Keep abreast of what your patients are currently seeing in the media with our round-up of popular news stories, available from WHF as abstracts with links to the full-text articles.

From the week of May 19, 2008:

HRT Hype Means Women Miss Out

In recent years hormone replacement therapy (HRT) has gotten a plethora of negative press, with articles and studies suggesting that the use of HRT can lead to heart disease and breast cancer among women, regardless of age. HRT is used primarily by women to control the symptoms of menopause, such as hot flashes and facial flushing. The Women’s Health Initiative (WHI), a landmark study involving more than 27,000 women, was halted after participants experienced an increased number of cardiovascular troubles, such as heart attack. After results from this study were published, HRT usage rates fell by half. However, many researchers dismiss HRT warnings, and find many flaws in the research that has been done. According to the International Menopause Society, the association between HRT and heart disease and breast cancer are not justified by the clinical evidence. Concerns are now being expressed that women are unnecessarily suffering the symptoms of menopause, when they could be safely using hormones to control many of their symptoms. Especially for healthy women at the onset of menopause, the use of HRT for several years may pose little risk to their health. While the debate over the safety of HRT continues, women should be proactive in approaching their health care provider with questions about HRT, and discussing whether treating their menopause symptoms with hormone therapy is a safe and appropriate course of action.

Read the full story on bbc.co.uk

CDC Recommends Shingles Vaccine for Those Over 60

Shingles, a disease caused by the chickenpox virus, causes blistering on the face and body that can lead to pain that lasts for weeks, months, or even years. Severe cases can also affect the patient’s hearing and vision. Of the 1 million reported cases of shingles in the United States each year, half of them occur in people aged 60 and older. Merck & Co offers a vaccine, ZOSTAVAX^®, which reduces patients’ risk of developing shingles by about two-thirds. The US Centers for Disease Control and Prevention (CDC) now recommends all adults aged 60 and older to be vaccinated against shingles. More than 50% of adults who live to the age of 85 will develop shingles at some point in their life. Widespread use of the ZOSTAVAX vaccine can help cut these numbers significantly, and help older people avoid the pain of shingles. Certain people should not receive this vaccine, such as those with an immunodeficiency disease. The cost of the vaccine is also expected to be a deterrent, as it is currently priced around $150. It is hoped that the new CDC recommendation will encourage more health insurance companies to cover the cost of the vaccine.

Read the full story on healthday.com

Mastectomies on the Increase

In 1990 breast cancer treatment guidelines were released announcing lumpectomy is equally effective for overall survival in women for early-stage breast cancer. Consequently, there was a rise in the number of lumpectomies performed, and mastectomies saw years of declining rates. In the past 10 years, however, this trend has started to reverse, in part due to greater use of magnetic resonance imaging (MRI). Doctors often detect cancer in multiple areas of the breast when using MRI, as well as finding noncancerous lesions that may prompt women to choose mastectomy over lumpectomy. Improvements in breast reconstruction options are also swaying women toward mastectomy, many of whom feel they have a far diminished chance of recurrence if they undergo a full mastectomy. Another factor in choosing mastectomy over lumpectomy is newly available genetic testing, which has alerted some women to a genetic predisposition they carry for developing breast cancer. Researchers have not yet determined whether rising rates of mastectomies will influence breast cancer recurrence rates and overall survival time, or if it is merely reflective of a more cautious and proactive approach to healthcare.

Read the full story on healthday.com

Screening for Abuse May Be Key to Ending It

According to guidelines set forth by the surgeon general, the American Medical Association, and other professional groups, domestic violence should be routinely screened for by doctors much in the same way that they screen for smoking and alcohol abuse. If a patient claims he or she is not a victim of abuse, the doctor should move on to the next question. But should physicians give more weight to a health risk that is much more prevalent in women than breast or colon cancer, both of which women undergo extensive screening for? Many healthcare providers do not routinely screen for domestic violence at all, for reasons such as not wanting to offend their patients, and not believing that asking will make any difference. Some patients who are victims of domestic violence report that their healthcare provider did not adequately inquire about the origin of their injuries. Others say that when they did disclose the abuse to their doctor, they received an uncomfortable or poor reaction. Doctors can help end domestic violence by being more alert for signs of abuse, and not being afraid to ask patients how their injuries occurred. Developing a better relationship with a patient can help encourage abuse victims to view their healthcare provider as someone to turn to for help. Physicians should also check for signs of depression, anxiety, alcohol and substance abuse, and chronic pain in suspected domestic violence victims, as abused women are at an increased risk for these conditions.

Read the full story on nytimes.com