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breast cancer | Research | 10 pages | source: Lancet (London, England) | Added Sep 16, 2019

Surviving cancer – is there a greater risk of cardiovascular disease long-term?

This study investigated if there is a higher risk of cardiovascular disease (CVD) in cancer survivors. They found that cancer survivors have a higher risk of CVD.

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breast cancer | Research | Treatment | 10 pages | source: The New England Journal of Medicine | Added Aug 14, 2019

How effective is alpelisib in hormone-receptor positive breast cancer with PIK3CA-mutations?

This study investigated the effectiveness of alpelisib (Piqray) in hormone receptor-positive (HR+) -human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC).

They found that alpelisib significantly improved survival in patients with PIK3CA mutations. 

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stroke | Research | Lifestyle | 10 pages | source: American heart journal | Added Jul 26, 2019

Smoking cessation after a first cardiovascular event lowers the risk of a second event

This study investigated the relationship between smoking and the risk of a second cardiovascular event (CVE). Researchers suggested that after a first CVE, smoking cessation (SC; quit smoking) lowers the risk of a second CVE. 

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prostate cancer | Research | 10 pages | source: Cancer | Added Jul 21, 2019

Depression in prostate cancer survivors

This study aimed to investigate depression in prostate cancer patients. This study found that depression is a major challenge for prostate cancer survivors.

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breast cancer | Research | Treatment | 10 pages | source: The New England Journal of Medicine | Added Jul 18, 2019

Evaluating ribociclib plus hormonal therapy in breast cancer

This study wanted to find out how well patients with hormone-receptor-positive breast cancer survived when treated with ribociclib (Kisqali) added to endocrine therapy. The study found that patients treated with this treatment combination had longer survival compared to endocrine therapy alone.

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prostate cancer | Research | 10 pages | source: The journal of sexual medicine | Added Jul 09, 2019

Male urethral "Mini-Sling" in treating stress urinary incontinence and climacturia after prostate cancer treatment

This study aimed to investigate the use of the 'mini-sling' surgery during placement of penile prosthesis for the treatment of urinary incontinence and climacturia (urine leaking during sexual intercourse) in men with erectile dysfunction after prostate cancer treatment. This study found that this procedure is promising for these patients.

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stroke | Expertise | 0 pages | source: NutritionFacts.org | Added Jun 30, 2019

Evidence-based medicine or evidence-biased?

Dr. Esselstyn’s landmark study showing even advanced triple vessel coronary artery disease could be reversed with a plant-based diet has been criticized for being such a small study. But the reason we’re used to seeing such large studies is they typically show such small effects. Drug manufacturers may need to study 7,000 people in order to show a barely statistically significant 15% drop in ischemic events in a subsample of patients, whereas Esselstyn got a 100% drop in those who stuck to his diet—all the more compelling given that those 18 participants experienced “49 coronary events [such as heart attacks] in the 8 years before” they went on the diet. And these were the worst of the worst—most of whom having already failed surgical intervention. So, when the effects are that dramatic, how many people do you need?

Before 1885, symptomatic rabies was death sentence until July 6th, when little Joseph Meister became the first to receive Pasteur’s experimental rabies vaccine. “The results of this [and one other] case were so dramatic compared with previous experience” that the new treatment was accepted with a sample size of two. So dramatic, compared with previous experience, no randomized controlled trial was necessary. “Would you—having been infected by a rabid dog—be willing to participate in a randomized controlled trial…when being in the control group had a certainty of a ‘most awful death’?” Sadly, such a question is not entirely rhetorical.

In the 1970s, a revolutionary treatment for babies with immature lungs called ECMO, extracorporeal membranous oxygenation, “transformed mortality in these [babies] from 80 per cent [down] to 20 percent, nearly overnight”—from 80% dead to 80% alive. Despite this dramatic success, they felt forced to perform a randomized controlled trial. They didn’t want to. They knew they’d be condemning babies to death. “They felt compelled to perform [such] a trial, because their claim that ECMO [worked] would, they judged, carry little weight amongst their medical colleagues unless supported by a [randomized controlled] trial.”

And so, at Harvard’s Children’s Hospital, 39 infants were randomized to either get ECMO or not—just get conventional medical therapy. They decided to stop the trial after the fourth death, so as not to kill too many babies. And, that’s what they did. The study “was halted after the fourth [conventional medical therapy] death,” at which point nine out of the nine ECMO babies had survived. Imagine being the parent of one of those four dead children—just as one can imagine being the child of a parent who died from conventional medical or surgical therapy for heart disease.

“Medical students in the United States are taught [very] little about nutrition. Worse yet, their training [actually] biases them against the studies that show the power of dietary approaches to managing disease,” by encouraging them “to ignore any information that does not come from…double-blind, randomized controlled trial[s]. Yet human beings cannot [easily] be blinded to a dietary intervention.” They tend to notice what they’re eating. As a result, physicians [may be] biased [in favor of] drug treatments and against dietary interventions for the management of chronic disease.”

“Evidence[-based medicine] is a good thing. However, the medical profession [may be] focusing too much on one kind of evidence, to the exclusion of [all] others”—degenerating into a “ignoring-most-of-the-truly-important-evidence[-based] medicine.”

And heart disease is the perfect example. On a healthy-enough plant-based diet, our #1 cause of death may “simply cease…to exist.” The Cornell-Oxford-China Study showed that even “small amounts of animal-based foods [was] associated with small, but measurable increases in [the] risk of [some of these chronic] disease[s].”

“In other words, the causal relationship between dietary patterns and coronary artery disease was already well established before…Ornish…and…Esselstyn…undertook their clinical studies. The value of their studies was not so much in providing evidence that such a dietary change would be effective, but in showing that physicians can persuade their patients to make such changes,” and also providing interesting “data on the speed and magnitude of the change in severe atherosclerotic lesions as a result of dietary therapy.”

So, “[a]ny complaints that these studies were small or unblinded are simply irrelevant. Because the evidence of the role of diet in causing atherosclerosis is already so overwhelming, assigning a patient to a control group [eating the Standard American Diet could be considered a] violation of research ethics.”

“Evidence of the value of…plant-based diet[s] for managing [chronic disease] has been available in the medical literature for decades.” Kempner at Duke; John McDougall; The Physician’s Committee for Responsible Medicine. “Denis Burkitt warned us” that the Standard American Diet “is the standard cause of death and disability in the Western world,” for decades. “Yet physicians,…in the [U.S.], are still busily manning the ambulances at the bottom of the cliff instead of building fences at the top.

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prostate cancer | Research | 10 pages | source: BJU international | Added Jun 30, 2019

What is the risk for bladder and rectal cancer in patients previously treated for localized prostate cancer?

This study investigated the rate of bladder cancer (BC) and rectal cancer (RC) after localized prostate cancer (PC) treatment.

They found that brachytherapy (BT) increased the risk of BC and RC in these patients. 

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breast cancer | Research | Guidelines | 10 pages | source: Annals of oncology: official journal of the European Society for Medical Oncology | Added Jun 30, 2019

Early breast cancer – a review of treatment guidelines.

This study reviewed early breast cancer (EBC) treatment guidelines.

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breast cancer | Clinical Trial | Added Jun 29, 2019

Searching for patients with advanced breast cancer to trial a new treatment.

This trial aims to find out how safe talazoparib (Talzenna) followed by a combination of talazoparib and avelumab (Bavencio) is in patients with advanced breast cancer. The main outcome that will be measured is if patients have side effects. This study is being conducted in Washington, the United States.

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