Jennifer Wider graduated from Princeton University in 1994 with B.A. in the humanities. She received her medical degree from the Mount Sinai School of Medicine in 1999. During medical school, she interned at a CBS local news affiliate and 20/20 in New York City. Jennifer worked as a senior editor at Medscape/CBS HealthWatch out of medical school. She has had many publications in newspapers, magazines and websites across the country and has been a guest on CBS News, National Public Radio and various cable channels. Jennifer was formerly the managing editor of the health channel at iVillage.com and currently reports on health and medical issues for the Society for Women's Health Research. As well, she is co-author of The Savvy Woman Patient.

Vulvar cancer is the fourth most common cancer of the female genital tract. In 2008, roughly 3,460 cases of vulvar cancer will be diagnosed in the United States and about 870 will die of this cancer, according to the American Cancer Society.

There are several different types of vulvar cancer. More than 90 percent are squamous cell carcinomas. Squamous cells are the same kind of cells that comprise most of the skin on the body and the cells that line the inside the body’s cavities. 

The second most common type of vulvar cancer is melanoma, accounting for about five percent of cases. Just like on other parts of the body, melanomas develop from the skin cells that produce pigment or color.   

The cause of vulvar cancer is unclear, but human papillomavirus is suspected to be a possible risk factor, as is smoking. Patients infected with HIV, the virus that can lead to AIDS may also be more vulnerable to developing vulvar cancer.

“In premenopausal women, many of these cancers are associated with HPV types 16, 18 or 33,” says Isabel Blumberg, M.D., a clinical instructor of obstetrics, gynecology and reproductive science at the Mount Sinai School of Medicine in New York, N.Y.

Vulvar cancer, which affects external female genital organs, is most common on the inner edges of the labia majora or the labia minora. The cancer can also affect the clitoris or Bartholin glands, the tiny, mucus-producing glands on either side of the vaginal opening. It most often affects women 65 years and older, but it can also affect younger women.

The symptoms may or may not be obvious. “Itching is a common complaint, although many patients may be asymptomatic,” Blumberg said. Other symptoms may include:

• Pain or tenderness;
• Burning sensation;
• Non-menstrual related bleeding;
• Any change in size, color, or texture of a birthmark or more in the vulvar area; or
• Open sores, bumps or lumps in the vulvar region.

“Any pigmented lesion in the vulvar area with an increase in size, change in color or development of ulceration should indicate further investigation,” says Amy Freeman, M.D., a board-certified dermatologist in private practice in Millburn, N.J. 

Like many cancers, the earlier the cancer is detected, the more curable it is. Vulvar cancer has a high cure rate, as long as it is detected and treated early. It’s very important for women to seek medical attention if they experience persistent itching, burning or pain in the vulvar region, or if they notice skin changes or open sores that won’t heal properly or in a timely fashion.

A biopsy is necessary to make a proper diagnosis. If the doctor finds an abnormal area in the vulvar area, he or she will biopsy a small piece of skin and examine it under a microscope. Vulvar cancer is most often treated with surgery. The type of surgery needed will be based on the size, depth and spread of the cancer.  Radiation may also be necessary. 

Women with a history of skin cancer may want to ask their dermatologists or gynecologists to add a vulvar examination to their annual check-ups. It is another opportunity for women to take charge of their own health.   

More information about vulvar cancer is available from the National Cancer Institute’s Web site: http://www.cancer.gov/.

The Most Common Spot For Melanoma

Stand Up And See That Cancer Research Is Still A Need

Some Medications Increase Skin Cancer Risk

Prevent Prostate Cancer--The Need To Be Screened

Stand Up And See That Cancer Funding Is Still A Need

Causes of Cancer Misconstrued?

M.D. Anderson Study Finds Racial Disparities Exist in Radiation Therapy Rates For Early Stage Breast Cancer

Largest study of its kind reveals blacks less likely than whites to receive standard of care.

WASHINGTON, DC – Black women are less likely than white women to receive radiation therapy after a lumpectomy, the standard of care for early stage breast cancer , according to a new study by researchers at The University of Texas M. D. Anderson Cancer Center.

The study, the largest of its kind, was presented today in advance of the American Society of Clinical Oncology (ASCO) Breast Cancer Symposium, and is the first national study to examine such racial disparities in radiation therapy. Led by Grace Li Smith, M.D., Ph.D., a postdoctoral fellow in M. D. Anderson’s Department of Radiation Oncology, the researchers reviewed the Medicare records of more than 37,000 patients diagnosed with early stage breast cancer in 2003.

“Although there have been smaller studies of racial disparities in breast cancer care, no prior research has examined the differences across the nation in the rates of radiation therapy after lumpectomy between whites and blacks,” said Smith, the study’s first author. “The national Medicare database, because it’s so comprehensive, allowed us to determine the extent to which racial disparities in radiation therapy affected patients across the country.”

For the retrospective cohort study, Smith and her M. D. Anderson colleagues used Medicare claims to examine the treatment history of women aged 66 and older diagnosed in 2003 with early stage, newly diagnosed breast cancer. Of the 37,305 women who underwent a lumpectomy for their breast cancer, 34,024 were white and 2,305 were black. Overall, 74 percent of the white women received radiation therapy after their lumpectomy; in contrast, 65 percent of the black breast cancer patients received the same treatment.

“The use of radiation after lumpectomy is considered to be the standard of care for women with invasive breast cancer, as clinical trials have demonstrated that it both reduces the chance of recurrence and improves the chance of survival,” said Thomas Buchholz, M.D. , professor in the Department of Radiation Oncology and the study’s senior author. “While there are some breast cancer patients, such as those over age 70, with significant co-morbidities for whom radiation would not be appropriate, this discrepancy remained consistent when specifically looking at patients under the age of 70.”

Perhaps the most unexpected aspect of the study, said Smith, was the magnitude of the disparity in specific areas of the country: the Pacific West, 72 (whites) vs. 55 percent (blacks); East South Central, 72 (whites) vs. 57 percent (blacks), and the Northeast, 70 (whites) vs. 58 percent (blacks).

However, in some parts of the country - the Mountain West (76 percent vs. 74 percent) and the North Central Midwest (74 percent vs. 72 percent) - there was virtually no discrepancy in radiation rates between whites and blacks. That level of geographic non-disparity was also surprising and of great benefit for further research, said Smith.

“Until further research is conducted, we may only speculate about the underlying reasons why black and white women are not receiving radiation at the same rate. We don’t know if fewer black women are receiving radiation simply because it is not offered to them, because they decline the treatment, or perhaps because they are unable to complete a whole course of treatment due to other health problems. These questions will be important subjects of future study. As a medical community, we need to identify and eliminate any obstacle prohibiting all women from receiving necessary care for their breast cancer.”

Smith’s plans for follow up research include evaluating the difference in radiation rates results in a difference in mortality. She also plans to investigate whether radiation patterns correlate with other illnesses secondary to breast cancer care, and if there are disparities in other types of cancer treatment.

Smith hopes that results from the study may prompt physicians and patients to work together to overcome some of the barriers to treatment.

“Physicians may be able to help patients identify specific barriers to their care and may be able to be influential in helping patients overcome such obstacles,” said Smith. “Or, if there are concerns or misconceptions about radiation treatment, patients themselves may play a role by becoming educated about the value of radiation after lumpectomy and helping to disseminate this information into their communities.”

In addition to Smith and Buchholz, other authors of the all-M. D. Anderson study include: Tina Shih, Ph.D., associate professor in the Department of Biostatistics; Ying Xu, M.D., senior statistical analyst, Division of Quantitative Sciences; Sharon Giordano, M.D., associate professor in the Department of Breast Medical Oncology; Benjamin Smith, M.D., adjunct assistant professor in the Department of Radiation Oncology; George Perkins, M.D., associate professor in the Department of Radiation Oncology; Welela Tereffe, M.D., assistant professor in the Department of Radiation Oncology; Wendy Woodward, M.D., Ph.D., assistant professor in the Department of Radiation Oncology.

The research was supported by a grant from the Department of Defense Breast Cancer Research Program, BC062438.

M.D. Anderson Doctor Making Cancer History

Fly American And Help Save Lives

Are You A Cancer Survivor?

by Kelly Jad'on

We are in a global war.  It is a fight against the disease known as cancer, and the clock is ticking.   

Emotionally, it is difficult to believe that someone you love is sick and may even die.  I remember the night my father was diagnosed with pancreatic cancer in an emergency room.  A man I never saw cry, shed tears that night.

Physically, treatments and the disease ravage the body.  In many cases the war against the cancer is won, but not without battles and the will to live.  

A tidal wave of cancer is headed to our shores, and financially, the impact of the cost for treatment is not always acceptable.  Devra Davis has written that soon we will not have enough surgeons and oncologists to handle our growing treatment needs.   Each year approximately $100 billion is spent on treatment alone,  many may not be able to afford the costs without adequate healthcare coverage.

President George W. Bush proclaims September, 2008 to be National Prostate Cancer Awareness Month and also National Ovarian Cancer Awareness Month.  Regarding prostate cancer he states, "My Administration remains committed to helping America's dedicated medical professionals learn more about the cause of prostate cancer and develop new and better ways to combat it. Since 2005, the Cancer Genome Atlas has studied the genetic sources of all types of cancer. By supporting medical research, conducting clinical trials, and developing new surgical techniques to help patients recover quickly, the National Institutes of Health, the National Cancer Institute, and the Centers for Disease Control and Prevention are helping lead the fight against prostate cancer."

Yes, we do lead the world in cancer treatment but will we lose ground without the proper funding?  During my search for a pancreatic cancer treatment for my father, I did not find a cure, nor even a useful treatment. But I was able to speak with researchers who advised me to contact our government, as funding for research had been cut.  The National Cancer Institute maintains that between 2004-2008, they've operated on a flat budget.  However, inflation has increased, and in order to continue, funding must be increased from $5.2 billion to $6 billion for 2009.  As time and money is lost, researchers leave, allowing the United States to fall behind as the world leader in cancer research.

Cancer research in the lab usually starts with grants from the federal government, the amounts designated by Congress and the President.  There are also grassroots foundations such as LiveStrong, Susan G. Komen for the Cure, and Stand Up To Cancer which strive to raise monies for survivor support and continued research.

On September 5, 2008 Stand Up To Cancer will be hosting a show across all major networks, in an effort to raise awareness of the need for a combined effort in this war.  We all need to stand up together and say "Hey!  What's been done is simply not enough."  Odds are that 1 of every 2 men and 1 of every 3 women will be diagnosed with cancer within his or her lifetime.  We can wait no longer.

Our Choice: To Make A Healthier America

Texas Holds The Cure To Cancer

Mike Milken was called “The Man Who Changed Medicine” in a Fortune magazine cover story highlighting his three decades of work to accelerate medical research. In 1982, he formalized his previous philanthropy by co-founding the Milken Family Foundation, which has been a leader in support of worldwide research on various forms of cancer, pediatric neurological disorders, Alzheimer’s and other diseases. He heads FasterCures, a Washington-based think tank dedicated to accelerating progress against all life-threatening diseases; and the Melanoma Research Alliance, which supports research on fatal skin cancers. He is the co-author of the best-selling Taste for Living Cookbook.

Milken also chairs the Milken Institute, a major economic think tank whose annual Global Conference brings 3,000 thought leaders from 60 nations to Los Angeles. As a financier, he is often said to have revolutionized modern capital markets, making them more democratic by innovating a wide range of financing techniques previously unavailable to most companies. Starting in 1969, he financed thousands of companies that created millions of jobs. He is a graduate of the University of California at Berkeley and the University of Pennsylvania’s Wharton School. He and his wife Lori, who have three children and three grandchildren, recently celebrated their 40^th wedding anniversary. Details are at www.mikemilken.com.

Mike Milken--

Biotechnology researchers work in a field of mind-boggling complexity that requires years of rigorous training. They can tell you how hard it is to make even small advances against major diseases. So assuming you don’t have an advanced scientific degree, you might think there’s nothing you can do to achieve the kind of medical breakthroughs that would eliminate half the diabetes cases, prevent one of every five cancer deaths, and save trillions of dollars. Anyone who developed a pill that could do that would win a Nobel Prize.

You have that pill. It’s called lifestyle choice. And it’s free.

The fact that lifestyle affects health isn’t news. But in a recent report, the Milken Institute showed lifestyle’s economic impact – how our choices contribute to chronic diseases that increase treatment and insurance costs, reduce productivity, erode our international competitiveness and, worst of all, magnify personal suffering.

The report, “An Unhealthy America: The Economic Burden of Chronic Disease,” quantifies the staggering costs of “failing to contain the containable.” In this presidential election year, we need more focus on these costs, which undermine prospects for extending health insurance coverage and for coping with the medical burden of an aging population. The opportunity costs also include diversion of skilled research and clinical talent to chronic-disease care.

For every dollar we spend on treatment, we lose three to four times as much indirectly. When chronically ill workers take sick days, their absenteeism reduces the supply of labor and with it the gross domestic product (GDP). But the greatest GDP impact is from “presenteeism,” which reduces output when sick employees show up for work to avoid losing wages and then perform below par. Combining the diversion of caregivers with the costs of absenteeism and presenteeism, the total impact of chronic disease already exceeds $1 trillion a year in the United States.

This cost is one of three interdependent health-policy concerns. The second is the cost of advanced research. Third is the system of distributing and paying for medical services so all Americans have access to high-quality care. If we address all three with good policy decisions, we can assure longer life spans and higher quality of life at substantially reduced cost. But we need to start now. By mid-century, the preventable impact of seven chronic diseases – diabetes, pulmonary conditions, hypertension, mental disorders, heart disease, cancers and stroke – could reduce annual GDP by six trillion dollars a year.

Behavioral choices – especially those that underlie obesity – often affect the prevalence, severity and costs of these diseases. While genetic factors are very important, as much as 70 percent of direct healthcare spending is to treat lifestyle-related conditions. In calculating cost savings, our report assumed only a modest reduction in the percentage of overweight and obese Americans from the current two-thirds to about half.

We can and should do better. One of every four Americans is now more than 20 percent above ideal body weight, the dividing line between overweight and obese. That’s up from one in eight as recently as 1990. What if we turned the clock back only a decade, returning to 1998 obesity levels? The impact would be 15 million fewer cases of the seven chronic diseases by 2023. In that year alone, without adjusting for inflation, we would reduce healthcare spending by $60 billion and increase productivity by $254 billion. In fact, the single most effective way to reduce the burden of disease and lower costs is to reduce obesity.

No one claims it’s easy to change diet and exercise habits. In my case, it took a doctor saying, “You have cancer.” Yet we’ve made progress against smoking – another entrenched habit – and I believe we can do the same with obesity.

It’s also vital that we build on our national commitment to medical research. If we continue cutting back on research, we risk losing a generation of young physician-scientists. Unfortunately, recent National Institutes of Health budgets have declined in real terms. Yet with better cooperation among industry, academic and government researchers, we can still make real progress toward life-saving cures. If that means eliminating some bureaucratic regulations that limit joint public-private efforts, let’s do it.

America woke up 50 years ago when Sputnik shocked us into action. We need similar resolve today so chronic diseases don’t undermine our economy from within the way the Soviet challenge of the 1950s threatened our security from without. Each of us can help by taking reasonable steps to reduce our personal chronic-disease risks. Progress against the preventable cost of these diseases will free up the human, social and financial capital we need to fund crucial research and provide high-quality healthcare to all Americans. 

The End of Cancer Begins With Everyone Standing Up

The Cost of Obesity in the United States

Lifetime Medical Costs of Obesity Are Unlikely To Spur Obesity Prevention Efforts

Robert Ferguson is a lecturer, author, nutritionist, celebrity trainer and weight loss expert. He has worked with elite professional boxers such as Fernando Vargas, Sergio Mora, Samuel Peter, Lucia Rijker, Stevie Forbes, and Maureen Shea. He created the Food Lovers Fat Loss System and guides his website: www.dietfreelife.com.

Robert Ferguson--

Mark Goulston , M.D. is a former UCLA professor who helps high performing leaders, senior management and sales people reach their full potential using skills he learned training FBI and police hostage negotiators. He is a member of the National Association of Corporate Directors and the Worldwide Association of Business Coaches and writes the weekly Tribune syndicated career advice column, "Solve Anything with Dr. Mark" and columns on leadership for FAST COMPANY and Directors Monthly and is an expert at People Jam. He is frequently called upon to share his expertise with regard to contemporary business, national and world news by television, radio and print media including: Wall Street Journal, Harvard Business Review, Fortune, Newsweek, Time, Los Angeles Times, ABC/NBC/CBS/Fox/CNN/BBC News, Oprah, and Today. Mark Goulston is the author of The 6 Secrets of a Lasting Relationship, Get Out of Your Own Way: Overcoming Self-Defeating Behavior, Get Out of Your Own Way at Work and PTSD for Dummies. For more information visit: www.markgoulston.com

Best Selling author, Brenda Watson ND, CNC, recently published The Fiber35 Diet: Nature's Weight Loss Secret.  Brenda lets us in on another weight loss secret she employs.

Brenda Watson--

By now, almost everyone’s heard the pitch for fish. Fish oil helps support heart and brain health. And yet, even though fish oil is a key player in fostering good health, Americans rarely include this necessary fat in their diets. Instead, most Americans consume fats found in vegetable oils, and these Omega-6 fats cause the body to release chemicals that promote inflammation. In contrast (and neglected in a world of fast and processed food), the Omega-3 fats in fish oil have been shown to reduce inflammation, keep mental processes sharp, and support a healthy cardiovascular system.

Important Health Support
Since World War II, our intake of Omega-6 fats has doubled while intake of Omega-3 fats has shrunk. Diets rich in Omega-6s may partly explain the increase in diabetes, heart disease and high blood pressure, depression, and weight gain. On average, today’s American consumes about forty times as much Omega-6s as Omega-3s when a healthier ratio would be a 2:1 ratio (Omega-6 to Omega-3), which could make a difference in our health today and tomorrow. Omega-3s include eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), and cold-water fish like mackerel, salmon, cod, flounder, albacore tuna, sardines and anchovies are rich sources.

Heart Help. Fish oil’s Omega-3 fats have been shown to produce dramatic benefits for the heart. A European study of people with heart disease found that one gram of fish oil a day for several years reduces the risk of heart attack by 25 percent (Lancet 1999; 354:447-55). Both EPA and DHA support healthy blood vessels, reducing inflammation and the dilation of arteries.

Brain Help. Omega-3s also support the health of an aging brain. In lab tests at the University of California at Los Angeles, researchers found that Omega-3 fats could protect against memory loss and reduce cell damage linked to Alzheimer's disease (Neuron, 9/2/04). In addition, their study suggested that Omega-3s in fish oil can slow the progression of the disease in its later stages.

Membrane Builders. Omega-3s are also linked to supporting the health of cell membranes. Cell membranes regulate the movement of molecules into and out of the cell, and Omega-3s may assist with a cell's natural flexibility. In contrast, high levels of Omega-6s may compromise that function, increasing inflammation and cell rigidity.

Losing Body Fat. Research shows that taking fish oil supplements may burn stored "bad" fat by displacing it with "good" fats like those in fish oils. An increase in Omega-3s can help your body eliminate stored Omega-6s more efficiently. Studies on animals indicate that without adequate Omega-3s in the diet, body fat tends to accumulate.

*Sources 1-7:
Exper Bio, 4/4/06
Amer Jrnl Resp & Crit Care Med, 12/05
CurrOpin ClinNutr Metab Care 2001 Mar;4(2):115-21
Arch Neurol. 2005; 62: 1-5
Cell Metabolism; vol. 1, pp. 309-322, May. 2005
Amer Thor Soc Intrnl Conf 5/25/04
Expel Bio Conf, 2002