Common blood pressure drug tied to increased risk of skin cancer

People who take a certain water pill prescribed to control fluid retention and treat high blood pressure may be more likely to get skin cancer than other individuals, a Danish study suggests.

While the drug, hydrochlorothiazide, has long been linked to an increased risk of sunburns, the current study offers fresh evidence that this commonly prescribed medication may also make people more likely to develop two types of skin cancer: basal cell carcinoma and squamous cell carcinoma.

For the study, researchers examined national prescription registry data on hydrochlorothiazide use from 1995 to 2012 as well as cancer registry records on skin malignancies diagnosed from 2004 to 2012.

Overall, people who took hydrochlorothiazide daily for at least six years were 29 percent more likely to develop basal cell carcinoma and almost four times more likely to get squamous cell carcinoma than individuals who didn’t take this medication, the study found.

“We already knew that hydrochlorothiazide makes the skin more vulnerable to damage from UV light of sun or sunbeds,” said senior study author Anton Pottegard of the University of Southern Denmark.

“However, we did not know that hydrochlorothiazide use also appears to translate into an increased risk of non-melanoma skin cancer,” Pottegard said by email.

The study included more than 71,000 people with basal cell carcinoma, 8,600 patients with squamous cell carcinoma, and a control group of more than 313,000 people in the Danish population who didn’t have these malignancies but were otherwise similar to the cancer patients.

About 2.7 percent of patients with basal cell carcinoma and 2.1 percent of the control group were high users of hydrochlorothiazide, with a lifetime cumulative dose of at least 50,000 milligrams, or roughly six years of daily use.

Ten percent of squamous cell carcinoma cases were high users, as were 2.8 percent of people in the control group.

With the highest cumulative hydrochlorothiazide exposure — approximately 24 years of daily use — patients were 54 percent more likely to develop basal cell carcinoma and more than seven times more likely to get squamous cell carcinoma.

The study wasn’t a controlled experiment designed to prove whether or how hydrochlorothiazide might cause skin cancer.

Another limitation is that researchers lacked data on two main factors that influence the risk of skin cancer: ultraviolet light exposure and skin type, the study authors note in the Journal of the American Academy of Dermatology.

“There may be a relationship between taking hydrochlorothiazide and risk for skin cancer,” said Dr. Aaron Farberg of the Icahn School of Medicine at Mount Sinai in New York City.

“However, the relationship may not be directly causative,” Farberg, who wasn’t involved in the study, said by email.

Even so, the findings add to the evidence suggesting that patients taking hydrochlorothiazide should take extra precautions to protect their skin from damage caused by the sun, said Dr. Elizabeth Martin, president of Pure Dermatology & Aesthetics in Hoover, Alabama.

“Everyone can reduce their skin cancer risk by avoiding unprotected exposure to UV light,” Martin, who wasn’t involved in the study, said by email. “Don’t use indoor tanning devices, and protect yourself from the sun by seeking sunscreen with an SPF of 30 or higher.”

Patients taking hydrochlorothiazide shouldn’t stop without first seeing a doctor, Pottegard cautioned. While there are other safe, affordable options to manage high blood pressure, patients already taking hydrochlorothiazide won’t meaningfully alter their skin cancer risk by staying on the drug for a few months until a physician can advise them, he said.

“If you are at an increased risk of skin cancer, due to high exposure to sunlight, have already experienced skin cancer, or are otherwise predisposed to skin cancer, you should consider consulting your physician regarding a potential therapy shift,” Pottegard said.

source: interaksyon.com

Hugh Jackman treated for skin cancer, again

LOS ANGELES | Oscar-nominated Australian actor Hugh Jackman has been treated for skin cancer for a third time in a year, a spokesman said Tuesday.

The 46-year-old first had a basal cell carcinoma (BCC) removed last November, when he posted a picture on Twitter of himself with a plaster on his nose. He did the same in May.

His spokesman Alan Nierob confirmed to AFP that Jackman had been treated for a third time. He declined to give any other details, but E! News cited a representative as saying that the star is now “all good.”

BCC is the most common form of skin cancer, with over 2 million cases diagnosed in the United States every year, according to the American Academy of Dermatology (AAD).

It usually develops on exposed skin such as the head, neck and back of hands, but is especially common on the face and nose. People who use tanning beds have a much higher risk of getting it.

Jackman, known for his roles in the “X-Men” blockbusters, was also nominated for an Academy Award and won a Golden Globe for 2012′s musical adaptation of “Les Miserables.”

source: interaksyon.com

‘Homeland’ actor James Rebhorn dies of melanoma: reports

James Rebhorn, the tall, lanky character actor who appeared in dozens of movies and television shows, including the Showtime political thriller “Homeland,” has died at 65, according to media reports on Sunday.

Rebhorn died on Friday of melanoma at his home in New Jersey, the New York Times reported. The newspaper cited his agent, Dianne Busch, who was not immediately available to comment.

The actor worked regularly in film, television and on stage and appeared in more than 50 films, including “Independence Day,” “My Cousin Vinny,” “Basic Instinct” and “Cold Mountain.”

He also was known for his role in “Scent of A Woman” in 1992, according to the Internet Movie Database.

As a stage actor, he appeared in a revival of “Twelve Angry Men” in 2004. He had numerous roles on television, including a memorable part as the assistant district attorney who sent the “Seinfeld” cast to jail in the series’ finale.

He had most recently appeared in “Homeland” as Frank Mathison, the father of Carrie Mathison, the CIA officer played by Claire Danes. The show has featured how both daughter and father have grappled with bipolar disorder.

Rebhorn was born on September 1, 1948, in Philadelphia, the Times said. He leaves two daughters, Hannah and Emma, and his wife, Rebecca Linn.

source: interaksyon.com

Actor Hugh Jackman reveals skin cancer scare on Instagram

LOS ANGELES | Australian actor Hugh Jackman said on Thursday that he had a skin cancer scare when doctors diagnosed a mark on his nose as cancerous cells.

Jackman, 45, posted a photo of his face and a bandage on his nose on his Instagram page, saying his wife, Deborra-Lee Furness, told him to get his nose checked, and he was diagnosed with basal cell carcinoma, cancerous cells that grow on the surface of the skin.

“Please don’t be foolish like me. Get yourself checked. And USE sunscreen!!!” the “Les Miserables” actor said in the Instagram caption.

Representatives for Jackman had no updates on the actor’s condition beyond his Instagram post.

The online medical site WebMD.com said basal cell carcinoma is the most common form of skin cancer and accounts for more than 90 percent of U.S. skin cancer patients. The basal cell carcinomas rarely spread but if not removed can damage and disfigure surrounding tissue.

Jackman is one of Hollywood’s leading action stars, best known as superhero Wolverine in the “X-Men” films.

He was nominated for a best actor Oscar this year for his role as prisoner-turned-businessman Jean Valjean in the film adaptation of “Les Miserables.” He also starred alongside Jake Gyllenhaal in this fall’s gritty drama “Prisoners.”

source: interaksyon.com

Top medical innovations treat headaches, diabetes

The best medical innovations for next year include an almond-size device implanted in the mouth to relieve severe headaches and a handheld scanner resembling a blow dryer that detects skin cancer, the Cleveland Clinic said on Wednesday.

The clinic's annual list of the best medical innovations for 2013 includes better mammography technology and new drugs to treat advanced prostate cancer.

Leading the 2013 list for innovations is an old procedure that has a new use due to findings in a recent study. Physicians and researchers at the clinic voted weight-loss surgery as the top medical innovation, not for its effectiveness in reducing obesity, but for its ability to control Type 2 diabetes, the most common form of the disease.

Over the years, bariatric surgeons noticed that the procedure would often rid obese patients of Type 2 diabetes before they even left the hospital.

Dr. Philip Schauer, head of the Cleveland Clinic's Bariatric and Metabolic Institute, led a study examining this phenomenon, and the prestigious New England Journal of Medicine published the results earlier this year.

"Bariatric surgery has been around for a while," Cleveland Clinic Chief Wellness Officer Dr. Michael Roizen said in an interview. "The reason it was chosen as the top innovation is because Medicare has broadened its indication for payment, and Medicaid in many states follows Medicare. A lot of the other (private) insurance companies started covering it, so it's much more accessible."

The criteria that insurers use to cover the surgery has been broadened because of its effectiveness in controlling Type 2 diabetes, he said.

The number of people affected by diabetes has tripled over the past 30 years to more than 20 million Americans, according to the Centers for Disease Control and Prevention. More than 90 percent of those cases are Type 2, a condition in which the body does not produce enough insulin or the cells ignore the insulin.

Doctors and researchers at the Cleveland Clinic voted for what they thought were the biggest, most significant innovations from the 250 ideas submitted from their colleagues. Roizen said one of the main criteria for getting on the list is the number of people that the product or procedure can potentially help.

For that reason, a device that helps relieve headaches, the second-most common ailment after the cold, was second on the clinic's list.

The miniaturized device—invented at the Cleveland Clinic and spun off into a separate, private company called Autonomic Technologies Inc—is implanted in the upper gum above the second molar to treat cluster and migraine headaches. A lead tip of the implant is placed near specific nerves behind the bridge of the nose.

When the patient feels the headache coming on, a remote control device is placed on the outside of the cheek, and the device delivers stimulation to those nerves, blocking pain.

The implant is available in Europe, but not in the United States. The company needs to do more studies to get approval from the US Food and Drug Administration, said Dr. Frank Papay, department chair of the clinic's Dermatology and Plastic Surgery Institute and a consultant to Autonomic Technologies.

A handheld device used to detect melanoma, the most deadly form of skin cancer, was also on the list.

"Up until now, we've counted on our eyes," Dr. Allison Vidimos, who chairs the clinic's dermatology department, told Reuters. "This device offers an objective look underneath the skin using a special spectrum of light."

It compares moles and other marks on the patient's skin with a large database containing information on all types of melanoma. It also rates the risk.

"All dermatologists fear missing melanomas," Vidimos said. "The cure rate can be close to 100 percent if caught early."

Vidimos said using a device, manufactured by Mela Sciences Inc and approved by FDA last year for use by trained dermatologists, helped prevent unnecessary biopsies. The Mela scanner is also approved in Europe.

Verisante Technology Inc also makes a scanning device, which is approved in Canada, Europe and Australia. It has applied for US approval, the company said.

Also on the list is a new type of mammography, called breast tomosynthesis. This technology provides greater detail of the image than the standard mammography, which renders a two-dimensional image.

For the patient, it may seem like there's no difference. "You still have the squish," said Dr. Alice Rim, the Cleveland Clinic's section head of diagnostic radiology. But the images produced by the new technology show the breast in slices, for more visible detail.

"With two-dimensional mammography, there are shadows, so it can be like a polar bear running around in a snowstorm," Rim said. "This eliminates the shadows, allowing increased detection and fewer call backs (for a second mammography)."

Other devices that made the list include mass spectrometry that allows microbiology laboratories to identify the type of bacteria in infections sooner and with more specificity, a new modular stent graft to treat complex aortic aneurysms, and a laser for cataract surgery.

Novel drugs to treat advanced prostate cancer were on the clinic's list because of their ability to halt the progress of the disease by blocking testosterone receptors.

A new technique to repair and regenerate damaged lungs, called ex vivo lung perfusion, is on the list. Experts say as many as 40 percent of previously rejected donor lungs may now be suitable for transplantation after undergoing this novel "lung washing."

The procedure involves placing donor lungs into a bubble-like chamber connected to a cardiopulmonary pump and ventilator. Over four to six hours, the lungs are repaired as special fluids are forced through the blood vessels. Nutrients are used to recondition the lungs as they inflate and deflate.

The final item on the list is neither a procedure, a drug nor a device, but healthcare programs that use incentives to encourage people to take better care of themselves.

For example, the Medicare Better Health Rewards Program Act of 2012 provides incentive payments to Medicare participants who voluntarily establish and maintain better health.

"We are seeing efforts to avoid rationing of healthcare and seeing programs with incentives built in if people maintain their health," Roizen said. "This can radically change the cost of care.

"We're seeing this more in big companies, the GE's and J&J's of the world. All companies are looking at how much they are spending on healthcare, and they are looking at ways they can reduce spending without rationing." –Reuters

source: gmanetwork.com