Breast Cancer

Breast cancer usually begins in the cells in the lobules, the glands that produce milk, or milk ducts glands channels, channels that connect the lobules to the 'nipple'. Rarely, breast cancer began in the stroma tissue, including breast tissue.

Over time, cancer cells can spread to healthy breast tissue makes its way to the lymph nodes in the armpit, a small organ that filters objects small organ that filters foreign objects foreign substances in the body. If cancer cells have spread to lymph nodes, then this becomes a way to other parts of the body. Breast cancer is always caused by abnormalities in genes (a "mistake" in the genetic material). Only 5-10% of cancers than inherited from the mother or father. Kirakira 90% of breast cancer is because breast adala because of a genetic disorder that occurs as a result of aging and other processes.

A person affected by this disease must be willing to perform various types of tests, examinations and treatment to undergo a series of super-intensive. All this is done for the development of cancer cells to spread wild-level known. This is what is called 'stage'. Stage 1 to stage 4 which at this stage, usually the breast must be removed.

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Obesity Linked to Higher Esophageal Cancer Death Rates

Obese people who have had surgery to treat esophageal cancerare twice as likely to have a recurrence of the disease or die from cancer within five years as patients of normal weight, according to a new study.

In the study, published in the Dec. 1 issue of the Journal of Clinical Oncology, researchers from theMayo Clinic in Rochester, Minn., suggested their findings could change the way some doctors treatobese patients with this type of cancer.

The investigators followed 778 people who had surgery for esophageal cancer and found that those who were classified as obese (a body mass index of 30 or higher) had a five-year survival rate of 18 percent. That survival rate jumped to 36 percent among people who were not overweight.

"Obesity is considered a risk factor in the development of this cancer, which is known to be both highly lethal and increasingly common," the study's lead investigator, Dr. Harry Yoon, an oncologist at the Mayo Clinic Comprehensive Cancer Center, said in a Mayo news release. "But prior to this study, we did not really understand the impact of obesity in this upper gastrointestinal cancer."

The study authors pointed out that their findings applied only to nonsmokers who had their esophagus removed. Yoon added that previous research has linked obesity to greater risk for cancer as well as increased risk of death from other types of tumors because extra weight results in a chronic inflammatory state.

The researchers noted their findings could change the approach they take with obese patients with esophageal cancer.

"As an oncologist, I did not typically speak to my patients about excess body weight as part of their care, because we are more often concerned about weight loss and maintaining proper nutrition, but that may change," said Yoon. "It would be helpful to be able to offer patients some measures that they can take to possibly impact their prognosis."

More information

The U.S. National Cancer Institute has more about obesity and cancer.

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Cancer Survivors Should Take Steps to Keep Healthy During Holidays

The holiday season can be especially meaningful for cancer survivors, but they need to take steps to ensure they stay healthy through this often hectic and stressful time.

One in 20 U.S. adults is a cancer survivor and their ranks are growing. Many of these folks have long-term health needs due to the disease and its treatment, experts at the Fred Hutchinson Cancer Research Center pointed out in a center news release.

Karen Syrjala, co-director of the center's Survivorship Program, offers holiday health tips for cancer survivors, including the following:

• Be prepared for your holiday stress points. Take steps to deal with family conflicts or trying to do too much. For example, if you have to see a difficult relative, plan something fun afterward so you can look forward to doing something enjoyable.
• Take control of your time and eliminate holiday events or traditions you feel you can do without. Also, try to postpone non-holiday events until the new year.
• Make sure to schedule time with people who mean the most to you. Spending time with those closest to you has a beneficial effect on both the body and brain.
• Keep physically active during the holidays and all through the year. It's good for your overall health and may even reduce your cancer-related risks.
• Eat a healthy diet. Focus more on giving your body what it needs (such as fruits and vegetables) and less on trying not to eat certain foods. Eating healthy foods before going to a party will make it easier to resist sweets and other unhealthy foods. Consult a nutritionist if you're not sure what is healthy for you or if you have digestion problems.
• Avoid alcohol or drink in moderation. Alcohol has been linked with an increased risk of cancer.
• Find time to relax your body and mind, and tend to your body's needs. If you're having physical problems, make a list and schedule an appointment with your doctor in the new year. Knowing you have a plan for dealing with these problems can ease your mind during the holidays.

More information

The U.S. Centers for Disease Control and Prevention has more about cancer survivors.

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Opting to track, not treat, early prostate cancer

John Shoemaker visited six doctors in his quest to find the best treatment for his early stage prostate cancer — and only the last one offered what made the most sense to the California man: Keep a close watch on the tumor and treat only if it starts to grow.

Very few men choose this active surveillance option. Yet Shoemaker is one of more than 100,000 men a year deemed candidates for it by a government panel. That's because their prostate cancer carries such a low risk of morphing into the kind that could kill.

The risk for them is so low, in fact, that specialists convened recently by the National Institutes of Health say it's time to strip the name "cancer" off these small, lazy tumors.

In the meantime, the panel wants more of those men offered the option of delaying treatment until regular check-ups show it's really needed. That endorsement promises to fuel efforts by the Prostate Cancer Foundation and a few other groups to spread the word to the newly diagnosed.

Shoemaker's journey shows how difficult that may be, from doctors who don't even bring it up to the fear factor.

"With prostate cancer, you hear the "C'' word, so to speak, and people freak out," says Shoemaker, 69, a businessman from Los Altos, Calif., who was intent on examining all his options.

Five years after his diagnosis — and five biopsies plus numerous blood tests and ultrasound scans later — Shoemaker's happy he found a surgeon who argued against immediate treatment. He's confident his prostate tumor hasn't grown, and avoided the pain and side effects of surgery or radiation.

Some 240,000 men a year in the U.S. are diagnosed with prostate cancer. Earlier this month, the NIH-appointed panel found that most have the low-risk kind, a legacy of using problematic PSA blood tests to screen healthy men for possible signs of this slow-growing cancer that will affect most men's prostates if they live long enough.

Yet 90 percent of such men choose immediate treatment such as surgery or radiation, risking serious and long-lasting side effects, such as impotence or incontinence, without good evidence about who will live longer as a result. One recent study tracked 731 men diagnosed with early stage prostate cancer for 10 years and found no difference in survival between those who had surgery and those who weren't treated unless they went on to develop cancer symptoms, an older option known as watchful waiting.

Active surveillance is much more aggressive than watchful waiting — men get regular scans, blood tests and biopsies to check the tumor, although the NIH panel found the degree of monitoring can vary by medical center. Active surveillance is designed to monitor men closely enough that they can get curative treatment quickly if it looks like they'll need it, well before any symptoms would begin.

"It's not treatment versus no treatment; it's about timing of treatment," Shoemaker's physician, Dr. Peter Carroll of the University of California, San Francisco, told the NIH. He's a well-known prostate cancer surgeon who also leads one of the country's few large active-surveillance programs, tracking more than 900 men for over five years. Most are treatment-free so far, and none has gone on to die of prostate cancer.

What's the advice for men? The NIH panel said men with a PSA level less than 10 and a Gleason score that's 6 or less are candidates for this type of active surveillance. The Gleason score measures how aggressive prostate cancer cells look under the microscope. Urologists can provide those numbers.

Then what? Today, what men decide to do next largely depends on the advice of the specialist they wind up seeing, and many either don't offer active surveillance or present it in a negative way, as doing nothing, the NIH panel learned. There's also the patient's instinctive "get it out" reaction.

Enter the National Proactive Surveillance Network — at http://www.npsn.net — a collaboration of two large active-surveillance programs, at Johns Hopkins University and Cedars-Sinai Medical Center, with the Prostate Cancer Foundation. First, it aims to educate men about active surveillance.

Within a few months, an interactive section of the site will be added to link men with doctors who offer active surveillance and track how they fare with input straight from the patients themselves, said Hopkins' Dr. H. Ballentine Carter.

"To me, it's an individualized approach rather than the one-size-fits-all approach of treating everyone," Carter says.

Beyond whether and how men choose surveillance, behavioral scientist Kathryn Taylor of Georgetown University wants to know how they decide to stick with it. About a quarter of men abandon the observation approach within two or three years, and as many as half by five years, the NIH panel learned. It's not clear how much of that was because they needed treatment, and how much was just the anxiety or getting tired of repeat biopsies.

Taylor is beginning a study of 1,500 newly diagnosed, low-risk prostate cancer patients at Kaiser Permanente in Northern California to see how many are told about active surveillance and what helped or hindered their decision.

"Living with untreated cancer is very difficult," she says, "and not everybody can do it, not surprisingly."

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Former Miss Venezuela dies of breast cancer at 28

Former Miss Venezuela Eva Ekvall, whose struggle with breast cancer was closely followed by Venezuelans, has died at age 28.

Her family said Ekvall died Saturday at a hospital in Houston.

Ekvall was crowned Miss Venezuela at age 17 in 2000, and the following year she was third runner-up in the Miss Universe pageant in Puerto Rico. She went on to work as a model, actress and television news anchor.

She also authored a book, "Fuera de Foco" ("Out of Focus"), about her struggle with cancer, which included images by Venezuelan photographer Roberto Mata.

She told the newspaper El Nacional in an interview last year after the book was published that "I needed to send the message of the need for cancer prevention."

On the cover was a portrait in which she appeared with makeup and her head shaved. The book also included images of her while going through chemotherapy.

"I hate to see photos in which I come out ugly," Ekvall told El Nacional. "But you know what? Nobody ever said cancer is pretty or that I should look like Miss Venezuela when I have cancer."

At the time, she was hopeful of overcoming cancer and wanted to write more.

Ekvall's family said in a statement Sunday that her remains were being cremated in Houston on Monday and that a service is to be held in Venezuela once her remains are returned to the country.

Ekvall said in a 2007 interview published in Venezuelan news media that although her mother is Jamaican and her father is American of Swedish and Hungarian descent, "I feel more Venezuelan than anybody."

She was married to radio producer John Fabio Bermudez and had a 2-year-old daughter.

In her book, Ekvall had described her joy at the birth of her daughter saying "that happiness, although (the daughter) may not know it or understand it, keeps me alive today."

The book included emails that she wrote to friends providing updates on her treatment and thanking them for their support, as well as short essays by relatives and friends reflecting on her ordeal.

Her father, Eric Ekvall, recalled in the book that his mother, also named Eva, had died of the same type of cancer at age 39.

"Those who know Eva know she doesn't give up," he said of his daughter. "She fights for what she wants."

Her death brought an outpouring of condolences from Venezuelans, including from some prominent artists and politicians who praised her in messages on Twitter.

One drawing posted online depicted her as an angel with white wings and a pink ribbon on her chest.

Ekvall's husband posted a photo on Twitter Sunday showing a close-up of his hand holding hers, resting on a bed, with the words "Always together ... I love you wife."

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Health panel takes heat on cancer screening advice

Dr. Ned Calonge knows firsthand how hard it is to tell Americans they'd be better off with fewer routine medical tests.

A long-time family doctor in Colorado, Calonge presided over the U.S. Preventive Services Task Force, an influential government-backed panel of health experts, when it said that most women under 50 could skip their regular mammograms.

The recommendation two years ago challenged the conviction of many breast cancer patients that they survived precisely because they were screened early. It unleashed a public fury that has weighed on the panel's deliberations ever since.

"We blew the message," said Calonge, now president and CEO of the Colorado Trust foundation. "The nuance was completely gone."

Two men phoned in death threats to Calonge. Protesters showed up by the offices of the government agency that supports the panel, tucked away in a Maryland suburb. The furor slowed down work on a decision to limit prostate cancer screenings as President Barack Obama fought to pass his signature healthcare law and his Democratic party faced a mid-term election challenge in 2010.

"There was a lot of pressure from above to be more careful politically and orchestrate things better," said Dr. Kenneth Lin, who at the time was an officer at the Agency for Healthcare Research and Quality (AHRQ), a Department of Health and Human Services entity that supports the panel. "Everything with the word 'cancer' got shoved back."

Calonge rotated off the panel this past March after eight years, while Lin quit AHRQ late last year in protest over the delay to prostate cancer screening guidelines that were only released in October. A White House official noted that Calonge has attributed the delay in a final decision on prostate cancer screenings to scheduling conflicts.

Their experience shows just how difficult it will be to curb spiraling costs in the world's most expensive healthcare system by determining what screenings work, based on a rigorous study of clinical evidence, and what can lead to unnecessary and risky procedures.

"More screening is not always better," said Dr. Christine Laine, a general internist and editor of the Annals of Internal Medicine who is not part of the panel. "That message is lost in healthcare in general."

The U.S. Preventive Services Task Force is right on the firing line. For much of its 27-year history, it helped convince millions of Americans to get screened early for disease.

Now the panel of primary care doctors, nurses and academics has reviewed a growing body of research that shows some early screening harms more people than it helps. But it has struggled to convince patients and doctors.

In the wake of the mammogram guidelines, the rate of such screenings for women aged 40 to 69 was barely changed in 2010 compared with 2009, according to the National Committee for Quality Assurance.

"We have a public health measure that we know is effective. Why is it continually being questioned?" said Dr. Carol Lee, breast imaging commission chairwoman at the American College of Radiology.

Graphic on mammograms: http://link.reuters.com/zuc25s

Graphic on U.S. cancer rates: http://link.reuters.com/byc25s

BROACHING THE NEGATIVES

The public at large is no less skeptical. A recent Gallup poll showed that nearly 60 percent of Americans believed that standard cancer screenings - including mammograms and prostate specific antigen (PSA) blood tests - were performed often enough. Thirty-one percent thought they should be conducted more frequently. Only 7 percent said they were done too often.

"It's extraordinarily hard to give up the notion that there's a way to protect yourself from dying from cancer... Our goal here is to make it a matter of evidence, not a matter of opinion," said Virginia Moyer, a pediatrician from Baylor College of Medicine, who now chairs the 16-member panel.

"Our successes are measured in positives," she said of the public's growing awareness of screening in the last three decades. "We are just beginning to approach the negatives."

Burned by the experience with mammograms, the task force is looking for a better way to deliver the message, consulting with powerful consumer interest groups, hiring public relations professionals and reworking some of the language tied to its system of letter-based recommendations.

"We're spending more time paying attention to how we say things to make sure it's understood well," said long-time panel member and current co-vice chair Dr. Michael LeFevre, a professor of family medicine at the University of Missouri School of Medicine. "We have no interest in being some wizard behind the curtain."

The panel now issues its recommendations in draft form first and solicits public comment before making them final. In about a year, the public may have a chance to chime in early on the evaluation process, including posing questions for researchers and reviewing the evidence report draft used by the panel.

Task force officials concede that the comments are unlikely to change the recommended letter grade, unless they introduce crucial new evidence. But they can point to misunderstandings and help the panel better craft its message.

In late October, the panel met with consumer interest groups, including retired persons lobby AARP and the Consumers Union, to get input on how to frame recommendations that was once reserved for patient advocates.

The public's participation has been unprecedented. The panel is now finalizing its PSA prostate cancer recommendation and public comments on the subject have reached into the thousands, LeFevre said.

WEIGHING THE EVIDENCE

The 2009 mammogram guidance from the task force was based on the panel's assessment of new research that showed most women over 40 face a 3 percent risk of dying from breast cancer if they have not been screened. Beginning mammogram screening at age 50 and following up every other year reduced that risk to 2.3 percent, compared with 2.2 percent risk starting at age 40.

An extra decade of screening could invite harms such as unnecessary biopsies and tests, the possible treatment of non-deadly cancers and radiation. Women in their forties are also more likely to receive false positive results.

Another view of the data showed that starting screening at age 40 led to 5,000 more mammograms, 500 false positive results and 33 biopsies for every breast cancer death prevented, according to LeFevre.

"If it was just how many deaths do you cause versus how many deaths you prevent, that would be too easy, that would be simple math," LeFevre said. "We start with somebody who feels well, and we risk making them feel worse."

The panel voted on a "C" recommendation, which calls for patients to decide on the screening with their doctor. But when the recommendation came out in November 2009, it started with a sentence saying the panel "recommends against" routine mammograms for most women under 50, and that language triggered the controversy.

Under pressure, the task force dropped the phrase "recommends against" a month later. Its rating on mammograms remains a "C."

The American Cancer Society questioned the evidence, saying the panel focused on gold-standard clinical trials but weeded out newer observational studies that showed better results.

"Screening is not perfect and it's not error-free, but the question is... do you take protective measures against the unlikely probability that you develop cancer... or do you take your chances?" said Robert Smith, director of cancer screening at the ACS.

That calculation still appears to be guiding doctors, either out of concern of missing an early sign of disease or fear of lawsuits, health experts said.

"Shared decision-making (between doctors and patients) sounds nice, but in practice usually you just end up doing the test," said Dr. Roger Chou, an internist and researcher at the Oregon Evidence-Based Practice Center. Chou authored the report on prostate cancer behind this year's task force recommendation.

POLITICAL RUMBLINGS

The heat over mammograms weighed on deliberations over prostate cancer screening. In 2008, the task force gave an "I" recommendation on the PSA test in healthy men under 75, which meant it had insufficient evidence to make a call.

The panel usually updates its recommendations every five years, but new research published in 2009 warranted an earlier evaluation. One U.S. study showed a slightly higher risk of death for men with no symptoms of illness who received a PSA test, while European research showed a slightly lower risk of death.

Although the PSA blood test itself is innocuous, data reviewed by the task force also showed that 90 percent of American men who tested positive got treated, even if they may have been able to forego it, LeFevre said. Out of 1,000 men treated, five would die, 70 would have serious complications and 200 to 300 would be impotent or incontinent.

Given the possibility of false positives in the screening and the fact that prostate cancer can take many years to progress and show symptoms, the question is whether those risks are greater than the risk of doing nothing.

"It looks like your chance of being alive and well is greater if you don't get screened than if you do get screened," LeFevre said.

In November 2009, task force members voted on a stronger "D" rating on PSA tests, meaning they recommended against the prostate cancer screening in men under 75.

But the timing was poor as Obama struggled to win over a majority of lawmakers for his healthcare overhaul and Congressional elections loomed large. Once the law was passed in March 2010, it brought more attention to the task force by mandating insurance coverage of services it does recommend.

Republicans opposed to the bill used the mammogram example to show how government could intrude on life or death decisions. The task force's "C" and "D" recommendations don't dictate insurance coverage, but Congress quickly turned around legislation to make sure insurers covered mammograms for women in their forties.

"The thought that my work was being use as a fulcrum by one party to kill the most substantial part of healthcare legislation since I've been in practice? I've got to tell you, that's something to lose sleep over," Calonge said.

Officials working with the panel heard that more controversy could threaten the task force budget, up for Congressional approval. In 2010, Health Department funding for the panel was $4.3 million. This year, the agency overseeing the panel spent about $11 million on work related to the task force.

Calonge says the panel wanted more evidence of how the tests could harm healthy patients, and ordered further research. He canceled a new vote on PSA screenings in November 2010, citing scheduling problems, a decision that was widely criticized.

"In my heart of hearts I'd really like to believe that we'd delay it anyway," without the surrounding politics, Calonge said. "We were trying to make the recommendations solid."

That was too much for Lin, who believed the evidence was already enough to show the public was at risk. After talking with his pastor and his wife, he quit AHRQ.

"Even delaying it for a few months, much less a year, it was really relegating the men to the harms they were exposed to," Lin said.

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Targeted Radiation for Breast Cancer May Be Overused: Study

The number of women with breast cancer who receive targeted radiation to the breast after a lumpectomy has jumped dramatically over the last decade.

However, only about a third of these women were considered "suitable" for the treatment, according to criteria used in a new study published in the Dec. 16 online issue of the Journal of the National Cancer Institute.

But guidelines on which women should or should not receive this type of radiation treatment, known as brachytherapy, are only newly published and it's unclear what the findings might mean to current breast cancer patients.

Use of "accelerated partial breast irradiation using brachytherapy" has risen steadily since about 2002, said study author Dr. Jona Hattangadi, a radiation oncologist with Brigham and Women's Hospital and the Harvard Radiation Oncology Program in Boston.

Although brachytherapy is vastly more convenient (taking place over the course of a week rather than six weeks), the worry is that directed radiation isn't comprehensive enough to find and kill all cancer cells lingering in the breast as compared with the current standard, whole breast radiation (WBI).

So, in 2009, the American Society for Radiation Oncology (ASTRO) issued the first guidelines for the use of brachytherapy, which identified patients as either "suitable," "cautionary" (suitability unclear) or "unsuitable" for the treatment, depending on a number of factors including age as well as various tumor characteristics.

These authors rounded up data on 138,815 U.S. women who had been diagnosed with breast cancer from 2000 to 2007 and who had either undergone brachytherapy or whole breast irradiation after a lumpectomy.
Some 2.6 percent of women underwent brachytherapy, two thirds of whom were either deemed "cautionary" (29.6 percent) or "unsuitable" (36.2 percent) according to ASTRO criteria.

Only about a third (32 percent) of patients would have been considered suitable under ASTRO's recommendations, the study authors said.

Use of brachytherapy rose from less than 1 percent in 2000 to almost 7 percent in 2007, but this varied greatly between geographical regions, the researchers noted.

For instance, women in urban areas were more likely to get brachytherapy than women in rural areas, which is surprising given that rural women would have the most to benefit from the convenience.

And white women were more likely to get brachytherapy than black women if they were considered "cautionary" or "unsuitable."

It's unclear what accounts for the variation or for the rise in numbers, although the authors did postulate that reimbursement patterns may play a role. Medicare started reimbursing for brachytherapy in 2004.

The main drawback of this study, the authors acknowledged, is that the data was gathered before the ASTRO guidelines were published.

Dr. Eric Horwitz, M.D., chair of radiation oncology at Fox Chase Cancer Center in Philadelphia, agreed that brachytherapy is "not for everybody" but that "it's an excellent technique if used on the right patients."

But who is the right patient? Generally people with smaller, localized tumors, he said.

Still, in the absence of long-term data, Hattangadi recommends that women getting treatment for early-stage breast cancer have a "thorough discussion with their physicians on the pros and cons of the approach."

The findings come just a week after presenters at a national conference found that women who had brachytherapy had double the rate of mastectomy later on compared with women who got whole breast irradiation. That study was led by Dr. Benjamin Smith of M.D. Anderson Cancer Center in Houston and presented at the San Antonio Breast Cancer Symposium

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What Is Esophageal Cancer, and Who Gets It?

Author and atheist Christopher Hitchens, 62, died Dec. 15 from esophageal cancer. Hitchens was famously atheistic, even in the face of his own mortality. His final piece was written even as he succumbed to pain and the cancer took all of his strength.

The New York Times reports Hitchens' cause of death was complications from esophageal cancer. Here's a look at the disease from a statistical standpoint.

What is esophageal cancer?


The esophagus is the organ that delivers food from the throat to the stomach. The National Cancer Institute states esophageal cancer forms in the lining of the esophagus. There are two types of esophageal cancer--one that forms in the flat cells that line the organ and the type that forms in specialized cells that naturally secrete mucus in the throat.

Who gets esophageal cancer?


The American Cancer Society states cancer of the esophagus can occur anywhere along the lining of the organ. Although rare, more and more people are getting this type of cancer in the United States.

Around 17,000 new cases of esophageal cancer were diagnosed in 2011. Around 14,700 people will die of the disease in 2011. The most common risk factors for esophageal cancer are smoking and frequent alcohol use.

A new factor being observed in America is obesity. Acid reflux disease can also lead to esophageal cancer. Diets low in fruits and vegetables can also be a risk factor.

Men have a three times greater risk for getting esophageal cancer than women. The reason is that men use alcohol and tobacco more than women. Age is also a factor. People older than 55 are responsible for 85 percent of esophageal cancer cases.

Five-year survival rates for esophageal cancer are 37 percent if the cancer is localized. The rate drops to 17 percent for all stages of the cancer.

Which famous people have had the disease?


MSNBC reported Ron Silver died of esophageal cancer in March of 2009. Silver was a regular on the television show "The West Wing" and was 62 at the time of his death. Japanese actor Mako, an Academy Award nominee in 1966, also passed away from complications of esophageal cancer. He was 72 when he died.

The Oral Cancer Foundation states one of the most prominent actors in Hollywood died from esophageal cancer. Humphrey Bogart succumbed to the disease at age 58. The underlying cause of his cancer was smoking cigarettes.

The New York Times reported Robert Kardashian, Sr. died of esophageal in 2003. He was O.J. Simpson's lawyer shortly after Simpson's ex-wife's murder. He was also the biological father of famous reality television stars Kim, Khloe and Kourtnery Kardashian.

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Cancer group aims to boost trust in guidelines

In a field plagued by frequent controversy, the American Cancer Society has taken "a major step forward" with a new system for developing trustworthy screening recommendations.

Instead of having cancer specialists develop its guidelines, the ACS now leaves that to generalist health care professionals accompanied by a patient advocate.

The approach has previously drawn criticism for another prominent guideline-writing organization. The ACS argues, however, that it gets rid of an obvious conflict of interest, because oncologists might benefit financially from recommending new screening tests, which lead to more diagnoses and treatment.

Still, pulling the cancer experts, or subspecialists, was the toughest part of revamping the guideline process, said Dr. Tim Byers of the ACS, who led the new efforts.

"The conflict is that they know the most about it, but they also have the most self-interest in it," he told Reuters Health.

The ACS is the largest voluntary health organization in the U.S., and its guidelines are used by patients, doctors, insurance companies and policymakers alike. An article in today's Journal of the American Medical Association outlines its new system.

Most other groups that develop medical guidelines still have leading specialists at the helm. One exception is the government-backed U.S. Preventive Services Task Force, which consists of generalists such as family doctors and public health experts.

A few months ago, the panel caused an uproar among urologists when it issued a draft recommendation that healthy men not get screened for prostate cancer with the so-called PSA test.

And in 2009, it triggered a media storm after it recommended that doctors scale back routine mammograms for women in their 40s and 50s. Both recommendations are at odds with the ACS's guidelines.

While the U.S. Preventive Services Task Force does consult with subject experts before making its recommendations, it hasn't been explicit about it, which has fueled criticism of its guidelines.

BE CLEAR ABOUT THE HARMS

Subspecialists will still have an advisory role in the guideline development at the ACS, but they will no longer be able to vote and will not be writing the guidelines.

Byers said making recommendations always involves some degree of value judgment, and that the new ACS guidelines will be more transparent about that.

"We need to more explicitly describe potential harms along with benefits, and when we make recommendations to be clear about the balance between benefits and harms," he said.

While some screening tests -- say, mammography or colonoscopy -- have been shown to save lives, all have downsides.

For instance, there is the cost of looking for disease in healthy people, the anxiety and the potential for procedure complications. The tests may also sound a false alarm that can lead to unnecessary biopsies, which carry their own risks. And in some cases, early detection means doctors diagnose and treat cancers that would never have caused any harm if left alone -- a phenomenon known as overdiagnosis.

"Overdiagnosis is an inherent issue in any screening, even screening that is proven to be beneficial like mammography," said Byers.

BREAKING NEW GROUND

The ACS will also conduct systematic reviews of the medical evidence before making recommendations, to make sure as much as possible of its guidance is based on data instead of opinion.

Recent studies have shown that many guidelines rely more on expert opinions that real experiments, making them vulnerable to personal biases.

In an email to Reuters Health, Dr. Sheldon Greenfield of the University of California, Irvine, called the ACS's new system "a major step forward."

He added that a major challenge would be to make sure the public grasps the complexity of the science in the guidelines.

Greenfield recently chaired an Institute of Medicine committee that released standards for how to make clinical guidelines better and more trustworthy.

Earlier this year, he told Reuters Health that good guidelines need to be based on extensive reviews of the medical literature done by researchers with no financial conflicts of interest.

Greenfield also said the guideline panels have to represent all stakeholders, including doctors from other specialties and patients. Fulfilling all three requirements, he said, was "about as common as peace in the Middle East."

Dr. Michael LeFevre of the U.S. Preventive Services Task Force also applauded the ACS's efforts.

"This is the first time I have seen a major organization use the Institute of Medicine model," he told Reuters Health.

WILL CANCER SCREENING GUIDELINES EVER BE THE SAME?

LeFevre said he believes the new system might help align the advice from the two organizations.

"Many of the differences between Task Force recommendations and others have to do with the different processes by which those conclusions are reached," he said. "The process that was outlined certainly moves in the direction of the process that we use."

Byers was less convinced that the differences would disappear. Instead, his hope is "that we can be more explicit about what the reasons for those differences are."

The ACS is currently developing guidelines on lung cancer screening, a topic that sparked debate in the media earlier this year. According to Byers, the new system will be used "in spirit" to those guidelines, although it is too late to apply it full-out.

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Endocyte slides on concerns about cancer drug

Shares of Endocyte Inc. continued to slide Wednesday on concerns about its experimental ovarian cancer drug EC145.

THE SPARK: Endocyte stock had lost two-thirds of its value Tuesday after the company reported additional data from a trial of EC145. It said patients who were treated with both EC145 and the cancer drug Doxil, a form of the drug doxorubicin, had median survival of 14.1 months after starting treatment. But it said patients treated with doxorubicin alone had median survival of 16.9 months.

Endocyte said some patients may have lived longer because they were treated after the trial ended.

It said the overall survival data was not statistically significant because that's not what the trial was designed to show. The trial was meant to show the drug could delay the progression of the disease, and Endocyte said in June that the drug met that goal. The new analysis was conducted by independent reviewers, while the earlier data came from the doctors treating the patients.

THE BIG PICTURE: The company has said it plans to file for marketing approval of EC145 in 2012, but a late-stage trial is being slowed down because of a shortage of Doxil.

Equipment failures and manufacturing problems have left thousands of patients on a waiting list.

Based on the new data, Endocyte plans to alter the design of its late-stage trial of EC145. It said it wants to include more patients with high levels of folate receptors, and will exclude patients who don't have the receptors because it is clear the drug won't work for those patients.

The clinical trial tested EC145 on 149 women whose cancer was no longer responding to platinum-based chemotherapy.

The company had said in June that women treated with EC145 lived for five months before their disease resumed progressing or they died and patients treated only with Doxil lived 2.7 months before their disease resumed or they died. EC145 is designed to target folate receptors on tumors, and patients whose tumors had high levels of those receptors had greater survival.

THE ANALYSIS: Wedbush analyst Gregory Wade said Wednesday that the drop in Endocyte's stock price was an "overreaction." He maintained an "Outperform" rating on the stock but cut his price target to $16 from $20.

Robert W. Baird analyst Christopher Raymond downgraded Endocyte shares to "Neutral" from "Outperform."

He said the new analysis will make it harder for Endocyte to get conditional approval of EC145 because the data show the drug didn't significantly postpone the disease's progression.

He cut his price target on Endocyte shares to $9 per share from $17.

SHARE ACTION: After falling 65.3 percent Tuesday, Endocyte shares tumbled another 6.4 percent, or 23 cents, Wednesday afternoon to close at $3.34.

Between its February initial public offering and Monday, the stock had traded as low as $6.15 and high as $14.80.

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Memory issues after cancer may not be due to chemo

Women treated for breast cancer with radiation with or without chemotherapy had more thinking and memory problems a few years after their treatment ended than women who'd never had cancer, in a new study.

Research has suggested some women experience mental haziness, dubbed "chemo brain," during and soon after chemotherapy treatment. And one recent study found evidence of changes in the activity of certain brain regions in women who'd undergone chemotherapy (see Reuters Health story of November 15, 2011).

But some researchers have questioned whether those problems are due to the specific drug treatments, or possibly to the cancer itself. In the new report, breast cancer survivors showed certain small mental deficits, regardless of whether or not they'd had chemotherapy.

"It's a very, very subtle thing. We're not talking about patients becoming delirious, demented, amnesic," said Barbara Collins, a neuropsychologist who has studied chemotherapy-related cognitive changes at Ottawa Hospital in Ontario, Canada, but wasn't involved in the new study.

"We're talking about a group of people that are saying, 'I'm pretty much still able to function, but I find it harder...it doesn't come as easily, and I can't do as many things at the same time.'"

The current study involved 129 breast cancer survivors in their fifties, on average. About half of them had been treated with radiation and chemotherapy, while the other women only had radiation.

Six months after finishing treatment, and another three years later, women took a range of thinking and memory tests. Their scores were compared against the performance of 184 women who'd never had cancer, but were a similar age and from the same areas.

On three out of five types of memory tests, women who'd had either course of treatment performed similarly to the non-cancer group. But on two, their scores were noticeably lower.

At both six months and a few years after treatment, cancer survivors scored worse on tests of "executive functioning," which included naming words beginning with a particular letter.

And on tests of processing speed, which included marking specific numbers on lists of random numbers and letters -- a measure of speed and concentration -- women who'd received radiation only or chemo and radiation had lower scores than women with no cancer history at the later time point.

Those scores differed by about one to three points on a scale where 50 is considered average.

CAUSES STILL UNCLEAR

One limitation of using tests to measure cognition is that it's not clear how exactly they apply to functioning in everyday life, Paul Jacobsen, from the Moffitt Cancer Center in Tampa, Florida, and his colleagues wrote Monday in the journal Cancer.

The researchers also didn't have information on women's thinking and memory skills before they were diagnosed with cancer or treated.

Cancer survivors who'd had radiation without chemotherapy scored similarly to those who were treated with radiation and chemo on all measures of mental ability.

That challenges the notion that chemotherapy is the driving force behind mental changes in breast cancer survivors, researchers said.

"People talk about 'chemo brain,' and there's sort of a general view that if people have cognitive problems after the cancer treatment, it must be due to the fact that they had chemotherapy," Jacobsen told Reuters Health.

"We provided the most definitive evidence to date to suspect it's not just chemotherapy that is contributing to cognitive problems after breast cancer."

What exactly might be the cause, or causes, is still up for debate.

"There is very likely something to do with having cancer that already affects your cognitive function," Collins said. "What is it? Could it be stress? Could it be anxiety? Could it be depression? That's a possibility."

It could also be that the immune system's response to cancer affects the brain, she added.

Collins said that most of the data still points to some mental effect of chemotherapy in certain patients -- but that small differences between treatment groups might have been missed in this analysis.

Still, she said, "We can't be too quick to conclude, even if we find some subtle things, that they're all due to the chemotherapy. We have to step very carefully here in terms of understanding what the real factors are."

Collins told Reuters Health that women should know foggy thinking and memory after cancer treatment tends to improve over time. "Nobody's suggesting they don't get their chemotherapy, not at all," she said.

Many women won't notice any mental fuzziness after treatment at all, Jacobsen added, but he said those that do should talk to their doctors to rule out other causes and to consider strategies to compensate for those problems.

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Pharmacyclics' blood cancer drug responses rise

Interim results from an early stage trial of Pharmacyclics Inc's experimental blood cancer drug show the number of leukemia patients responding to the medicine has increased over time.

At 10 months follow-up, 70 percent of patients treated with the lower dose of the drug, known as PCI-32756, had a significant improvement in their condition. That is up from the 48 percent response rate reported by trial investigators after six months of follow-up.

The trial includes 61 patients with chronic lymphocytic leukemia who have stopped responding to at least two other types of treatment.

In the high-dose group, 44 percent of patients have responded to PCI-32756 after 6.5 months of follow-up.

The findings are "phenomenal," especially for patients who had already been treated with earlier rounds of therapy, said Dr, John Byrd, professor of hematology and oncology at Ohio State University in Columbus, and a lead investigator in the trial.

The updated results are being presented at a meeting of the American Society of Hematology.

PCI-32765 is an oral drug designed to target an enzyme known as Bruton's tyrosine kinase and block the function of cancerous B-cells. The drug is being studied as a treatment for a range of B-cell malignancies.

Side effects seen in the CLL trial included diarrhea, nausea and high lymphocyte counts.
Eighty-two percent of patients remain on treatment, and 8 percent have seen their disease worsen.

Pharmacyclics said earlier this week it had licensed PCI-32765 to Johnson & Johnson for $150 million upfront and as much as $825 million in payments tied to development milestones.

The announcement sent shares of Pharmacyclics down nearly 20 percent as investors theorized that the J&J deal made it less likely Pharmacyclics would be acquired by a larger company, at least in the near term.

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Deadly Tasmanian Devil cancer found in 'clean' area

A deadly cancer riddling Australia's Tasmanian Devil has been found in an area thought to be free of the disease, troubling officials struggling to keep the animal alive in the wild.

The facial tumour disease has so far been confirmed across more than 60 percent of the small island state of Tasmania, but it came as a surprise that it was found in one animal in the Zeehan area in the state's west.

"Although our monitoring does indicate a westward movement of the disease, and we expected to continue to detect cases west of the known perimeter, this detection is not in an area we expected to see the disease at this stage," Save the Tasmanian Devil Program's Howel Williams said Friday.

The furry marsupials were declared endangered in 2009 after the contagious cancer began sweeping through the population, disfiguring their faces so badly they are unable to eat and starve to death.

Estimates suggest that some 70 percent of devils have already been lost to the infectious disease, which is spread by biting.

Williams said the sickness, which scientists believe could see the entire wild population of devils vanish within 20 to 50 years, was unusual in its persistence.

The detection of a case beyond the known perimeter highlighted to officials that they could not rely on a single measure to conserve the species in the wild, he said.

Williams said the government had a "thriving" insurance population of Devils, which secured the animals's long-term future in captivity and was working to keep other areas in the wild free of the disease.

Williams told ABC Radio that officials would press ahead with plans to build a 12.5 kilometre (almost 8 mile) fence to protect healthy devils in the wild from infected animals in one part of the state's west.

Tasmanian devils first came to prominence when their unearthly shrieks and grunts while devouring corpses of dead animals terrified European settlers arriving on the island in the 19th century.

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Starchy Foods May Boost Risk of Breast Cancer Recurrence

Increased consumption of carbohydrate-rich foods, especially starches, may boost the risk of breast cancer recurrence, new research finds.

Researcher Jennifer Emond, a public health doctoral student at the University of California, San Diego, looked at changes in the amount of carbohydrates, particularly starchy foods such as potatoes, that breast cancer survivors ate over a one-year period. Then she tracked the number of recurrences.

"Women who increased their carbohydrates and particularly their starch intake had a greater risk of recurrence than the women who decreased [it]," she said.

A link between a high-carb diet and a higher breast cancer risk has been reported before, but this new study focused particularly on starchy carbs, said Emond. She was scheduled to present the findings this week at the 2011 San Antonio Breast Cancer Conference.

Carbohydrates provide needed nutrients and energy, but some carbs are healthier than others. Refined carbohydrates, such as white breads and white pasta, contain more starch than whole grains. "We didn't pinpoint the exact foods," Emond said.

Emond looked at a subset of women who participated in the Women's Healthy Eating and Living Dietary Intervention Trial, which evaluated the effects of a plant-based diet for breast cancer survivors.

She divided the roughly 2,650 women into four groups, based on lowest to highest carbohydrate intake. She found that cancer recurred in 9.7 percent of those who decreased starch consumption the most compared with 14.2 percent of those with the biggest increase in starch consumption.

The women reported their carb intake at the start of the study and a year later. Carbohydrate intake was about 233 grams a day at the study's start. Those whose cancer recurred had an average increase in carbohydrates of 2.3 grams a day. Those who did not see a recurrence had an average decrease of 2.7 grams of starch a day.

Changes in starch consumption were behind nearly half the carbohydrate intake change, she found. Those whose cancer did not return decreased starch intake by 8.7 grams a day, while those with a recurrence decreased starch by only 4.1 grams a day, she said.

According to the U.S. Department of Agriculture, one slice of bread has 12.5 grams of carbohydrate, of which 10 grams are starch. A cup of pasta has 43 grams of carbs, 36 of which are starch.

Emond said she cannot explain the link between starch and breast cancer recurrence with certainty. However, starchy foods boost insulin levels, and elevated insulin levels have been linked with higher breast cancer risk, she said. The insulin may stimulate the growth of tumor cells, she explained.

The increased risk with higher starch intake held even when weight changes were taken into account, Emond said. Obesity and breast cancer have long been linked.

Marji McCullough, strategic director of nutritional epidemiology for the American Cancer Society, said the findings are noteworthy. "This is an important area of research because women who have been diagnosed with breast cancer want to know how to lower their risk of recurrence," she said.

But it's too soon to advise making any dietary changes, McCullough said. "Dietary recommendations change when several studies show the same thing," she said.

The effect of diet on breast cancer recurrence risk is much less clear than the data on the importance of maintaining a healthy body weight, she said.

"The American Cancer Society recommends that breast cancer survivors strive to achieve and maintain a healthy weight through a mostly plant-based, varied diet and regular physical activity," McCullough said.

Emond agreed it's too soon to make new diet recommendations. However, she suggested women follow the 2010 Dietary Guidelines for Americans, which recommend limiting foods with added sugars that contribute to starch intake, she said.

In a second study involving diet and breast cancer, researchers found that following a low-carbohydrate diet just two days a week produced more significant weight loss than a standard low-calorie diet followed daily. People following the intermittent diet for four months lost an average of 9 pounds while the other dieters lost an average of 5 pounds, the British researchers found.

The two-day-a-week low-carb plan was also better than the daily diet at lowering blood levels of insulin, the researchers said. McCullough called that finding ''intriguing."

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

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Second Cancer Often Same Type as the First, Study Finds

If cancer survivors develop a second cancer, it's most likely to be the same type of cancer as the first, researchers report.

About 15 percent of cancer survivors worldwide are diagnosed with a second primary cancer, the authors of the new report pointed out.

In the study, investigators analyzed data from the entire population of Denmark (7.5 million) from 1980 to 2007 and found that about 10 percent (765,255 people) had one or more diagnoses of primary cancer, for a total of 843,118 diagnoses.

Cancer survivors had a 2.2-fold risk of developing a second primary cancer of the same type as the first type of cancer, and a 1.1-fold risk of developing a different type of second primary cancer, the findings showed.

The risk varied, depending on the type of cancer. The risk of a second cancer of the same type was greatest among sarcoma survivors and lower among prostate cancer survivors. The risk of a second cancer of a different type was highest among larynx cancer survivors and lower among prostate cancer survivors, according to the report published Nov. 28 in CMAJ (Canadian Medical Association Journal).

"The striking contrast between the 2.2-fold increased risk of a second primary cancer being the same type as the first and the 1.1-fold increased risk of it being different from the first cancer suggests that characteristics of the individual patient were involved," wrote study author Dr. Stig Bojesen of Herlev Hospital, Copenhagen University Hospital and the University of Copenhagen, and colleagues. "The risk of a second primary cancer seems to be specific to cancer type and is probably driven by the patient's genetic and lifestyle risk factors."

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Chronic Bowel Disease Drugs Linked to Skin Cancer Risk

Some patients with inflammatory bowel disease may be at increased risk for skin cancer due to their use of immunosuppressant drugs to treat the intestinal disorder, according to the results of two new studies.

The studies, published in the November issue of the journal Gastroenterology, noted that immunosuppressants are commonly used to treat patients with irritable bowel disease, or IBD. Currently, there are no specific recommendations for skin cancer screening in IBD patients.

In one study, French researchers led by Dr. Laurent Peyrin-Biroulet, of University Hospital of Nancy, found that both past and present use of a widely used class of immunosuppressants called thiopurines significantly increased the risk of non-melanoma skin cancer in irritable bowel disease patients.

"The increased risk of skin cancer that we found in our study was observed in all patients, even before the age of 50 years. As expected, this risk increased with age. All patients with irritable bowel disease currently receiving or having previously received thiopurines should protect their skin from UV radiation and receive regular dermatologic screening, regardless of their age," Peyrin-Biroulet said in a news release from the American Gastroenterological Association.

Non-melanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma, which are the most common cancers diagnosed in North America.

In the second study, Canadian researchers found that certain people with inflammatory bowel disease, such as men with a form of the disorder known as Crohn's disease, may already be at increased risk for basal cell carcinoma, and the use of thiopurines increases this risk.

"All individuals should be protecting themselves against skin cancer," lead author Dr. Harminder Singh, of the University of Manitoba, said in the news release. "But, it is especially important that physicians stress the need to be extra vigilant about skin care with their irritable bowel disease patients, especially among those exposed to immunosuppressants such as thiopurines."

However, Singh and his colleagues added that there was only a small absolute increased risk of non-melanoma skin cancer seen in the study, which may not warrant stopping treatment with thiopurines in IBD patients who need the immunosuppressants to control their disease.

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Bee Gee Robin Gibb has liver cancer: report

Robin Gibb, singer and musician with legendary band the Bee Gees, is being treated for liver cancer after being diagnosed with the disease several months ago, the Sunday Mirror reported.

The 61-year-old singer, whose frail appearance has caused concern among Britain's media, was hospitalised last week after making an emergency call from his house in Thame, south west England, according to the tabloid newspaper.

Robin's twin brother Maurice died in 2003 from complications resulting from a twisted intestine, and younger brother Andy died in 1988 following a battle against cocaine addiction.

Older brother and fellow Bee Gee Barry has returned to Britain along with 91-year-old mother Barbara, according to the report.

The British-born brothers scaled the heights of the pop world in the 1970s with disco hits "Stayin' Alive" and "Night Fever", and notched up over 200 million record sales during a career which has spanned seven decades.

Robin was forced to cancel several appointments last month, including one with British Prime Minister David Cameron, after he was hospitalised with severe stomach pains.

His spokesman said the family did not want to comment on the reports.

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Grandmother defies cancer to win gold at SEAGames

A cancer-stricken Singaporean grandmother who postponed chemotherapy to compete in the Southeast Asian Games for the first time took an emotional gold at the weekend, according to a report Monday.

Tan Yoke Lan, 63, underwent a mastectomy after being diagnosed with stage two breast cancer and travelled to Indonesia against medical advice, Singapore's Straits Times reported.

She also deferred chemotherapy to kill the remaining cancerous cells in her body until after the Games, where on Sunday she earned a gold medal in the women's pairs of bridge with partner Seet Choon Cheng.

"Just a few weeks ago, I was unsure whether I would be able to make it here," Tan, who has six grandchildren, was quoted as saying. "But I came because I didn't want to let my partner and my team-mates down."

The pair won Singapore's first gold in the event, shedding tears and hugging each other at the Jayakarta Hotel in Palembang -- which is co-hosting the Games with Jakarta.

Tan overcame dizzy spells and had to take frequent rest between rounds of the game -- which can last for up to 10 hours a day -- on her way to gold.

She faces chemotherapy on her return to Singapore but said her love of bridge compelled her to delay treatment.

She was a "fighting person and I will fight till the end", she declared.

The biennial SEA Games sees 11 nations compete for hundreds of gold medals. It ends on Tuesday.

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Newt Gingrich Hospital Cancer Divorce Story Refuted

As the media prepares its campaign to take down former House Speaker Newt Gingrich, as it did Herman Cain, Rick Perry, and Michele Bachmann, an old story about the presidential candidate and his first wife has been refuted.

The story goes that Gingrich served his first wife, Jackie Battley Gingrich, with divorce papers as she lay dying of cancer. It has become part of the black legend of Gingrich, boosting the narrative of his being a mean, heartless man willing to trample on anyone for personal or political gain, contrasting with the conservative theme of family values.

There is one problem with the story. It isn't true, as we have from the testimony of one of Gingrich's daughters.

In fact, the divorce, requested by Mrs. Gingrich, has already been set in motion before her hospital stay. Far from dying of cancer, the first Mrs. Gingrich had a benign tumor removed. The conversation in the hospital room was not a sudden shock as the legendary story suggests. The first Mrs. Gingrich is very much alive, albeit a private person who does not give interviews.

The black legend of the hospital room cancer incident should serve as a warning about believing stories of public people whose sources are dubious at best. One does not know how the story, first published in 1984 by Mother Jones, was concocted, but it has proven useful for Gingrich's enemies over the years. In fact, it will likely prove to be too useful to be put to rest, despite the refutation of Ms. Jackie Gingrich Cushman. The cancer divorce story has haunted Gingrich for decades, after all.

It is not that Gingrich's personal life is pristine pure, as the former Speaker himself will readily admit. No doubt a Republican candidate with two nasty divorces and three marriages will have a difficult time, especially with evangelicals who regard adultery with a jaundice eye. But Gingrich has also said that he has repented his sins and has asked for forgiveness. If he has, in effect, gone on and sinned no more, then his questionable personal past should remain there. If the country can forgive Bill Clinton for turning the Oval Office into a trysting spot, it can forgive Newt Gingrich.

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Alcoholics More Likely to Die of Cancer: Study

Alcoholics have a higher rate of death from cancer and other causes than other people, a new study finds.

Italian researchers examined data on nearly 2,300 male and female alcoholics who were treated at the Alcohol Center of Florence between 1985 and 2001.

They found a higher rate of death among alcoholics than among the general population for multiple types of cancers, particularly cancers of the pharynx, oral cavity, liver and larynx. Risk of death from cancer of the esophagus, rectum, pancreas and breast was also heightened among alcoholics.

Alcoholics were also more likely to die of infections, diabetes, violent crimes and diseases of the immunological, nervous, cardiovascular, respiratory and digestive systems.

The findings appear online and in the February 2012 print issue of the journal Alcoholism: Clinical & Experimental Research.

"Our study has provided strong evidence that alcohol addiction significantly increases the risk of death from several causes in comparison to the general population in a Mediterranean country...," corresponding author Domenico Palli, head of the nutritional and molecular epidemiology unit at the Cancer Research and Prevention Institute in Florence, said in a journal news release. "Alcohol's role as a 'dietary' carcinogen emerged quite clearly."

The researchers also found that female alcoholics had higher survival rates than male alcoholics, possibly because women are more likely to get help for alcoholism, Palli said.

Alcohol consumption causes about 4 percent of all deaths and 5 percent of all diseases worldwide, according to background information in the news release.

"Clearly alcohol abuse can compromise the structure and functionality of several human organs, thus directly increasing the risk of death," Palli concluded. "Other aspects of the characteristic lifestyle of alcoholics -- smoking, drug abuse, promiscuity and a poor diet -- may contribute to this high-risk pattern together with reduced health-consciousness."

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