It ’s not gonna’ kill you to take hormone replacement
It’s not going to kill you to take hormone replacement therapy. That’s the take home message from the latest analysis of the Women’s Health Initiative, the largest and longest randomized trial of hormone replacement therapy (HRT) in menopausal women. After almost 18 years of follow up in the WHI, there was no increase in overall mortality, including death rates from cancer, in women taking HRT for up to 5.6 years (estrogen plus progestin) or 7.2 years (estrogen alone). There was a non-significant reduction in mortality among those who started HRT between ages 50 and 59, the group most likely to be prescribed hormone therapy for menopausal symptoms. I’ve blogged before about the results and limitations of the WHI, which found, on balance, that the health risks of HRT (breast cancer, blood clots, stroke) about equaled its health benefits (protection against colon cancer and osteoporosis) in women staring HRT on average 10 years after the onset of menopause. The study (and the US Preventive Services Task Force) concluded that there was no reason for women to take HRT for preventive health reasons. The biggest criticism of the WHI was that it did not include women most likely to benefit from taking HRT – those with hot flashes, night sweats, insomnia and other menopausal symptoms. These women start HRT at menopause, not 10 years after it’s over. In this younger group, more recent research suggests there may be a reduction in heart dis...
The objective of this compound is to decrease the rate of rectal toxicity related to radiation therapy, by creating a gap between the prostate and rectum. Secondary benefits include decreased urinary complications and improved sexual quality of life. The hydrogel spacer maintains space for approximately 3 months, and is absorbed in about 6 months.
To evaluate the efficacy and clinical impact of 3 Tesla in-bore trans-rectal magnetic resonance-guided biopsy (3T MRGB) for prostate cancer (PCa) detection based on PIRADSv2 in patients with either suspected prostate cancer or under active surveillance.
A pulmonary arteriovenous malformation (PAVM) is an anomalous connection between a pulmonary artery and a pulmonary vein that lacks a capillary bed. The most common symptoms of PAVM are dyspnea, exercise intolerance, migraine, stroke or transient ischemic attack, and lung hemorrhage. The treatment of choice is transcatheter embolization with the most common embolic devices being coils (multiple manufacturers) or Amplatzer plugs (AVP) (St. Jude Medical, Plymouth, MN) to occlude the malformation. The newest embolic device for PAVM occlusion is the microvascular plug (MVP) (Micro Vascular Plug System, Medtronic, Minneapolis, MN).
We describe our experience using MRI fused CBCT guidance for prostate biopsy. There are no published reports on the use of CBCT guidance in prostate biopsies. We hypothesize this technique will have an adequate safety profile while accurately detecting prostate cancer.
Image-guided thermal ablation has become the standard of care for treating early stage liver cancer. However, a significant limitation to a successful ablation procedure is the heat-sink effect, which may lead to suboptimal thermal dose delivery. Currently, there is no reliable method for quantifying the heat-sink effect due to limited information on blood vessel flow and its associated anatomy relative to the ablation zone. The purpose of this study was to use 4D-flow MRI to map out liver flow patterns and correlate flow rates with ablation zone volumes.
Biphenotypic hepatocellular-cholangiocarcinoma (HCC-CC) is a rare type of primary liver cancer that carries a poor prognosis. Since most patients present at a stage too advanced for surgical resection, loco-regional liver directed therapy is often performed for palliative or downstaging purposes. The purpose of this study is to evaluate patient outcomes after Yttrium-90 radioembolization (Y90) in patients with HCC-CC.
Immunotherapy is a paradigm-shifting advance in cancer care, but the overall response rates remain low. There has been a renaissance in the concept of promoting the immune-responsiveness of the tumor immune microenvironment via intratumoral (IT) delivery of immunostimulatory agents. However, the optimal method for IT delivery of such medications that maximizes IT dispersion while minimizing perilesional leakage and systemic distribution is unknown. The purpose of this study was to characterize IT drug distribution and its influence on drug efficacy using conventional end-hole needles (EHNs) versus multi-sidehole needles (MSHN).
Ports and gastrostomy/gastrojejunostomy tubes (G/GJ-tubes) are common devices utilized during treatment of oncology patients. Combining port and G/GJ-tube placement into a single session can be advantageous from both patient care and resource utilization perspectives. We compared the rates of infection and other device complications in patients receiving a port and G/GJ-tube in one session compared with receiving the devices in two sessions.
We report a novel procedure for primary direct percutaneous jejunostomy under fluoroscopic guidance, utilizing a low profile technique which makes placement safe and efficacious.
To examine the efficacy of image-guided percutaneous interventions in pain and local tumor control in the treatment of osseous metastases from breast cancer.
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