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Hopkins News for You
THE STAFF OF JOHNS HOPKINS INTERNATIONAL WISHES OUR FRIENDS AROUND THE WORLD A HAPPY AND HEALTHY HOLIDAY SEASON AND NEW YEAR!
This is a service for our friends around the world from Johns Hopkins International. To receive reports, please send e-mail to patientnewsletter@jhmi.edu with the name of this e-newsletter.
December 2003
Combined Chemotherapy and Radiation Saves Voice in Larynx Cancer Patients
Seeing into the Brain During Surgery
1. Daily Vitamins Could Prevent Vision Loss
2. Fighting an Old Myth: Women Are Not Immune to Heart Attacks
Combined Chemotherapy and Radiation Saves Voice in Larynx Cancer Patients
Results of a national clinical trial confirm that simultaneous treatment withchemotherapy and radiation preserves the voice of patients with advanced larynx cancer without compromising survival rates. The study's authors report that the findings, published in the New England Journal of Medicine, are important enough to have the combination treatment become the standard of care for such patients.
"Chemotherapy and radiation together are recommended for advanced laryngeal cancer patients who are otherwise in good health and want to preserve their voice," says Hopkins oncologist and otolaryngologist Arlene Forastiere, M.D.
"For patients who have other significant medical problems or little support at home, we would recommend radiation alone. In all cases, patients should be followed closely during treatment by a head and neck surgeon, so that surgery can be performed if there is residual or recurrent cancer after treatment."
In the researchers' experience, the combined treatment has reduced the need for complete removal of the larynx from 100 percent to about 15 percent. Removing the larynx leaves patients unable to speak with their natural voice; they typically use speaking aids such as an electronic device.
Seeing into the Brain During Surgery
Neurosurgeons at Johns Hopkins have entered an era in which they receive instant feedback as they operate. The technology that allows this is a new intraoperative Magnetic Resonance Imaging (MRI) scanner that can detect if a sliver of a tumor has been missed, allowing the surgeon to go back to remove it before the patient even leaves the operating table.
According to neurosurgeon Jon Weingart, M.D., the scanner also allows neurosurgeons to compensate for small shifts the brain may make during surgery. "It means we can do our jobs with more precision, more completely and in a way that is much safer for our patients," he says. The new $1 million machine gives Hopkins capabilities available at only a handful of institutions in the United States.
1. Daily Vitamins Could Prevent Vision Loss
If people at risk for advanced age-related macular degeneration (AMD) took daily supplements of antioxidant vitamins and zinc, many could avoid AMD-associated vision loss over the next five years, according to results of a recent study on the public health implications of AMD prevention led in part by researchers at Hopkins' Wilmer Eye Institute. AMD is the leading cause of blindness in developed countries.
The recent study on the public health impact of AMD is based on an earlier study two years ago of adults ages 55 to 80 with varying levels of AMD. That study showed that among people at high risk for late-stage AMD and central vision blindness in both eyes, a dietary supplement of vitamins C, E and beta carotene along with zinc lowered the risk of progressing to advanced disease by about 25 percent. Daily supplements also reduced the risk of vision loss by about 19 percent. By contrast, the supplements had no preventive effects against development of cataracts or for people without AMD or an early stage of AMD.
"The challenge lies in identifying individuals at risk, since many with the intermediate stage of AMD do not have symptoms. Regular retina exams performed by an ophthalmologist could identify those in this intermediate stage," says Hopkins ophthalmologist Neil Bressler, M.D.
2. Fighting an Old Myth: Women Are Not Immune to Heart Attacks
The facts are compelling. More women die of heart disease than any other disorder. The myth that women are immune to heart attack and stroke grew from a fact: Women generally develop heart disease years later than do men. However, Hopkins Cardiologist Roger Blumenthal says there are plenty of exceptions to even that rule.
"Women lose that 10 to 15 year advantage if they smoke, if they have diabetes, if they have a family history of early heart disease, or if they've had an early menopause and thus become estrogen deficient."
Women also can have different heart attack symptoms than men, he adds. "Men are more likely to have a heart attack with chest pain in the center of their chest that may radiate to their neck or their arm. Women may be more likely to have atypical symptoms such as shortness of breath, perhaps some upper abdominal discomfort, perhaps some shoulder discomfort. If you experience such symptoms, go immediately to an emergency room.
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