Health Headlines - October 17

Marriage Won't Affect Breast Cancer Prognosis

Marital status does not affect prognosis for women with early stage breast cancer who are treated with lumpectomy and radiation.

This finding, presented Sunday at the 47th annual meeting of the American Society for Therapeutic Radiology and Oncology in Denver, is in contrast with previous cancer research.

It's unclear how the results will influence treatment decisions, other than to reassure women that, whether they are single, married, widowed or divorced, their prognosis is the same, said Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Clinic Foundation in Baton Rouge, La.

Dr. Shelly B. Hayes, lead author of the study and chief resident in the radiation oncology department at Fox Chase Cancer Center in Philadelphia, borrowed the idea for the study from similar research done on survival rates of men and women with head and neck cancer who underwent radiotherapy.

In those cases, men who did better in terms of survival were married, although there was no apparent association between survival and marital status for women.

The differences may have been attributable to psychosocial factors. For someone with head and neck cancer, every day of treatment missed decreases the cure rate by 3 percent. Married men, it is surmised, may be more compliant with treatment, with their wives making sure they get to treatment sessions, researchers said.

Women also may be getting themselves to treatment sessions. "Women, in general, tend to be more compliant with treatment than men," Hayes confirmed.

Women with breast cancer are an entirely different patient population, however. "People with head and neck cancer are generally smokers and drinkers," Hayes explained. "The risk factors are quite different than for breast cancer so there's a whole set of psychosocial issues that generally aren't present with breast cancer patients."

Hayes' study involved 2,143 women with early stage breast cancer treated with both lumpectomy and radiation at Fox Chase Cancer Center between 1984 and 2003.

Participants were divided into four groups based on marital status: married (63 percent), single (10 percent), divorced or separated (10 percent) and widowed (18 percent). They were followed for a median of 76 months.

The research team found no statistically significant association between marital status and relapse-free survival. "Marital status alone wasn't significant as an independent predictor of outcome in terms of freedom from cancer," Hayes said.

Age, on the other hand, was found to be predictive of relapse-free survival, with women younger than age 40 doing worse than women over 70, despite similar tumor characteristics and treatment factors.

"Because marital status wasn't independently predictive of outcome while age was, maybe with younger women we need to be more aggressive in treating breast cancer," Hayes said.

There were, however, other differences corresponding to marital status. Women younger than 40 were more likely to be single, while women older than 70 were more likely to be divorced. Divorced women on the whole were younger than married women. Women who had been widowed were more likely to have tumors detected by mammography rather than a physical exam.

Two other studies, also from Fox Chase Cancer Center, addressed differences in breast-cancer outcome based on treatment decisions.

One study found that the order in which tamoxifen and radiation are given following a lumpectomy for early stage breast cancer does not affect recurrence, survival or complication rates. Giving tamoxifen at the same time as radiation, however, has negative cosmetic results, the researchers said.

The second study found only a marginal benefit in giving an aromatase inhibitor drug to women with invasive breast cancer who have already undergone lumpectomy, radiation and five years of tamoxifen. Adding an aromatase inhibitor to this group of women, all of whom were disease-free after their treatment, would result in just a 1 percent to 2 percent clinical benefit.

Usually, a benefit level of 3 percent is needed before adding another therapy. Women with node-positive breast cancer along with women aged 60 or younger would be more likely to benefit from an aromatase inhibitor after an initial five years of tamoxifen, the researchers said.

Health Tip: Jumping for Joy Over a Trampoline?

No matter how much your child begs you to buy a home trampoline, your answer should always be "no," advises the American Academy of Pediatrics.

Every year, emergency rooms treat thousands of children with trampoline-related injuries, most of which occurred at home.

The academy recommends that trampolines be used only in supervised training programs at outdoor playgrounds or in schools.

Because of their immature motor skills, children under age six shouldn't use trampolines at all, the AAP warns.

Health Tip: Don't Leave Your Infant Alone

Although your young infant may not be able to get around much, she may still be able to wiggle her way to harm.

Here are some safety tips, courtesy of Cincinnati Children's Hospital.

Never leave your baby at home alone.
Only leave your baby alone in a room when she is in a playpen or crib.
Stay with your baby when she is on a dressing table, bed or couch.
Stay near your infant when she is in an infant seat, swing or high chair.
Never leave your baby alone in a room with a dog, cat or any uncaged pet.