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C O N V E R S A T I O N S
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unclear, it’s too early to make such a health recommendation. (Lancet 1998;35 1:104-107).
. .
As a women’s health nurse practitioner, I see many women over the age of 65 who aren’t sure how ofien they should be getting mammograms. Are these women iypicul of women evetywhere when it comes to screening recommendations?
Q.
.
Absolutely. In fact, about half of women over the age of 65 , don’t think they need regular, annual mammograms, according to a study published in January in the American /ournal of Preuentiue Medicine. Because half of cancer deaths each year in women aged 65 or older are breast cancer-related, regular mammogram screening is critical, according to the study’s authors. Dr. Celette Sugg Skinner of the Washington University School of Medicine in St. Louis reported that only about half o f the 253 mainly black women studied had a mammogram in the past two years. Of the remainder o f the group, one third said they didn’t even consider getting tested, and another 16 percent said they were thinking about getting tested in the next six months. The study zeroed in on a couple of reasons why older women may be failing to get annual mammograms: lack of discussion between women and their primary care provider about the need for screening; lack of access to local health clinics for screening, and the lack o f transportation to such clinics. According to Skinner, worries about finding a lump were also a strong barrier against screening, as were misconceptions about treatment. Current guidelines suggest that all women over the age of 65 get regular, annual mammograms. (AJPM 1998;14:54-63).
I’ve heard that acetaminophen can cut ovarian Q m I c u n m risk. Are there any studies out supporting that? Recent reports from the British medical journal, Lancet, seem to indicate that long-term usage of over-the-
.
A. 22
AWHONN Lifelines
counter forms of acetaminophen may cut ovarian cancer risk by as much as half. In a five-year study that included 1,086 women, researchers looked at the effects of aspirin, ibuprofen, and acetaminophen (most commonly sold as Tylenol); women took at least one dose per week for at least six months. Five hundred sixty three women in whom ovarian cancer had been diagnosed were compared to 523 healthy women. In all, researchers found that ovarian cancer risk was cut 48 percent among acetaminophen users, 25 percent among aspirin users, and not at all among ibuprofen users. For women who had had at least one dose per week for 10 years, ovarian cancer risk was cut 60 percent. So, should primary care providers advise women to throw a bottle of Tylenol into their shopping cart? Not yet, say the study’s authors. Because the underlying biophysical mechanisms remain
. Q .. .
N o w that the weight loss dtng fenfkuramine has been pulled off the market, is it Jafe to use an herbal remedy that claims to be as effective without the possible harmful side effects? Physicians at the Mayo Health Clinic advise staying I away from weight-loss remedies that claim to be a safe alternative to the once-popular fen-phen diet drug combination, because some of these drugs contain a plant-derived chemical that can also be harmful. Ephedrine is an amphetamine-like stimulant that speeds metabolism but is also linked to heart attacks, seizures, strokes, and even death. You may see it on packages listed as ma huang, ephedra, epitonin, sida cordifolio, or simply under its generic name. The Food and Drug Administration has proposed regulations that would limit the amount of this substance in such remedies, but, until then, users are advised to take caution. In fact, Mayo Clinic physicians say that, because they haven’t been adequately tested, there’s no way to be sure you’re getting a “safe” dosage of the substance. Also, no current data indicate that ephedrine is effective as a weight-loss agent. (Mayo Clinic Health Letter 1997;12:4).
A
For all of of us chocolate-loving readers, are
there any data that link chocolate to migraine headaches? was not more There may be some good likely to provoke news ahead for chocolate headache within lovers. Recent research from the group and, in the University of Pittsburgh 3 percent of the Medical Center looked at 63 women who women, half of whom suffered developed a from migraine headaches. The headache and blamed it on the women were first asked to remove chocolate, the culprit actually amine-rich foods thought to trigturned out to be the carob. The ger migraines (such as cheese, researchers, writing in the neuropeanuts, pork, chocolate, and logical journal Cephalalgia, specualcohol) from their diet for at least lated that the craving for chocotwo weeks. At the end of that l a t e - o r sweets-actually triggered period, the women were given the onset of headache, because two, unmarked 60-gram samples these cravings typically occur in of chocolate or carob which were periods of high stress. eaten at random intervals. The (Cephululgiu 1997;17:855-862). researchers found that chocolate Volume 2, Issue 2
W I T H
C O L L E A 6 U E S
unclear, it’s too early to make such a health recommendation. (Lancet 1998;35 1:104-107).
. .
As a women’s health nurse practitioner, I see many women over the age of 65 who aren’t sure how ofien they should be getting mammograms. Are these women iypicul of women evetywhere when it comes to screening recommendations?
Q.
.
Absolutely. In fact, about half of women over the age of 65 , don’t think they need regular, annual mammograms, according to a study published in January in the American /ournal of Preuentiue Medicine. Because half of cancer deaths each year in women aged 65 or older are breast cancer-related, regular mammogram screening is critical, according to the study’s authors. Dr. Celette Sugg Skinner of the Washington University School of Medicine in St. Louis reported that only about half o f the 253 mainly black women studied had a mammogram in the past two years. Of the remainder o f the group, one third said they didn’t even consider getting tested, and another 16 percent said they were thinking about getting tested in the next six months. The study zeroed in on a couple of reasons why older women may be failing to get annual mammograms: lack of discussion between women and their primary care provider about the need for screening; lack of access to local health clinics for screening, and the lack o f transportation to such clinics. According to Skinner, worries about finding a lump were also a strong barrier against screening, as were misconceptions about treatment. Current guidelines suggest that all women over the age of 65 get regular, annual mammograms. (AJPM 1998;14:54-63).
I’ve heard that acetaminophen can cut ovarian Q m I c u n m risk. Are there any studies out supporting that? Recent reports from the British medical journal, Lancet, seem to indicate that long-term usage of over-the-
.
A. 22
AWHONN Lifelines
counter forms of acetaminophen may cut ovarian cancer risk by as much as half. In a five-year study that included 1,086 women, researchers looked at the effects of aspirin, ibuprofen, and acetaminophen (most commonly sold as Tylenol); women took at least one dose per week for at least six months. Five hundred sixty three women in whom ovarian cancer had been diagnosed were compared to 523 healthy women. In all, researchers found that ovarian cancer risk was cut 48 percent among acetaminophen users, 25 percent among aspirin users, and not at all among ibuprofen users. For women who had had at least one dose per week for 10 years, ovarian cancer risk was cut 60 percent. So, should primary care providers advise women to throw a bottle of Tylenol into their shopping cart? Not yet, say the study’s authors. Because the underlying biophysical mechanisms remain
. Q .. .
N o w that the weight loss dtng fenfkuramine has been pulled off the market, is it Jafe to use an herbal remedy that claims to be as effective without the possible harmful side effects? Physicians at the Mayo Health Clinic advise staying I away from weight-loss remedies that claim to be a safe alternative to the once-popular fen-phen diet drug combination, because some of these drugs contain a plant-derived chemical that can also be harmful. Ephedrine is an amphetamine-like stimulant that speeds metabolism but is also linked to heart attacks, seizures, strokes, and even death. You may see it on packages listed as ma huang, ephedra, epitonin, sida cordifolio, or simply under its generic name. The Food and Drug Administration has proposed regulations that would limit the amount of this substance in such remedies, but, until then, users are advised to take caution. In fact, Mayo Clinic physicians say that, because they haven’t been adequately tested, there’s no way to be sure you’re getting a “safe” dosage of the substance. Also, no current data indicate that ephedrine is effective as a weight-loss agent. (Mayo Clinic Health Letter 1997;12:4).
A
For all of of us chocolate-loving readers, are
there any data that link chocolate to migraine headaches? was not more There may be some good likely to provoke news ahead for chocolate headache within lovers. Recent research from the group and, in the University of Pittsburgh 3 percent of the Medical Center looked at 63 women who women, half of whom suffered developed a from migraine headaches. The headache and blamed it on the women were first asked to remove chocolate, the culprit actually amine-rich foods thought to trigturned out to be the carob. The ger migraines (such as cheese, researchers, writing in the neuropeanuts, pork, chocolate, and logical journal Cephalalgia, specualcohol) from their diet for at least lated that the craving for chocotwo weeks. At the end of that l a t e - o r sweets-actually triggered period, the women were given the onset of headache, because two, unmarked 60-gram samples these cravings typically occur in of chocolate or carob which were periods of high stress. eaten at random intervals. The (Cephululgiu 1997;17:855-862). researchers found that chocolate Volume 2, Issue 2