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Vol. 10, No. 2 · April 2006 · Editor: Martha L. Golar, Esq.
“The State of Cancer Care in New York” DATE: Tuesday, April 25, 2006 TIME: 6:30 P.M. PLACE: Skadden Arps Slate Meagher & Flom Four Times Square (between 6th Avenue & Broadway) New York, NY GUEST SPEAKER: Lawrence D. Brown, Ph.D. Dr. Brown, a political scientist, is Professor of Health Policy and Management Research at Columbia University’s Mailman School of Public Health. He is the author of Politics and Health Care Organization: HMOs as Federal Policy (Brookings Institution, 1983) and of articles on the political dimensions of community cost containment, expansion of coverage for the uninsured, national health reform, the role of analysis in the formation of health policy, and cross-national health policy. Dr. Brown edited the Journal of Health Politics, Policy and Law for five years, has served on several national advisory committees for the Robert Wood Johnson Foundation, has an RWJF Investigators in Health Policy Research award, and is a member of the Institute of Medicine. ANNUAL DINNER – SAVE THE DATE JALBCA’s annual dinner is scheduled for May 15, 2006, at The Water’s Edge, Long Island City, NY. Click here for PDF invitation. · National Breast Cancer Coalition (NBCC) Annual Advocacy Training Conference · Current News Items · Joint Program with NYU · JALBCA February program -- Julie Mitnick, M.D. · Calendar of Events National Breast Cancer Coalition (NBCC) Annual Advocacy Training Conference The NBCC Fund has scheduled its annual advocacy training conference for April 29 to May 2, 2006. The conference will take place at the Renaissance Hotel in Washington, DC. NBCC is the nation’s largest breast cancer advocacy group. For additional information, contact NBCC at 800.22.2838 or visit www.stopbreastcancer.org. Current News Items Natural Estrogen Levels Tied to Stroke Risk. At the American Stroke Association conference in February 2006, research results of a recent study of raloxifene, sold under the name Evista by Eli Lilly & Co., were presented. The study was led by Dr. Jennifer Lee of University of California in San Francisco and involved over 7,000 women. The main objective of the study was to test raloxifene in the treatment of osteoporosis (for which it has been approved). Women with osteoporosis, who were at least two years past menopause (after which estradiol levels drop significantly), participated in the study. They were randomly assigned to either a placebo or to raloxifene, a “designer estrogen” that blocks natural estrogen in certain parts of the body such as the breast, while increasing estrogen’s effects in other parts of the body, such as the bones. After four years, estradiol levels were measured. Among those who took raloxifene, those with lower estradiol levels had a 70% lower risk of stroke than those with higher levels. The study was financed by Eli Lilly & Co. Several women’s health researchers have said that it may be particularly risky for women to take hormones after menopause if they already have high natural estradiol levels. Note that raloxifene currently is sometimes used as a substitute for tamoxifen. Raloxifene, however, is approved by the FDA at this time only in postmenopausal women to prevent and treat osteoporosis. Both tamoxifen and raloxifene are SERMs, selective estrogen receptor modulators, not hormones. New Research Shows Artificial Light at Night Stimulates Breast Cancer Growth in Laboratory Mice. The December 1, 2005 issue of the scientific journal Cancer Research published results of a new study in laboratory mice that showed that nighttime exposure to artificial light stimulated the growth of human breast tumors by suppressing the levels of the hormone melatonin and that extended periods of nighttime darkness greatly slowed the growt of these tumors. The research was conducted at the Bassett Research Institute of the Mary Imogene Bassett Hospital in Cooperstown, New York and The Thomas Jefferson University in Philadelphia, Pa. NIH agencies provided funding for the research. This was apparently the first experimental evidence that artificial light plays an integral role in the growth of human breast cancer. Les Reinlib, Ph.D., a program administrator with the National Institute of Environmental Health Sciences (an agency of NIH) grants division, was quoted as saying, “The risk of developing breast cancer is about five times higher in industrialized nations than it is in underdeveloped countries… These results suggest that the increasing nighttime use of electric lighting, both at home and in the workplace, may be a significant factor.” It was already known from prior research that artificial light suppresses the brain’s production of melatonin. According to the researchers, the hormone melatonin strongly influences the body’s circadian rhythm, an internal biological clock that regulates sleep — wake cycle, body temperature, endocrine functions, and a number of disease processes including heart attack, stroke and asthma. David Blask, M.D., Ph.D., a neuroendocrinologist and lead author on the study said, “Evidence is emerging that disruption of one’s circadian clock is associated with cancer in humans, and that interference with internal timekeeping can tip the balance in favor of tumor development .” Dr. Blask explained that many tumors are largely dependent on a nutrient called linoleic acid, an essential fatty acid typically found in vegetable oils, in order to grow and melatonin (produced by the pineal gland, located in the brain) interferes with the tumor’s ability to use linoleic acid as a growth signal. This interference then causes tumor metabolism and growth activity to shut down. In other words, excessive light during the night wo u l d decrease the level of melatonin, allowing the tumors to use more linoleic acid. If this link between artificial lighting and cancer is confirmed, it would seem there will be a focus on the use of indoor lighting which has a wavelength and intensity that does not disrupt melatonin levels, and therefore internal timekeeping, and more closely mimics natural sunlight. Election of JALBCA Officers for 2006-2007 The following JALBCA officers have been elected to serve for the coming year and will be installed at the upcoming annual dinner. President Hon. Barbara Panepinto Judith Livingston, Esq. Vice Presidents Hon. Joan B. Carey Edward Kornreich, Esq. Cecelia F. Marcus, Esq. Barbara Paul Robinson, Esq. Hon. Ellen M. Spodek Secretary Hon. Eileen Bransten Assistant Secretary Debra Lennon, Esq. Treasurer Hon. William C. Thompson Assistant Treasurer Marvin Moskowitz, Esq. Joint Program with NYU On March 8, JALBCA co-sponsored a program with NYU Medical Center entitled “The Inside Scoop: Making Health News Work for You”. The evening consisted of a discussion about the vital role of the media in disseminating health information to the public. The program was moderated by the Hon. William C. Thompson, Justice, Appellate Division, Second Dept. (Retired). The participants and their areas of focus included the following: Health News on a National Level: How the Information Gets to You Elizabeth Kaledin, Correspondent CBS Evening News Stories Close to Home: Bringing Local Health News to the Public Graciela Rogerio, Producer, WABC-TV Reading Beyond the Headlines: Developing a Critical Eye for Print News Paul Shin, MA, MS, Staff Writer, New York Daily News Accuracy in Reporting: What Are the Legal Guidelines? Stephanie S. Abrutyn, JD, Senior Counsel, Home Box Office, Inc. The panel of speakers discussed the need, and the process followed by journalists, to validate the information which is reported to the public. It was noted that since journalists are not subject to a regulatory framework in connection with this process, there are no specific rules to be followed to evaluate the reliability of information which is disseminated to the public. Therefore, while journalists should attempt to check sources and validate information, the check-and-balance in the process is essentially an honor system, with consumers being reliant on the rigor of each journalist’s due diligence. JALBCA February Program -- Julie Mitnick, M.D. 
On February 27, Julie Mitnick, MD spoke on the subject of “Emerging Trends in Breast Imaging” to an audience of approximately 35 people. At the outset, Dr. Mitnick noted the trend of successful screening in that the tumors n ow being located are one-half the size of those identified in the past. She also discussed the difficulties confronted by radiologists who have patients with breast implants, since these interfere with the ability to accurately read the mammogram results. Other general trends, which are not specific to imaging
but which are relevant to radiologists, are the fewer number of radiologists who want to perform mammographies, the reduction in Medicare reimbursement for the procedure, and the increase in lawsuits against radiologists.Dr. Mitnick reviewed current screening recommendations. The procedure is generally recommended for people starting at age 40, how ever screening is also recommended for certain groups of people who are younger: those with a personal history of breast cancer, a high risk lesion on biopsy, a strong family history, a BRCA gene mutation, and a history of chest radiation. Further, Dr. Mitnick presented slides to demonstrate how cancer presents to a radiologist and how to increase the odds of detection. As to the latter, Dr. Mitnick mentioned the possibility of double readings (which increases sensitivity by 10%), computer- aided detection (which increases sensitivity by 7%), use of an experienced facility/radiologist, and use of additional tests such as ultrasound and MRIs. MRIs enable the radiologist to evaluate breast implants, monitor responses to therapy and define the extent of the disease (e . g ., multi-centricity of the cancer). Moreover, MRIs are not affected by post-surgical or post-radiation fibrosis, or by breast density, which is a problem with conventional mammography. The overall sensitivity of mammograms is 80-85%, whereas the sensitivity of mammograms involving dense breasts, common among younger women, is only approximately 48%. One problem with MRIs is that it is a non-specific diagnostic tool which, by being very sensitive, picks up multiple areas, both malignant and benign. This can lead to false positives and unnecessary biopsies. Dr. Mitnick recommended that MRI facilities also have biopsy capability so that biopsies can be performed at the same facility if something troublesome is identified in the MRI. She further stated that a breast MRI should be performed at a breast-imaging facility, rather than a general body-scanning facility.  Additionally, Dr. Mitnick discussed calcifications, approximately 80% of which are benign. Showing several examples on slides, she indicated the potential threat of calcifications which h ave an irregular appearance or which are linear and branching. Finally, Dr. Mitnick reminded the audience that screenings are costly procedures and insurance companies are reluctant to c over them. The standards for insurance reimbursement eligibility are limited. Calendar of Events Tuesday, April 25, 2006 The State of Cancer Care in New York
Monday, May 15, 2006 Annual Dinner at The Water's Edge, Long Island City, NY. Save the date. Click here for PDF invitation. SHARE Self-Help for Women with Breast or Ovarian Cancer) 1501 Broadway New York, NY 11530 Also: QueensSHARE, HarlemSHARE, and BrooklynSHARE www.sharecancersupport.org Newly Diagnosed with Metastatic Disease. If you have been diagnosed with metastatic breast cancer within the last 6 months, join other SHARE participants who have been living with metastatic disease for many years. Bring your concerns and questions to these interactive sessions. Please register through the Main office phone number or through the SHARE Breast Cancer Hotline (212) 382-2111, or through the SHARE Ovarian Cancer Hotline (212) 719-1204.
MEMORIAL SLOAN-KETTERING CANCER CENTER Post-Treatment Resource Program Educational Forums 1275 York Avenue, Room M107 New York, NY 10021 212.717.3527 www.mskcc.org Focus on Lymphedema
Autologous Stem Cell Transplant: Transitions
ADELPHI NY STATEWIDE BREAST CANCER Hotline & Support Program Adelphi University School of Social Work Garden City, NY 11530 www.adelphi.edu/nysbreastcancer/index.html JALBCA does not endorse the content or efficacy of any workshops or programs listed in the Calendar of Events; listings are for informational purposes only, so that our readership is aware of current offerings. |
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