- Lung cancer linked to risk of stroke: study
- Poor women get more unneeded breast cancer surgery
- Libya rulers say they seize Gaddafi desert outposts
Posted: 21 Sep 2011 09:55 PM PDT
REUTERS - People recently diagnosed with lung cancer are at a higher risk of having a stroke than those without lung tumours, according to a Taiwanese study.
Researchers at China Medical University looked at data covering more than 150,000 adults and found that among those with lung cancer, 26 in every 1,000 experienced a stroke every year, compared with 17 in 1,000 who did not have cancer.
Lifestyle issues that might influence stroke risk -- such as smoking, drinking or diet -- were not factored in, said Fung-Chang Sung, senior author of the study, which was published in the journal Stroke.
Still, the risk was highest during the first three months after a lung cancer diagnosis for men and during the first four-to-six months for women.
"Lung cancer is associated with increased risk of subsequent stroke within one year after diagnosis for men and two years after diagnosis for women," Sung and colleagues wrote, adding that the risk subsequently decreased after that period of time.
The researchers also found that a less common type of stroke -- hemorrhagic stroke, caused by sudden bleeding into the brain -- occurred more often among the lung cancer patients than ischemic stroke, which is usually caused by a clot blocking blood flow to brain tissue.
Some evidence suggests that excessive bleeding and blood clots, both of which can be caused by tumours, as well as chemotherapy side effects, could partly explain the apparent link between cancer and stroke, researchers note.
"The most common type of lung cancer, adenocarcinoma, increases the body's propensity to form blood clots, even more so than other types of cancer," said Andrew Russman, a stroke specialist at the Henry Ford Hospital in Detroit, who was not a part of the study.
More than 52,000 people with lung cancer and more than 104,000 people without lung cancer were selected from a nationwide health insurance database.
Most of the study population was blue-collar workers such as farmers, fishermen and vendors, who tended to have high blood pressure, diabetes and heart disease.
"There's a higher rate of high blood pressure and diabetes and pulmonary disease in patients with lung cancer," Russman said.
"I think this reflects the heavy burden of smoking and smoking-related risk factors in the population."
According to the American Lung Association, smoking is directly responsible for approximately 90 percent of lung cancer deaths, while the American Heart Association said in a report that strokes accounted for one of out eighteen deaths in the United States in 2007.
"In the U.S., smokers have twice the risk of having a stroke, regardless of lung cancer," Russman said.
(Reporting from New York by Linda Thrasybule, editing by Elaine Lies)
Copyright © 2011 Reuters
Posted: 21 Sep 2011 08:50 PM PDT
REUTERS - Old, poor and Hispanic women are all more likely to have unnecessary breast cancer surgery despite 2005 recommendations for gentler treatment, according to a U.S. study.
Based on a California state cancer registry, researchers whose findings were published in the Archives of Surgery found that more than a third of some 18,000 women who had undergone a mastectomy for early-stage breast cancer had had lymph nodes under the armpits removed as well.
Yet for these women, their cancer had not yet spread beyond the breast.
"The women that were getting this unnecessary surgery were more likely to be of lower socioeconomic status, were older, or were Hispanic," said Sharon Lum, a breast surgeon at Loma Linda University in California, who worked on the study.
In 2005, guidelines recommended surgery that spares most of the lymph nodes, avoiding side effects such as pain, swelling and numbness later on.
In addition, since the mid-2000s, the American Society of Clinical Oncology has urged doctors to consider removing only the lymph nodes closest to the tumor to see if the cancer had spread beyond the breast.
Even if it had, a study earlier this year suggested that removing the lymph nodes does not help women live longer, as long as they are getting chemotherapy and radiation.
Lum said it was hard to figure out why the women receiving the unnecessary surgery were from those particular groups from the data. The gentler surgery isn't more expensive, but it does require more coordination between different departments, adding an extra step that some surgeons might prefer to avoid, Lum added.
"There are surgeons that choose not to do it, and there are patients that don't know it's better," she said.
"The take-home message for patients and surgeons is, you have to be educated about the downstream consequences of the surgery you choose to do."
In an editorial published along with the study, Jan Wong of East Carolina University in Greensville, North Carolina, said the study raises troubling questions.
"Do these data lend further evidence to the difficult of tranlsation evidence-based recommendations of care into clinical practice? If so, what are these reasons for this and how might this be corrected?" he wrote.
"Might these data suggest the selective management of women with early breast cancer based on the level of insurance coverage?"
He added that the study showed that health care systems need to more carefully examine the process of care and intervene with corrective action when needed. SOURCE: http://bit.ly/oJk1hK
(Reporting from New York by Frederik Joelving at Reuters Health; editing by Elaine Lies)
Copyright © 2011 Reuters
Posted: 21 Sep 2011 08:50 PM PDT
TRIPOLI/NORTH OF BANI WALID, Libya (Reuters) - Libya's interim rulers said they had captured one of Muammar Gaddafi's last strongholds deep in the Sahara desert, finding chemical weapons, and largely taken control of another.
In another boost, the National Transitional Council (NTC) had an unexpected windfall when it found $23 billion worth of assets left unspent by Gaddafi in Libya's central bank, the Financial Times reported on Thursday, citing officials in London and Tripoli.
The NTC is under pressure to assert its control over the country and also to revive Libya's economy and finance government institutions, hit by the long struggle to overthrow Gaddafi.
The NTC's military spokesmen said its forces had seized the outpost of Jufra about 700 km (435 miles) southeast of Tripoli, and most of Sabha.
"The whole of the Jufra area -- we have been told it has been liberated," spokesman Fathi Bashaagha told reporters in the city of Misrata on Wednesday. "There was a depot of chemical weapons and now it is under the control of our fighters."
His comments could not be confirmed independently. Under Gaddafi, Libya was supposed to have destroyed its stockpile of chemical weapons in early 2004 as part of a rapprochement with the West under which it also abandoned a nuclear programme.
However, the Organisation for the Prohibition of Chemical Weapons says Libya kept 9.5 tonnes of mustard gas at a secret desert location.
Gaddafi loyalists have been holding out in Jufra and Sabha along with the bigger strongholds of Bani Walid, southeast of Tripoli, and Gaddafi's hometown of Sirte since the fall of the capital in August.
"We control most of Sabha apart from the al-Manshiya district. This is still resisting, but it will fall," said another NTC military spokesman, Ahmed Bani.
CNN, citing a correspondent in Sabha, reported that NTC fighters had occupied its centre on Wednesday after taking the airport and a fort the day before.
NATO countries extended for three more months the air cover that helped anti-Gaddafi fighters to victory.
However, chaos prevailed among fighters besieging Gaddafi's other two remaining major strongholds. Several attempts by NTC fighters to take Bani Walid and Sirte in the past week have ended in disarray and panicked retreat.
At Bani Walid, bored militiamen fired weapons at camels and sheep while awaiting orders on Wednesday, as much a danger to themselves as to Gaddafi fighters holed up in the town.
One man shot his own head off and killed another fighter while handling a rocket-propelled grenade in full view of a Reuters team. In another incident, a fighter wounded himself and another fighter after losing control of his machinegun.
Seven NTC fighters were also killed in an ambush by pro-Gaddafi soldiers inside Bani Walid, NTC officials said.
At Bani Walid, troops from other areas have been arguing with local fighters, and there has been talk of traitors infiltrating the ranks and sabotaging the assault.
NTC official Abdullah Kenshil told Reuters that pro-Gaddafi forces in Bani Walid had killed at least 16 civilians there in the last two days after suspecting they supported the NTC.
"They were killed in cold blood. They were all civilians and they were killed execution-style," he said. His account could not be independently verified.
Sporadic fighting also continued outside Sirte, where an NTC push from the east toward Gaddafi's birthplace has been blocked for days by heavy artillery fire from loyalist soldiers.
Fighters making their way back from the front line said they were meeting fierce resistance at Khamseen, 50 km (30 miles) east of Sirte, and that they lacked the firepower to respond.
"I'm 100 percent sure that there is someone important in Sirte, either Gaddafi himself or one of his sons, because his forces have become suicidal in the Khamseen area," NTC fighter Hamed al-Hachy told Reuters.
NTC officials found $23 billion worth of assets in the Central Bank of Libya this month, boosting efforts to fund the country's recovery, the Financial Times reported.
Wafik Shater, a finance official in the NTC's stabilisation team, told reporters in Dubai the central bank had "several billion Libyan dinars". One billion Libyan dinars is worth about $820 million.
Shater said the NTC had enough money to run the country for up to six months. "We're in better shape than we anticipated initially," he added.
Libya has been pressing the international community to lift sanctions to release around $170 billion of frozen Libyan assets to the country's new leaders.
Libya's frozen assets have been held by various governments over the last half year in compliance with a U.N. sanctions regime imposed in February and March.
Copyright © 2011 Reuters
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