VIEWS: 4 PAGES: 8 POSTED ON: 7/28/2011
THE VOICE Issue 16, Spring 2010 for Women & Families New Health Care Law Spreads a Little Sunshine When your doctors recommend a payments to doctors through third medication or treatment to you, are What’s Inside parties, such as public relations they influenced by gifts from the firms, and that would be unaccept- companies that make those prod- able. And, it’s very unfortunate that Cancer Prevention 5K ........2 ucts? We’re not talking about free the information won’t be public pens — we’re talking about “con- until 2013.” Tanning Bed Safety ............3 sulting fees” and gifts that may not require anything more than signing What Works? Weight and Cancer..............4 a piece of paper. In the past, you’d never have known. Patients will also benefit from a part Glucosamine........................5 of the new health care law that The new health care law changes establishes a nonprofit institute to Early Breast Cancer ............6 that. It’s just one of several sections compare the effectiveness of drugs, of the law that have not received medical devices, and other treat- Meet Board Member much media attention but will help ments. This research is urgently Dr. Ben Gitterman................7 improve health care for everyone. needed. According to the Institute of Medicine, “More than half of the Sunshine Helps Prevent treatments delivered today [are] Kickbacks and Biased without clear evidence of effective- Medicine ness.” National Research Center NRC for Women & Families worked The law establishes the Patient- for Women & Families for three years on the Physician Centered Outcomes Research Payments Sunshine Act, which Institute, which will give guidance became part of the health care on which products or treatments We are dedicated to improving reform bill President Obama signed work best. It will not force doctors, the health and safety of adults into law in March. The sunshine patients, government agencies, or insurance companies to choose one and children by using part of the law requires drug and medical device companies to list treatment over another, even when research to develop more a treatment is clearly inferior or payments to doctors, which will be effective programs and policies. available to the public on a govern- superior. The Institute’s findings ment web site beginning in will be made available to doctors, Cancer Prevention September, 2013. patients and the public, with the hope that the information will be and Treatment Fund “Making this information public is a used to improve the quality of med- Our new program, the Cancer Prevention & step in the right direction to protect ical care. Treatment Fund, helps adults and children consumers and patients,” says Paul Brown, NRC’s Government Comparative effectiveness research reduce their risk of getting cancer and helps Relations Manager. “But we’re has the potential to save billions of everyone get the best possible treatment. dollars by determining which treat- keeping a sharp eye out for loop- CFC # 11967 holes. Companies might try to hide continued on page 5 EVENTS First 5K Run/Walk for the Cancer Prevention and Treatment Fund! Our first Cancer Prevention and Both runners received a $50 and to honor those who lost their Treatment Fund 5k Run/Walk was Potomac River Running Store gift lives to cancer. We thank all those held in Arlington, Virginia on certificate. Complete results can be who participated in, volunteered, or March 27 on the Washington & Old found on our website at donated to our first 5k, and we hope Dominion Trail. It was so popular www.stopcancerfund.org/events. you and your friends will come back that we had to turn peo- in October. Special thanks to runner ple away. So, we’re Brian Dauernheim for raising $435 doing another walk on from friends and family to help us the same trail this fall, on prevent cancer!” Sunday, October 3. See announcement at the bottom of “It was a little colder the page for information about than expected for late Friend and Family sponsorships to March, but a beautiful honor loved ones. sunny day for runners, walkers, and those push- ing strollers for a great Thanks to our cause,” says Emily Hartman, the NRC Sponsors of the March 5k: Research and Administrative From Left to Right: Tom Walton, Ronda Walton, Matthew Mom’s Organic Assistant—and dedicated Crooks, and Shawn Monk wait for the awards ceremony. runner—who was in charge of the Market race. Runners and walkers ranged Long and Foster of in age from 7 to 75, with most par- “We want to have one 5k every ticipants over the age of 30. year, but thought we’d try an autumn run/walk because the Falls Church Children under the age of 15 weather is a little more predictable” received a blue ribbon for partici- explains Paul Brown, Government pating, and prizes were distributed Relations Manager and enthusiastic Luluemon Athletica to winners according to age groups: runner. “So, instead of waiting til Honest Tea 15-24, 25-34, 35-44, and over 45. next year, we’ve scheduled it for early October, and we’re moving it a The first place male finisher was little later in the morning to make it Shawn Monk from Fort Collins, more family friendly.” Brugger’s Bageles Colorado, with a time of 19:01. Amy Bortnick from Berwyn Heights, NRC wants runners, walkers, par- Marlyand grabbed the first place ents with strollers—everyone—to Reston Shirt female slot with a time of 22:35. help us celebrate cancer survivors Mark your calendars! Our next 5K race will be Sunday, October 3, 2010, at 11a.m. October For more information, please contact Paul Brown at Su M Tu W Th F Sa firstname.lastname@example.org or call (202) 223-4000. 1 2 Individuals or families that wish to honor loved ones with cancer are 4 5 6 7 8 9 3 invited to celebrate their lives with Friend and Family sponsorships 10 11 12 13 14 15 16 at our October race. 17 18 19 20 21 22 23 2 HEALTH MATTERS Tanning Beds: Safe Alternative to Sun? Tanning beds are advertised as a newer kind of “high-pressure” sun- they just assumed tanning devices safe alternative to a natural suntan, lamp exposes frequent users to even were safe instead of asking compa- and almost 30 million people in the more UVA — eight to twelve times nies to prove that they are safe. As U.S. use them each year, many of the amount of UVA they would oth- a result, companies had no incentive them adolescents. They are espe- erwise receive from the sun each to do research to find out if their cially popular with teen girls getting year. tanning devices were causing any ready for prom season, and young harm or even to show they were people who don’t want to look pale safer than other tanning devices on when they first go to the beach. These increase your risk the market. for all three types How safe are they? of skin cancer: That may change soon, because the FDA is now deciding whether tan- Tanning beds expose people to a lot • Lifetime exposure to UV radia- ning device companies need to pro- of artificial ultraviolet (UV) radia- tion (from the sun or tanning beds) vide evidence of safety, and if so, tion in a short period of time. In the what kind. Meanwhile, more than past, tanning beds gave off mostly • Family history of skin cancer half of all states have restrictions UVA radiation with a small amount prohibiting or limiting tanning bed of UVB. Now, many manufacturers • Geographic location (people use by minors, and the American are increasing the amount of UVB who live close to the equator as Academy of Pediatrics has recom- radiation to speed up the tanning well as in the mountains are mended that tanning beds not be process. This is risky because UVB exposed to higher levels of UV used by anyone under 21. radiation is the kind that causes the radiation) skin to redden and burn and is even Skin cancer is the most common more likely to cause cancer than • Fair skin that freckles or burns form of cancer, with more than one UVA radiation. easily million cases diagnosed each year in the U.S. There are three types of Getting sunburns when you are • Severe sunburns as a child skin cancer: squamous cell, basal young greatly increases your cell, and melanoma. Squamous cell chances of developing skin cancer. In July 2009, the International carcinomas typically occur on sur- One study found that nearly 60% of Agency for Research on Cancer faces exposed to excessive sunlight, teens who use tanning beds have released a report that placed tanning such as the ears or face. This type of gotten burns from them. While UVA beds in its highest cancer risk cate- skin cancer can spread quickly to radiation is less likely to burn, it gory, “carcinogenic to humans.” other organs in the body. Basal cell penetrates deeper into the skin, This means that there is enough evi- carcinomas account for 8 out of 10 causing damage that can lead to dence to conclude that tanning beds skin cancers. They grow very slowly skin cancer. can cause cancer in humans. The and rarely spread to other parts of agency, which is part of the World the body (as a result, they are highly Regardless of their mix of UVA and Health Organization (WHO), had treatable). UVB rays, tanning devices age the previously classified tanning beds as skin by destroying skin fibers and “probably carcinogenic.” The Melanomas are the most dangerous damaging elasticity. The result: change comes after an analysis of type of skin cancer. They are less wrinkles, dark spots, and a leathery more than 20 studies showing that common than basal and squamous texture. people who begin using tanning cell carcinomas but much more seri- devices before age 30 are 75% more ous. Melanomas usually are noticed Just one 8-20 minute session exposes likely to develop the most serious as a change to an existing mole or a person to more UV radiation than type of skin cancer. an entirely new mole that is black or an entire afternoon spent in natural has a blue-black area. Their diame- sunlight. For a frequent tanning bed One of the reasons that tanning beds ter is typically larger than that of a user (approximately 100 sessions per are so dangerous is that the Food pencil eraser. If caught early, year, at 4 MED/session), annual and Drug Administration (FDA) has melanomas are often completely UVA exposure can be up to five not regulated them. The agency curable. However, they are much times as high as what they would treated tanning beds like band-aids more likely to spread to other parts receive from the sun in a year. A rather than like prescription drugs: of the body if not found early. ■ 3 HEALTH MATTERS Weight and Cancer: What You Should Know There are many reasons why being excess weight is partly due to the esophagus, and kidney. Unlike the overweight is bad for our health, hormones secreted by fat tissues. findings of the latest study, this ear- but most people don’t realize that One of those hormones is estrogen, lier study found that obesity was cancer is one of them. We know which increases the risk of endome- only weakly associated with post- that excess body weight can con- trial cancer (also called uterine can- menopausal breast cancer. tribute to serious medical conditions cer) and breast cancer. such as heart disease and type 2 dia- Does losing weight reduce betes, but new research shows that Fat cells also trigger a type of long- your risk of cancer? the habits that lead to excess body term immune response in the body fat might also increase the risk of because it recognizes that the extra Several studies have shown that a developing certain types of cancer. fat is not supposed to be there, and diet high in fat increases the risk of responds with inflammation which postmenopausal breast cancer, After studying people in 30 can make the body less able to fight prostate cancer, and pancreatic can- European countries, Dr. Andrew off disease. cer. Other studies have indicated Renehan says that obesity could become the most important known cause of cancer for women “within Why is being overweight even riskier for women? the next decade." Renehan studied cancer diagnoses in 2008 and found In addition, long-term inflammation that high fat diets increase the risk that more than 124,000 (about 3% of may cause insulin resistance, which of death from cancer and that low cancer diagnoses in men in those along with high blood sugar levels, fat diets reduce the chances of can- countries and almost 9% in women) has been proposed as another expla- cer recurrence. Since eating fats is were attributable to overweight and nation for why obesity increases the also likely to cause obesity, it is dif- obesity. risk of cancer. The higher the insulin ficult to determine whether weight level of a breast cancer patient, the or diet is a stronger predictor of Although women and men had sim- greater the chance of death: insulin increased cancer risk. In other ilar levels of obesity, as measured by is believed to play a role in promot- words, is it the fat you eat or the fat their BMIs, the risk of obesity-relat- ing tumor growth and in inhibiting on your body that puts you at the ed cancer for women was almost cancer treatment. greatest risk of cancer? three times the risk for men. Three cancers—two of which affect only Are we sure? Can losing weight prevent you from women—accounted for almost two- getting cancer? Losing weight may thirds of all new obesity-related can- Even before this new study, the reduce the risk of prostate cancer cers in 2008: endometrial cancer, National Cancer Institute estimated and esophageal cancer. Several stud- post-menopausal breast cancer, and that 20-30% of the most common ies have found that intentional colorectal cancer. cancers in the United States may be weight loss after menopause can related to being overweight and/or reduce the risk of breast cancer. U.S. obesity rates have recently lev- lack of physical activity and might eled-off at about one in three adults, also account “for up to 14% of can- The bottom line: when weight goes and the American Institute for cer deaths in men and 20% of cancer up, so does the risk of many cancers. Cancer Research estimates that will deaths in women.” Every new study When weight goes down, or at least result in more than 100,000 new fills in another piece of the puzzle, doesn’t go up, the risk of certain cases of cancer in the U.S. each year. helping to explain how fat fuels cancers goes down. The exact rela- tumor growth. tionship between cancer and excess body weight has not been firmly How does obesity increase A previous studied by Renehan established. We still do not under- the risk of cancer? found that excess weight in men stand how an individual person’s was most strongly associated with diet, level of physical activity, and cancer of the esophagus, thyroid, genes can all be factored together to What does excess body weight have colon, and kidneys. That study also calculate his or her cancer risk. to do with cancer, and why is being found that excess weight in women overweight even riskier for women? was most strongly associated with Researchers think that the danger of cancer of the uterus, gallbladder, 4 HEALTH MATTERS Glucosamine Supplements: Good for joints but possibly not for diabetes New Health Care Law Glucosamine is a popular supplement for many peo- ple who suffer from joint pain. Most dietary supple- continued from front page ments make health claims that aren’t backed by scien- ments are safest and most effective. tific research, but NIH reports that daily doses of glu- The FDA does not require those cosamine can lower pain. As a result, the supple- kinds of comparisons and NIH only ments are recommended by many physicians. rarely does. The Agency for Health However, glucosamine is a sugar that is partly Research and Quality does, and in processed like other forms of glucose—mainly the House of Representatives ver- through the “Hexosamine Signaling Pathway.” This sion of the health care bill, this work pathway is involved in insulin resistance (insulin resistance increases a per- would have been done by that fed- son’s chances of developing type 2 diabetes). eral agency. “We are concerned about Congress requiring the More research is needed to determine whether glucosamine supplements Institute’s board to include repre- can cause diabetes in healthy adults, but meanwhile, if you are already at sentatives of companies that sell risk for diabetes or have diabetes, you will want to think twice before taking medical products,” adds Brown. glucosamine. “We will be watch-dogging the Institute to make sure that they are Glucosamine is already used in laboratory settings and animal studies to focused on improving the public induce insulin resistance, indicating that scientists are confident it has that health, not protecting profits.” effect. A study of healthy men and women taking 1500 mg of glucosamine for six weeks, published in The American Journal of the Medical Sciences, con- These are just two of the many hid- cludes that adults who already have poor insulin sensitivity will increase den gems in the new health care their risk for diabetes if they take glucosamine. reform law. More widely publicized benefits include requiring insurance The bottom line: if you have a family history of diabetes or are overweight, companies to cover dependent chil- glucosamine could put you at greater risk for diabetes. dren up to age 26 in family insur- ance policies, and banning discrimi- nation for pre-existing conditions. Leaving A Legacy “There are so many ways to improve health care in this country, and the new law takes some impor- If we can’t live forever, at least we can help keep our tant steps in that direction,” says Dr. legacies alive, as well as the legacies of those most Diana Zuckerman, President of NRC important to us. Creating an internship is a wonderful for Women & Families. “The big fights – such as keeping drug prices way to honor a family member, friend, or create your down and expanding Medicare to own legacy. Internships provide training that can let younger people pay into medical coverage – were impossible to win result in a lifetime of good works, and help NRC make this year, but we won some of the a difference in the lives of adults and children every smaller ones, and those will help day. You can donate to legacy internships, or establish millions of Americans. We will con- tinue to work with Congress to a new internship or fellowship through a donation of improve the law that passed.” cash or stock, a distribution from a retirement plan or life insurance policy, or a will. We don’t accept funding from drug companies, so we rely on individual contributions. We welcome donations For more information, call Brandel at (202) 223-4000 online (www.center4research.org), by check, through United Way (just write in or email her at email@example.com our name) or federal employees can designate CFC # 11967 5 HEALTH MATTERS Helping Women with Early Breast Cancer Board of Directors The good news about breast cancer is that women are being diagnosed earlier than ever before, and mortality rates have decreased. The bad news is that George Thomas Beall, Managing Director women with the earliest, most treatable cancer are more afraid than they Global Social Marketing Practice, Ogilvy Public Relations Worldwide need to be. Our Cancer Prevention and Treatment Fund is making sure that patients and health professionals understand the latest information about the Wendy Braund, MD, MPH, MSEd most common very early form of breast cancer, Ductal Carcinoma in Situ U. S. Department of Health & Human Services (DCIS). Arthur L. Caplan, PhD, Director Center for Bioethics, University of Pennsylvania School of Medicine Thanks to a generous grant from the DC Cancer Consortium, we will be working with local providers and patients to develop a model program and Ben Gitterman, MD, Associate Professor Pediatrics and Public Health materials to help women get the best treatment. Children's National Medical Center Because of the widespread use of mammography, the number of DCIS cases Mary G. Hager, MA, Writer has shot up by 750% over the last two decades! About one out of every five Nancy Hardt, MD, Professor and breast cancer diagnoses is DCIS. Associate Dean, University of Florida College of Medicine Why is that good news? A diagnosis of DCIS means that cancerous cells were Judith L. Harris, JD Partner, Reed Smith found in the lining of the breast duct and will not spread. Cancer that does not spread is not dangerous. If they aren’t treated, however, about half the Alan Mendelson, LLD women with DCIS will eventually get Stage 1 breast cancer, which can spread Axion Venture Partners and can be fatal. Since it is not possible to predict who will go on to develop Sharon Scribner Pearce, Director of Stage 1 breast cancer and who won’t, all women with DCIS should be treated. Public Policy, Girl Scouts of the USA The most dreaded breast cancer treatments Omega Logan Silva, MD are not needed to treat DCIS Former President, American Medical Women’s Association The most dreaded breast cancer treatments are mastectomy (removing the Susan F. Wood, PhD entire breast) and chemotherapy (which often causes nausea and hair loss) George Washington University and neither are needed to effectively treat DCIS. Instead, the standard treat- Diana Zuckerman, PhD, President ment recommended for most women with DCIS is lumpectomy and radia- NRC for Women & Families tion, which results in a survival rate of more than 96%. Some women also take tamoxifen, a hormone treatment that further reduces the already low National Advisory Board risk of cancer. The Honorable Rosa DeLauro (CT) Unfortunately, many women are not fully informed about the difference Mark Frankel, PhD, AAAS between DCIS and “regular breast cancer” – the kind that can spread and be fatal. As a result, many women with DCIS undergo mastectomies that are Pat Hendel, Commissions for Women not medically necessary. The survival rates are no better for women under- Phyllis Katz, PhD, Institute for Research on going mastectomy or even a double mastectomy. Social Problems Sally Kenney, PhD, U. of Minnesota A few years ago we worked with the National Institutes of Health (NIH), the Center for Women & Public Policy National Cancer Institute, and the Agency for Healthcare Research and Quality to develop a very successful free patient booklet, “Surgery Choices Rebecca Klemm, PhD Klemm Analysis Group for Women with Early-Stage Breast Cancer.” Using that booklet as a model, we will develop a free booklet for patients with DCIS. We will convene local Irene S. Levine, PhD breast cancer experts, physicians, and other health care providers in NYU School of Medicine Washington, D.C., to discuss the newest research and expert consensus state- Lisa Lopez, JD, Haemonetics ment issued a few months ago by NIH. We will then pilot test the booklet with women in Washington, D.C. Mary McDonough, Actress and Director Shari Miles, PhD, American Psychological Meanwhile, our work on DCIS has already helped many women across the Association country. They are contacting us through our online hotline and web site The Honorable Olympia Snowe (ME) (www.stopcancerfund.org). “We’re excited that we will now be able to reach out to and help women right here in our own community,” explains Brandel Judy Woodruff, The NewsHour with Jim Lehrer France de Bravo, our Director of Outreach and Communications. 6 POLICY MATTERS Meet Board Member Dr. Benjamin Gitterman Dr. Benjamin Gitterman is a pedia- He co-founded and is Co-Director of should also be asking, ‘What’s your trician who is also a pioneer in the the Mid-Atlantic Center for Chil- home like? Have you done recon- relatively new field of children’s dren’s Health and the Environment struction? Does your family use environmental health. When he’s nine years ago. The center is one of alternative medications?’” explains not attending to his young patients ten federally funded Pediatric Gitterman. in Children’s Hospital National Environmental Health Specialty Medical Center and in Silver Spring, Units and provides medical consul- Being appointed to the Governor’s Maryland, he is helping to educate tations and information to parents Council on Children’s Health and other doctors, medical students, and and health care professionals in Environment for Maryland has policy-makers on the many environ- Delaware, Maryland, Pennsylvania, given him new opportunities to pro- mental health issues that affect our Virginia, Washington, D.C. and tect children. His influence, how- nation’s children. These include West Virginia. ever, is nationwide: he has been on asthma, which is exacerbated by air the EPA Science Advisory Board for pollution, cancer-causing chemicals Children’s Environmental Health in our homes and food, and many and serves as a liaison to the other health issues. Advisory Committee on Children’s Lead Poisoning and Prevention for Dr. Gitterman’s interest in environ- the CDC. mental health was sparked when he was working in Denver and was Taking the Pie Out of the Sky told that all children on Medicaid would have to be tested for lead. “I “There are practical ways to connect thought that was not the best use of with underserved and middle class resources. It was hard for me to families on environmental health imagine that kids in Colorado might besides talking about carbon foot- be suffering from the same health prints and the far-off dangers of problems as inner city children liv- global warming,” Gitterman points ing in old buildings in New York out. “My role is to bring the pie out with lead pipes and layers of lead Hidden Environmental Risks of the sky. We need to tell people paint.” He soon learned, however, what’s useful for them—whether it’s that lead poisoning was an issue, Most parents and all doctors are a pediatrician dealing with migrant and they published their findings. aware of the dangerous exposures families who work with pesticides and ingestions that send a child to or a parent who needs tips for man- Dr. Gitterman grew increasingly the hospital—whether from some- aging his child’s weight.” concerned about the sometimes thing found under the sink or in the invisible health risks of children’s medicine cabinet. But there are less “I’m excited to be the most recent homes and neighborhoods, and obvious “poisonings” that are per- addition to the board of NRC, par- before long the Children’s haps even more dangerous. These ticularly because of NRC’s work on Environmental Health Network con- include children becoming obese environmental health: testifying tacted him. They asked him if he because the community they live in before the FDA on Bisphenol A in would become a spokesperson and has no stores with healthy foods and baby bottles and in the linings of advocate, teaching environmental no safe places for play and physical canned food and infant formula; health to pediatricians, public health activity, and babies drinking from helping to pass legislation to remove specialists, and others working plastic milk bottles or sippy cups lead and phthalates from toys; and closely with families. made from chemicals linked to can- raising awareness about the need for cer and other health problems. more research on the health risks of He moved to Washington, D.C. in cell phones.” 1995 to continue caring for under- Gitterman’s goal is excellent care, served children and their families, which includes ensuring that pedia- “We’ve worked with Ben for years and to educate doctors, parents, and tricians are making environmental and it’s great to have his input, policy makers about reducing health health part of routine exams. “Just energy, and collaboration,” says risks in children’s homes and com- as a pediatrician asks, ‘How much NRC president Dr. Diana munities. milk does your baby drink? How Zuckerman. well does he sleep?’ he or she 7 We Gratefully acknowledge the following 2009 In this Issue of THE VOICE President’s Circle Donors: Thomas Beall New Health Care Law Spreads a Little Sunshine Page 1 Nancy Beang First Cancer Prevention 5K Michael Berman Page 2 Ryan Bradshaw Tanning Bed Safety Page 3 Arthur Caplan Weight and Cancer Joshua Frederickson Page 4 Judith Harris Good for joints but Glucosamine Supplements bad for diabetes? Sandra Hittman Page 5 See page 5. Lisa Lopez Help for Early Breast Cancer Alan Mendelson Page 6 Susan Wood Meet Board Member Dr. Ben Gitterman Page 7 Anne and Leo Zuckerman NRC NONPROFIT ORGANIZATION U.S. POSTAGE PAID PERMIT NO. 2442 FOR WOMEN & FAMILIES National Research Center for Women & Families www.center4research.org Cancer Prevention & Treatment Fund www.stopcancerfund.org 1701 K Street, NW, Suite 700 Washington, DC 20006 Phone: (202) 223-4000 To:
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