Source: fox news

Broken sleep raises risk of stroke

As people age, they experience new sleep patterns. Insomnia creeps in and falling asleep takes longer. Sleep fragmentation, when sleep is interrupted by repeated awakenings or arousals, can also be a problem.

Changes that occur in circadian rhythms, the body clock that coordinates timing of bodily functions, including sleep, can cause older people to become sleepier in the early evening and to wake earlier in the morning.

Sleep problems can stem from an underlying medical or psychiatric condition, but they are also a risk factor for further health issues, including cardiovascular disease.

Poor sleep quality has been linked with more severe arteriolosclerosis in older people’s brains and of higher levels of oxygen-starved brain tissue, or infarcts. These factors increase the risk of stroke and cognitive impairment.

In the current study, researchers wanted to see if there was an association between sleep fragmentation and detailed microscopic measures of blood vessel damage and infarcts in autopsied brain tissue from the same individuals.

Reduced supply of oxygen to the brain
The team, led by Dr. Andrew Lim, an assistant professor of neurology at the University of Toronto, Canada, examined autopsied brains of 315 people, of whom 70% were women; the average age was 90 years.

Participants had undergone at least 1 full week of around-the-clock monitoring for rest or activity, from which sleep quality and circadian rhythms were quantified. Sleep fragmentation caused sleep to be disrupted on average almost seven times each hour.

In all, 29% of the patients had suffered a stroke, while 61% had signs of moderate to severe damage to their blood vessels in the brain.

Greater sleep fragmentation was associated with a 27% higher chance of having severe arteriolosclerosis. For every additional two arousals per hour of sleep, there was a 30% higher chance of having visible signs of oxygen deprivation in the brain.

Other cardiovascular risk factors, such as body mass index (BMI), smoking history, diabetes, hypertension and other medical conditions such as Alzheimer’s disease, pain, depression or heart failure were all adjusted for.

Source: Medical News Today

Infertility treatment ‘does not affect offspring’s early development’

There are ongoing concerns that conception through infertility treatment may negatively impact the development of offspring. But a new study hopes to alleviate these concerns, after finding that children conceived thorugh infertility treatment were at no higher risk for early developmental delays than those who were not conceived through such treatment.

Edwina Yeung, PhD, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) – part of the National Institutes of Health (NIH) – and colleagues publish their findings in JAMA Pediatrics.

According to Centers for Disease Control and Prevention (CDC), around 1.5% of all infants in the US are conceived using assisted reproductive technology (ART), such as in vitro fertilization (IVF).

Previous studies have suggested such treatment may lead to developmental problems among offspring; Yeung and colleagues point to a 2013 Swedish study that identified an 18% greater risk of intellectual disability among children conceived through a form of ART called intracytoplasmic sperm injection (ICSI). However, many other studies have found no such association.

Additionally, the researchers note that few studies have assessed how non-ART infertility treatments, such as ovulation induction (OI) – the stimulation of ovulation through medication – impacts the risk for developmental delays among offspring.

“In response to critical data gaps, we designed the Upstate KIDS Study to specifically assess the association between the mode of conception and children’s development through age 3 years,” say the authors.

Drawing data on infertility treatment types and offspring’s development
The Upstate KIDS Study involved 1,422 mothers of 1,830 children who were conceived through infertility treatment and 3,402 mothers of 4,011 children who were not conceived through such treatment. All children were born in New York State between 2008-2010.

The team notes that parents of twins and other multiples were included in the study, and there were around three times as many singleton children in the non-treatment group than the treatment group.

Four months after the mothers gave birth, they were asked to complete a questionnaire detailing the type of infertility treatment they underwent. These included ART treatments, such as IVF, frozen embryo transfer, assisted hatching and zygote intrafallopian transfer, and the non-ART treatment OI, with or without intrauterine insemination (IUI).

When the children were aged 4-6, 8, 12, 18, 24 and 36 months, their mothers completed a questionnaire that was used to identify developmental disabilities. Specifically, the questionnaire was used to assess children’s fine motor skills, gross motor skills, communication, problem-solving abilities and personal and social functioning.

Findings ‘provide reassurance’ to couples receiving infertility treatment
Overall, the researchers found there was no difference in the risk of developmental disabilities between children conceived via infertility treatment – regardless of ART or non-ART treatments – and those who were not.

Accounting only for children who were conceived via ART, the researchers found they were more likely than those in the non-treatment group to have developmental delays; they were most likely to have difficulties with problem-solving and personal and social functioning.

However, when the team accounted for the significantly higher number of twins in the ART group – after noticing twins were at higher risk of developmental problems than singletons – there was no difference in the risk of developmental disabilities between children conceived through ART and those in the non-treatment group.

Additionally, the researchers found no difference in the percentage of children who were referred for assessment by developmental specialists between treatment and non-treatment groups.

Among children who were diagnosed with a developmental disability aged 3-4 years, the researchers identified no significant differences between those conceived through infertility treatment and those who were not.

Source: medicalnewstoday

Could too much green tea be harmful to health?

For centuries, green tea has been hailed for its numerous health benefits. But according to a new study, the beverage could do more harm than good if consumed in large amounts.

In a new study published in the Journal of Functional Foods, researchers reveal how exposure to excessive amounts of green tea impaired the reproductive function of fruit flies, as well as the development of their offspring.

While it is unclear whether the beverage has the same impact on humans, the team says their findings warrant caution against consuming large amounts of green tea and other nutraceuticals.



Green tea is made from fresh leaves of the Camellia sinensis plant. Because green tea is one of the least processed forms of tea, it retains the majority of its antioxidants and polyphenols, which are known to be largely beneficial for health.

Previous research has suggested green tea can aid weight loss, reduce cholesterol and protect against numerous illnesses, including cancer, heart disease and Alzheimer’s disease.

However, some studies have reported negative health effects if the beverage is consumed in large doses; animal studies have linked excessive green tea consumption to dramatic weight loss and impaired embryonic development.

Green tea ‘should be consumed in moderation’

To reach their findings, lead investigator Mahtab Jafari, associate professor of pharmaceutical sciences at the University of California-Irvine, and colleagues exposed embryos and larvae of fruit flies, or Drosophila melanogaster, to varying doses of green tea.

Fruit flies are often used to study human disease because they share 75% of the same genes that cause disease in humans.
The team found that 10 milligrams (mg) of green tea led to slower development of larvae. There was also a significant reduction in the number and size of offspring that emerged.

Female offspring exposed to 10 mg of the beverage showed a reduction in reproductive output, as well as a 17% reduction in lifespan.

In addition, the researchers found 10 mg of green tea led to morphological abnormalities in reproductive organs of the fruit flies, including atrophy in the testicles and ovaries.

Green tea was found to protect the flies against dehydration, but it also increased susceptibility to heat stress and starvation.

While the study did not assess the mechanisms by which green tea affected the development and reproduction of the fruit flies, they hypothesize that high doses of the beverage may trigger excessive apoptosis, or programmed cell death, to produce such effects.

Source: Medical News Today

Herbal Medicine – The Power of Peppermint

Studies have shown peppermint oil to be fairly effective at relieving irritable bowel syndrome (IBS), a collection of symptoms that includes abdominal pain and cramping, bloating, constipation and diarrhea that affects 5 to 20 percent of the population.

At the mention of peppermint, candy canes and ice cream comes to mind. But did you know that peppermint is also an age-old herbal medicine that has been used to treat a wide range of abdominal woes? The oil extracted from the peppermint plant contains a host of compounds, but the most abundant and perhaps the most pharmacologically important is menthol.


mint leaves

Studies have shown peppermint oil to be fairly effective at relieving irritable bowel syndrome (IBS), a collection of symptoms that includes abdominal pain and cramping, bloating, constipation and diarrhea that affects 5 to 20 percent of the population. One explanation is that the oil—especially the menthol—blocks calcium channels, which has the effect of relaxing the “smooth” muscles in the walls of the intestines. Recently, Alex Ford, a McMaster University researcher, concluded that instead of popular over-the counter drugs, peppermint oil should be the first line of defense against IBS.

Peppermint can temporarily allay itching caused by insect bites, eczema and other lesions, including the rash of poison ivy. Peppermint tea can be used as a mouthwash for babies with thrush (yeast in the mouth) or for reducing nausea and vomiting during pregnancy, especially for women who want to avoid stronger medications.

Source: Health News

Drug derived from Caribbean reefs may treat psoriasis, MS

A biotechnology company developing an unusual drug—derived from the venom of a sea anemone to treat autoimmune diseases such as psoriasis and multiple sclerosis—reported encouraging results from a phase 1 clinical trial.

Seattle-based Kineta Inc. said it expects early next year to begin recruiting patients for the next stage of the drug’s development, a phase 2 clinical trial. Kineta said the drug, called dalazatide, is intended to block only the white blood cells that cause many autoimmune diseases. Traditional treatments for autoimmune disorders suppress the entire immune system, putting patients at risk for infections.

Phase 1 trials are preliminary, meant to test the safety and tolerability of a new drug in a small group of patients. The bulk of new drugs tested fail to advance to phase 2 trials, which test a product’s efficacy among a larger group.

Autoimmune diseases affect as many as 23.5 million people in the U.S., especially women, according to the National Institutes of Health. Prevalence of the diseases, in which the immune system attacks the body’s own organs, tissues and cells, is increasing, for reasons that aren’t clear. There is no cure.

“The results of this trial indicate an important advance in developing next-generation treatments for autoimmune disease that specifically regulate the immune response without broad immune suppression,” said Dr. Shawn Iadonato, Kineta’s chief scientific officer.

Source: fox news

World Autism Awareness Day: Caring for a child with ASD

Autism is a neurodevelopmental disorder that affects the normal brain’s function. The condition makes a person hard to communicate with and relate to other people.

The disease is part of the autism spectrum and therefore is sometimes referred to as an autism spectrum disorder, or an ASD. It is believed that symptoms occur in the first two years of an individual’s life and the condition remains with the person for his/her whole life.

The disease affects children of all races, both boys and girls in all geographic regions, and is on the rise. In India, it is said that about 10 million people have been affected with autism.

In order to create awareness about the disease, World Autism Awareness Day is observed on 2 April every year since 2008. Since then, the Autism Day has been celebrated with specific fundraising and awareness-raising events every year.


It is not known what causes autism, however, many researchers believe genetics is 90% responsible of the risk of a child getting autism. Some cases are linked to chemical exposure during pregnancy.


Symptoms may include – impairments in social interaction, impairments in communication, restricted interests and repetitive behaviour. Symptoms and severity may also differ for each child in each of the affected areas.

Also, parents often observe that their child with autism avoids eye contact with others and prefers to play alone. It is found that majority of the children with autism have below-normal intelligence, and teenagers with the condition often suffer from depression and anxiety.

Also, some of the autistic kids develop seizure disorder like epilepsy as they enter their teens. Parents should seek timely medical help if their child develops symptoms similar to ASD. While the symptoms related to autism can also be linked with other developmental disorder, early treatment can make a big difference.

Coping and support

  • For parents, caring for a child with autism can be physically, emotionally challenging.
  • But, it is important for parents to learn about the disorder as this will help them better understand their child.
  • Talking to other families of children with ASD may provide useful tips and advice in caring for an autistic kid.
  • Also, apart for medical care, parents should keep themselves updated with latest technologies and therapies.


Autism cannot be cured, but it can be treated and children can improve their language and social skills.

Since some cases are linked to chemical exposure during pregnancy, it is recommended to avoid alcoholic beverages, drugs during pregnancy. Also, getting immunized against German measles (rubella) prior to pregnancy can prevent rubella-associated autism.

Source: Zee news

World Cancer Day: Foods That Prevent Cancer

World Cancer Day’ is celebrated annually on 4th of February to deepen our understanding of this killer disease. There has been enough research to validate that food acts as the most promising ammunition to fight the battle against cancer.


1) What is the most common cause of cancer?

Cancer is the abnormal growth of cells. There are around 100 types of cancer. The most common types of cancer are – Men: Lung, esophagus, stomach, oral and pharyngeal cancers. Women: Cervix and breast cancers.

Cancer has many possible causes, the prominent ones being –

Genetics: Certain cancers run in families. For example, certain mutations in the BRCA1 or BRCA2 genes greatly increase a person’s risk of developing breast and ovarian cancer.

Smoking: Cigarette smoking accounts for around 30% of all cancer deaths. It is linked with increased risk of these cancers – lungs, larynx, oral cavity, nose and sinuses, esophagus, stomach, pancreas, cervix, kidney, bladder, ovary, colon, rectum and acute myeloid leukemia. Chewing of tobacco, a carcinogen, is linked to dental caries, gingivitis, oral leukoplakia, and oral cancer.

Diet and Lifestyle: Research shows that a poor diet and not having an active lifestyle are the key factors that can increase a person’s risk of developing cancer.

Three things to keep in mind in order to stay cancer free:

  • – Get to and stay at a healthy weight throughout your life.
  • – Be physically active on a regular basis.
  • – Make healthy food choices with a focus on plant-based foods.

2) What are the foods that up the risk of developing cancer?

Some cancers like that of the stomach have a more direct relationship with food. Foods which should be consumed in moderation to avoid the incidence of cancer are –

  • Processed meats such as bacon, sausages, lunch meats and hot dogs.
  • Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).
  • If you eat red meat, choose lean cuts and eat smaller portions.
  • Prepare meat, poultry, and fish by baking, broiling, or poaching rather than by frying or charbroiling.

3) What are the preventive foods that guard against cancer?

In accordance with the most common types of cancers that our country suffers from, the following foods can help:

Oral Cancer: A diet rich in green and yellow vegetables and proper oral hygiene has been shown to offer protection against oral cancer.

Breast Cancer: Reduction of high calorie foods, increased intake of fruits and vegetables and regular physical activity is preventive.

Lung Cancer: Avoid tobacco and stay free from environmental pollutants. Increase intake of vegetables, fruits and beta carotene.

Stomach Cancer:Diets high in fruits and vegetables particularly raw vegetables, citrus fruits, and possibly allium vegetables (onions, leeks, garlic etc.), foods with high levels of carotenoid, high vitamin C intake and consumption of green tea helps prevent stomach cancers.

4) What foods help in healing cancer and how?

Good nutrition is a key to good health. Foods which are rich in Vitamin C, Beta-carotene and Lycopene are known to protect DNA from damages. Research proves that these foods help in healing cancer –

Apple: Apple contains quercetin, epicatechin, anthocyanins and triterpenoids which have anti-inflammatory and antioxidant properties that help to lower the risk of cancer specifically Colorectal cancers. The apple peel is the most nutritious as the majority of Quercetin (80%) is found in it. Other cancers in which apples are known to heal are lungs, breast and stomach.

Blueberries :Blueberries have great antioxidant power, due to the presence of many phytochemicals and flavonoids like Anthocyanins, Ellagic acid and Urolithin. These are known to decrease free radical damage to DNA that leads to cancer. They also decrease the growth and stimulate self-destruction of mouth, breast, colon and prostate cancer cells.

Broccoli, Brussels sprouts, Green Cabbage, Cauliflower, White Turnip, Kale, Green Collard: The Glucosinolates is converted into isothiocyanates and indoles on consumption, which decreases inflammation, one of the risk factors of cancer. Beta-carotene promotes cell communication that helps control abnormal cell growth.

Cherries: Both sweet and tart cherries are a good source of fiber, vitamin C, and potassium. The dark red color comes from anthocyanins, which are antioxidants.

Cranberries: They are high on dietary fiber and vitamin C. They’re very high in antioxidant power, most of which comes from phytochemicals like anthocyanins, proanthocyanidins and flavonols, ursolic acid, benzoic acid and hydroxycinnamic acid. Proanthocyanidins and ursolic acid decrease growth and increase self-destruction of several types of cancer in cell studies.

Grapefruit: An 18th century hybrid of the pummelo and sweet orange. It is grown mainly in the Americas. Its name derives from the fruit’s appearance as it grows: grape-like clusters on trees. Grapefruit contains these naringenin and other flavonoids like limonin and other limonoids, beta-carotene and lycopene (pink and red varieties). Foods containing lycopene lower the risk of prostate cancer.

Green Tea: Since ancient times, tea has been used as both beverage and medicine. Both black and green teas contain numerous active ingredients, including polyphenols and flavonoids, which are potent antioxidants. One class of flavonoids called catechins has recently become the focus of widespread study for their anti-cancer potential. Tea is the best source of catechins in the human diet, and green tea contains about three times the quantity of catechins found in black tea. In laboratory studies, green tea has been shown to slow or completely prevent cancer development in colon, liver, breast and prostate cells. Other studies involving green tea have shown similar protective effects in tissues of the lung, skin and digestive tract.

Winter Squash/Pumpkins: They contain Alpha and Beta carotene which is converted to Vitamin A inside the body. The yellow pigmented lutein, zeaxanthin helps to filter high energy ultra violet rays that can damage our eye’s lens and retina. Lab studies suggest that dietary intake decreases the chances of skin cancer related to exposure from sun.

Walnuts: The major actives found in walnut are – Elligtannins, Gamma-tocopherol, Alpha-linolenic acid, phytosterols and Melatonin. Laboratory studies show that consuming walnuts helps in breast cancer, colon tumor and prostate cancer. The studies also show decreased damage to DNA by regular consumption of walnut.

Source: NDTV

Ebola cases may hit 1.4 mn mark by January 2015, warns CDC

The Centers for Disease Control and Prevention has reportedly predicted that the number of Ebola cases in Liberia and Sierra Leone could rise to between 550,000 and 1.4 million by January if there are no “additional interventions or changes in community behavior.”

Liberia Ebola

The prediction was made in a report released by the CDC on Tuesday and is based on a new forecasting tool developed by the organization. The estimated range is wide because experts suspect that the current count is highly under-reported, reported  The CDC said that it was possible to control the epidemic and end it eventually if 70% of Ebola-infected people are properly cared for in medical facilities.

However, in a press conference on Tuesday, CDC Director Tom Frieden, warned that this model was based on older data from August and the numbers were not projections, but “scenarios.” It also did not take into account the medical help coming from the United States and other countries. However, he added that the model does suggest that the current surge of help can curb the epidemic and is “exactly what’s needed” to end it.

According to a World Health Organization estimate, the official death toll in West Africa has risen to more than 2,800 in six months, with 5,800 Ebola cases confirmed as of Monday. The report came a day after the WHO warned that that the number of people infected with the Ebola virus could reach 20,000 by the beginning of November if efforts to contain the outbreak are not accelerated.

Source: ierra leone times

Dr M R Rajagopal selected for international award

Dr M R Rajagopal, a leading palliative care physician from India who, for more than 20 years, has battled conditions that cause patients to suffer severe pain unnecessarily, has been selected as one of the four 2014 recipients of the Alison Des Forges Award for Extraordinary Activism, Human Rights Watch said

Dr M R Rajagopal selected for international award

As clinician, academic, and activist, Dr Rajagopal is a global force behind efforts to promote and put into practice palliative care as a human right. He built the world’s most successful community-based palliative care programme, and he and his organization, Pallium India, played a key role in convincing India’s government to make morphine accessible, according to a statement by Human Rights Watch.

Human Rights Watch honours Dr Rajagopal for his efforts to defend the right of patients with severe pain to live and die with dignity, the statement said.

The other three courageous and tireless advocates for human rights who have been selected for the award are Shin Dong-Hyuk from North Korea, Father Bernard Kinvi from the Central African Republic and Arwa Othman from Yemen.

According to Human Rights Watch, the winners are leading voices for justice in their countries, working relentlessly to protect the rights and dignity of others. They will join one past international recipient of the award as they are honoured at the Human Rights Watch ‘Voices for Justice’ Annual Dinners held in 20 cities worldwide in November 2014 and March-April 2015.

“The Alison Des Forges Award honours people of extraordinary compassion and courage who work on behalf of some of the world’s most vulnerable people,” said Kenneth Roth, executive director of Human Rights Watch. “The award winners have spoken out and intervened in the face of opposition, indifference, and at times life-threatening danger.”

The award is named for Alison Des Forges, senior adviser at Human Rights Watch for almost two decades, who died in a plane crash in New York State on February 12, 2009. Des Forges was the world’s leading expert on Rwanda, the 1994 genocide, and its aftermath. The Human Rights Watch annual award honours her outstanding commitment to, and defence of, human rights. It celebrates the valour of people who put their lives on the line to create a world free from abuse, discrimination, and oppression.

Source: India Medical Times