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Treating melanoma

If a growth or mole looks like a melanoma, the doctor will take a biopsy to confirm the diagnosis. This entails removing either a sample of tissue or else the entire growth and some surrounding skin, and examining the tissue under a microscope to determine whether it's cancer. Depending on how deep a melanoma is, additional tissue may have to be removed. In some cases, lymph nodes may be removed, too. A procedure called sentinel node biopsy can show whether the lymph node nearest the tumor contains any cancer cells. If it does, surgery to remove additional nodes right away can improve survival.

In addition to surgery, treatments for melanoma include immunotherapy (which strengthens the immune system against the cancer), chemotherapy, and radiation therapy. Newer, so-called targeted treatments include drugs that target specific genetic changes seem in people with certain forms of melanoma. For example, about half of melanomas have genetic changes (mutations) in a gene called BRAF, which signals melanoma cells to grow and divide quickly. Drugs that inhibit BRAF, such as vemurafenib (Zelboraf ) and dabrafenib (Tafinlar), and related proteins are now available.

Stopping estogen therapy may bring back the blues for some women

As estrogen levels fall during menopause, a woman's risk of depression triples. Estrogen therapy helps elevate mood for some women, but a study published in the May 27, 2015, issue of JAMA Psychiatry has indicated that depression may recur once women stop using estrogen.

A team of researchers at the National Institute of Mental Health studied 56 postmenopausal women, 26 of whom had a history of depression and 30 who had never been depressed. The women were each given an estrogen patch to wear for three weeks and tested for depression. None were depressed.

The Department of Defense wages war on prostate cancer

Active and retired servicemen with prostate cancer can get access to clinical trials, experimental therapies, and state-of-the-art care through the Department of Defense’s Center for Prostate Disease Research (CPDR).

Ask the doctor: New DNA-based test for colorectal cancer

Q. I heard that there is a new stool test for colon cancer screening. Can this test replace colonoscopy for me? I am 68 years old with no history of colon problems, and my last colonoscopy was normal.

 

 

A. Among screening tests for hidden colorectal cancer, colonoscopy remains the "gold standard" because it's the most effective technique for detecting colon cancers and simultaneously provides an opportunity to remove any precancerous growths (polyps). The new DNA-based stool test (Cologuard) is less invasive and inconvenient than colonoscopy and finds more cancers and polyps than older stool tests, but it does not entirely eliminate the need for colonoscopies.

Prostate cancer: Treat or wait?

Choosing active surveillance for prostate cancer depends on carefully weighing medical as well as personal factors.

Image: Thinkstock

An approach called active surveillance allows some men with low-risk cancer to delay the decision to treat.

Can't wait to see the doctor? You have choices

Emergency rooms, urgent care clinics, and retail clinics offer immediate care. Your symptoms determine which to use.

You've probably had an illness or injury that you weren't quite sure how to handle. Maybe it was a rattling cough, a finger slammed in a car door, or a rash crawling up your arm. If you can't get in to see your doctor, you have a few options for immediate treatment—the clinic at the nearby shopping mall, an urgent care center, or the emergency room at the nearest hospital. How do you decide which one to go to?

Ask the doctor: My waist has expanded but I haven't gained weight. Is this because I've stopped wearing a belt?

Q. The article in your December 2014 issue about women's waistlines expanding the past few years intrigued me, because I have experienced an increase, and I have not gained weight. My theory is that the styles of the past few years—pants riding low on the hips, no belts at the waist, and loose shirts—may have caused my waist to increase from 24 to 25½ inches. I am 59 years old, so it also could be aging in general, but I still think the belted styles kept women smaller. Am I right?

A. There is no evidence that the physical effect of wearing a belt influences waist circumference. At best, wearing a belt is one way to keep tabs on your waistline. While having to loosen their belt a notch may drive some women to re-examine their diet and exercise routines, it doesn't sound as if you need to do that. I think your alternative explanation that aging is responsible is more likely to be true.

IV osteoporosis drug builds bone in older women who can't take the oral version

A study published online April 13, 2015, in JAMA Internal Medicine indicates that a single infusion of the bisphosphonate drug zoledronate (Reclast) can be used to increase bone density in women who can't take oral versions of bisphosphonates. Taking an oral bisphosphonate like alendronate (Fosamax) is effective in building bone for women with osteoporosis, but it requires a commitment—taking the drug on an empty stomach and remaining upright for 30 minutes afterward. Because this may not be practical for women in assisted living facilities, they often aren't given bone-building drugs, even though their risk of hip fracture is eight to nine times that of women living at home.

The researchers studied 181 women with osteoporosis residing in assisted living facilities. The average age was 85. The women were randomly assigned to one of two treatments—1,200 milligrams of calcium and 800 IU of vitamin D daily as supplements plus a single intravenous infusion of zoledronate or the same daily doses of the supplements alone.

Preventing ingrown toenails

An ingrown toenail is one of the most common sources of foot pain. Although it's usually just a nuisance, it can be a serious problem for anyone with diabetes or circulatory difficulties.

An ingrown toenail develops when the side of the nail digs into the skin. This can lead to pain, irritation, swelling, and redness. The big toe is most often affected, although no toe is immune. The problem usually develops because the nails have not been trimmed properly. Overly tight shoes may also be a factor. Some people have an inherited tendency to develop the problem.

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