Dr Bob's Newsletter September 2004 by Robert Roy MD

Additional Treatment for Prostate Cancer May Enhance Improved Outcomes

A recent article in the Journal of the American Medical Association showed improved survival in men who underwent a combination of androgen suppression and radiation therapies. In the study of 206 men who had localized prostate cancer. This study is significant because of the shortened time of male hormone sup- pression. There are numerous side effects with long term suppression. When compared with radiation alone the combination therapy improved survival from 78% to 88%.

Dr Bob's Take: this was a well conducted study and may be a landmark study. It may be the basis of a new treatment method for men with prostate cancer which is localized. A larger study though is still needed to be sure these results can be duplicated.

MRI Screening for Breast Cancer

A recent article in the New England Journal of Medicine showed that MRI screening for women who are at high risk for breast cancer was much better. High risk was defined as those women who had family history of breast cancer and those who are genetically predisposed with positive BRCA tests. In the study 1900 women the study picked up 51 women with breast cancer of which 20 were not detected by routine mammograms or breast examinations. The women were followed on average for 2.9 years.

Dr Bobs Take: This is both good news and bad. The good news is that another diagnostic method is starting to be used for high risk women. The bad news is there are many false positive results. False positive is where there is an abnormality thought to be a tumor but turns out it wasn't. Routine mammograms have much less false positives. Also, the MRI techniques vary widely from center to center.

Drug + Therapy Combo Best for Teen Depression

A major study has proved that a combination of counseling therapy and anti depressants are much better than either alone. This was a study done through Duke University. There were 439 children age 12 -17 y.o. There was less suicide tendency with the combination. Dr Bobs Take: I would agree in my experience the combined counseling and medication work best for teens in the high risk for suicide.

Flu Vaccine Will Be Late

About half of the flu vaccine will be late reaching doctors offices. One of the two manufacturers, Chiron Corp, has had contamination problems and is destroying about one million doses.

Guidelines for receiving Flu vaccine are:

1. People 65 years and older;

2. Those with chronic lung (including asthma), heart, diabetes, HIV/Aids or undergoing chemotherapy;

3. People in nursing homes;

4. Children 6 months or older who have chronic heart or lung conditions;

5. Children or adults who have been hospitalized during the previous year;

6. Children 6 months to 18 years of age who are on long-term aspirin therapy;

7. Women who will be pregnant during flu season;

8. All children 6 month to 23 months of age;

9. People 54 ? 64 y.o.;

8. People living with those with the chronic diseases listed above.

Dr Bobs Take: those who are at high risk (# 1 to 4) should be vaccinated early (October). For those you should make an appointment with your physician NOW. By end of November or mid December everyone who needs it should be your vaccinnated.

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BIO:

A family physician by training with over 20 years of practice. The need to interpret how the latest news affectsr my readers is important. I have 2 websites physician-on-health.com and orchids-plus-more.com

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