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National alliance of breast cancer organisations
Where on the web Chernobyl revisited http://www.ibrae.ac.ru/english/index_eng.html The website of Russia’s Nuclear Safety Institute (IBRAE) offers fascinating insights into that nation’s efforts to take protective countermeasures against the far-reaching consequences of the accident at the Chernobyl nuclear power plant. Two detailed and powerful reports recently posted on the site document (in English and Russian versions) the breadth and scope of these efforts and provide a seemingly unbiased assessment of both achievements and failures. The Russian national report, Chernobyl Accident: Results and Problems in Eliminating its Consequences in Russia 1986–2001, examines the public health and environmental impacts of the accident. Unusually, although it is a scientific document, the report has an emotional quality, particularly in sections that summarise the population effects. For example: “The prolonged stress to
which both population and liquidators have been subjected, frequent selfrestrictions in consumption of valuable foodstuff out of fear to ‘eat’ radionuclides, the life standards much poorer as compared to those in ‘clean’ territories, in combination with closer attention of medical staff have resulted in that many indices characterizing the morbidity and health of population/liquidators have turned to bad.” From an oncology standpoint, the report notes that, because of such “extraordinary measures” as evacuations and multiple regulatory interventions, only the rate of thyroid cancers – primarily in individuals who were children at the time of the accident – has increased due to radiation exposure. Even that consequence could have been avoided or significantly reduced if iodine prophylaxis had begun immediately,
but this was not the case. Moreover, many people living in areas of greatest iodine-131 contamination continued drinking milk in the first few weeks following the accident, further amplifying the risk of thyroid cancer. The second report, Medical Consequences of the Accident at the Chernobyl NPP: Forecast and Factual Data in the National Registry, by scientists at the Russian Academy of Medical Sciences’ Medical Radiology Research Center in Obninsk, presents results of “onco-epidemiological” research on radiation exposure, including sections on lessons learned from Hiroshima and Nagasaki, projected rates of various cancers resulting from delayed effects of exposure, actual morbidity and mortality rates from 1986 through 2000, and an overview of the types of studies that remain to be done. Marilynn Larkin
National alliance of breast cancer organisations http://www.nabco.org/ Just occasionally, I discover a website that really impresses me. That happened this week as I logged on to the site of the National Alliance of Breast Cancer Organisations (NABCO). Not only was I pleasantly surprised, but very impressed by what I found. NABCO is an American alliance of over 400 organisations dedicated to breast cancer research, treatment and prevention. The organisation is non-profit making, and seems to provide an excellent education and support serive for those affected by breast cancer. What struck me most was the clear and accurate reporting of scientific research. For example, a recent study of prophylactic bilateral mastectomy is described in sufficient detail for a woman to get a clear idea of the risks and benefits of the procedure, as well as the limitations of the study from which the research originated. The original article is referenced for further information. This contrasts to the way in which much medical
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research is reported in the lay media. That example is one of many presented in the ‘Ask NABCO online’ section – a system through which a woman can submit queries regarding breast cancer. Not all are answered and those posted on the website tend to be quite general in nature. Individual questions can be directed to the Information Services Department at NABCO, although it is unclear who writes the answers. That is not a problem with the ‘online chat archive’, which provides transcripts of live web broadcasts between named representatives of well known organisations such as the US National Cancer Institute (NCI) and Weight Watchers International, as well as practicing clinicians who provide (necessarily generalised, though accurate) answers to women’s questions. Other sections will be of interest to health professionals as well as patients. A recent posting that particularly impressed me describes the advent of digital mammography. It
provides sufficient detail for an interested professional, very different in tone and content from items often found on websites. There is also a list of current events. Details are given of all sorts of courses and events related to breast cancer, from creative writing, a lecture on wigs for cancer sufferers, a course for social workers in end-of-life care and how to plan a palliative care programme. Though mostly US based, there are details of events on an international scale, some of which may be of interest to UK readers. The features I have mentioned represent a fraction of those available. In summary, this website is interesting, well written and easy to navigate. My only personal regret is that it is so US-centred. Although I would gladly welcome such a site with information on a European level, this does not detract from the usefulness and interest of much of this site to a users outside the USA. Mona Okasha
THE LANCET Oncology Vol 2 July 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.
which both population and liquidators have been subjected, frequent selfrestrictions in consumption of valuable foodstuff out of fear to ‘eat’ radionuclides, the life standards much poorer as compared to those in ‘clean’ territories, in combination with closer attention of medical staff have resulted in that many indices characterizing the morbidity and health of population/liquidators have turned to bad.” From an oncology standpoint, the report notes that, because of such “extraordinary measures” as evacuations and multiple regulatory interventions, only the rate of thyroid cancers – primarily in individuals who were children at the time of the accident – has increased due to radiation exposure. Even that consequence could have been avoided or significantly reduced if iodine prophylaxis had begun immediately,
but this was not the case. Moreover, many people living in areas of greatest iodine-131 contamination continued drinking milk in the first few weeks following the accident, further amplifying the risk of thyroid cancer. The second report, Medical Consequences of the Accident at the Chernobyl NPP: Forecast and Factual Data in the National Registry, by scientists at the Russian Academy of Medical Sciences’ Medical Radiology Research Center in Obninsk, presents results of “onco-epidemiological” research on radiation exposure, including sections on lessons learned from Hiroshima and Nagasaki, projected rates of various cancers resulting from delayed effects of exposure, actual morbidity and mortality rates from 1986 through 2000, and an overview of the types of studies that remain to be done. Marilynn Larkin
National alliance of breast cancer organisations http://www.nabco.org/ Just occasionally, I discover a website that really impresses me. That happened this week as I logged on to the site of the National Alliance of Breast Cancer Organisations (NABCO). Not only was I pleasantly surprised, but very impressed by what I found. NABCO is an American alliance of over 400 organisations dedicated to breast cancer research, treatment and prevention. The organisation is non-profit making, and seems to provide an excellent education and support serive for those affected by breast cancer. What struck me most was the clear and accurate reporting of scientific research. For example, a recent study of prophylactic bilateral mastectomy is described in sufficient detail for a woman to get a clear idea of the risks and benefits of the procedure, as well as the limitations of the study from which the research originated. The original article is referenced for further information. This contrasts to the way in which much medical
456
research is reported in the lay media. That example is one of many presented in the ‘Ask NABCO online’ section – a system through which a woman can submit queries regarding breast cancer. Not all are answered and those posted on the website tend to be quite general in nature. Individual questions can be directed to the Information Services Department at NABCO, although it is unclear who writes the answers. That is not a problem with the ‘online chat archive’, which provides transcripts of live web broadcasts between named representatives of well known organisations such as the US National Cancer Institute (NCI) and Weight Watchers International, as well as practicing clinicians who provide (necessarily generalised, though accurate) answers to women’s questions. Other sections will be of interest to health professionals as well as patients. A recent posting that particularly impressed me describes the advent of digital mammography. It
provides sufficient detail for an interested professional, very different in tone and content from items often found on websites. There is also a list of current events. Details are given of all sorts of courses and events related to breast cancer, from creative writing, a lecture on wigs for cancer sufferers, a course for social workers in end-of-life care and how to plan a palliative care programme. Though mostly US based, there are details of events on an international scale, some of which may be of interest to UK readers. The features I have mentioned represent a fraction of those available. In summary, this website is interesting, well written and easy to navigate. My only personal regret is that it is so US-centred. Although I would gladly welcome such a site with information on a European level, this does not detract from the usefulness and interest of much of this site to a users outside the USA. Mona Okasha
THE LANCET Oncology Vol 2 July 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.