Tiny Wireless Pacemaker Shows Early Promise

By Dennis Thompson
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- A new wireless pacemaker appears safe and feasible for use, potentially advancing the technology that cardiologists use to maintain heart rhythm in patients, according to results from a new clinical trial.

Doctors successfully implanted the device in 32 out of 33 patients. Of these, two people who received the pacemaker developed side effects -- a complication-free rate of 94 percent. Complications for the patient with unsuccessful implantation, however, proved to be severe.

After three months, the new pacemakers continued to function well, the researchers reported in the April 8 issue of the journal Circulation. They expect to report longer-term outcomes later this year.

The concept of a self-contained wireless pacemaker has been around more than 40 years, and this first successful use of such a device to treat humans is considered a step forward for cardiology.

"This is an advance that will have a huge impact on the field," said Dr. Bradley Knight, a cardiologist at the Northwestern University Feinberg School of Medicine and a spokesman for the American Heart Association. "This opens up a whole bunch of new potential opportunities for pacing a patient's heart."

Today's pacemakers maintain the heart's rhythm by sending electrical signals through wires that run from the device into the heart through a person's veins, said the study's lead author, Dr. Vivek Reddy, director of the cardiac arrhythmia service at Mount Sinai Hospital in New York City.

"These leads are the weak link for the whole system," Reddy said of the wires. The leads tend to break over time, and when they do doctors must extract and replace them.

Unfortunately, the wires sometimes grow into the wall of the vein, and laser surgery could be required to cut them free.

This new wireless pacemaker contains its own pulse generator, and is affixed directly inside the right ventricle of the heart through a catheter run up a vein from a patient's leg or groin, Reddy said. The nonsurgical procedure is faster and easier than the surgery currently required to implant a pacemaker, the researchers said.

The unit itself is smaller than a triple-A battery -- 6 millimeters in diameter and about 42 millimeters long. "The total amount of space it displaces is about 1 cc of fluid, so it's very, very small," Reddy said.

The wireless pacemaker is expected to operate for eight to 14 years before it runs out of juice, Reddy said.

The pacemaker is manufactured by Nanostim Inc., of Sunnyvale, Calif. The study was funded by Nanostim, which, according to the study, employs two of the researchers and has provided several more with grant support. Reddy also has stock options in the company.

The clinical trial for the device involved 33 patients at two hospitals in Prague and one in Amsterdam. The average age of the patients was 77, and two-thirds were men.

One patient experienced complications during the implant procedure, and this case highlights one of the potential problems with the new pacemaker, Reddy and Knight said.

Since the device must be placed inside the heart, there is a risk that the heart muscle can be torn during the procedure. That's what happened to the 33rd patient, who underwent emergency surgery to repair the tear but later died after suffering a stroke.

Two patients who successfully received the implant later developed complications.

In one patient, the pacemaker drifted into another heart chamber through a hole in the person's heart wall left by a birth defect. Doctors discovered the problem, removed the device in about six minutes and replaced it with another wireless pacemaker, according to the study.

The second patient with complications experienced fainting and rapid heart beat, and doctors ended up replacing the pacemaker with an implantable cardioverter-defibrillator.

Also, the pacemaker initially would be of limited use in the United States because it can only provide pacing to one chamber of the heart. Between 75 percent and 80 percent of patients in the United States need pacemakers that help control the rhythm of both the upper and lower chambers of their heart, Reddy said.

This wireless pacemaker would at first be useful in treating people who have atrial fibrillation -- an irregular heartbeat -- since they need pacing only in their right ventricle, Knight said. It also could help people with less severe heart problems who need only intermittent pacing.

Knight said he believes problems related to heart tears and single-chamber pacing will be resolved as newer, smaller models of wireless pacemaker become available.

"This is just the beginning," he said. "These things will get smaller and be able to be placed in multiple locations in the heart."

For example, dual-chamber pacemaking could be achieved using a pair of the wireless devices -- one in the upper atrial chamber and another in the lower ventricular chamber -- if communication is established between them to sync their pulses.

Clinical trials for the device already have begun in the United States, Reddy said. The first American received a wireless pacemaker about a month ago at Mount Sinai Hospital.

Researchers hope the device can receive approval from the U.S. Food and Drug Administration by 2016. The wireless pacemaker currently is available to patients outside the United States, Reddy said.

The medical device firm Medtronic has developed a competing wireless pacemaker, Reddy said, and clinical trials for that device started in late 2013.

Because of the competition, Reddy expects that the new pacemakers will be more expensive than current devices but not exorbitantly so.

"I'm sure they'll charge a premium in the beginning, but if there's any competition they can't charge too much more," he said.

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Vivek Reddy, M.D., director, cardiac arrhythmia service, Mount Sinai Hospital, New York City; Bradley Knight, M.D., cardiologist, Northwestern University Feinberg School of Medicine, Chicago, and spokesman, American Heart Association; April 8, 2014, Circulation

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Medical Marijuana Pills May Ease Some MS Symptoms: Review

By Maureen Salamon
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- Medical marijuana pills and sprays might ease the symptoms of multiple sclerosis, but most other alternative therapies do little to lessen the pain and muscle rigidity that often accompanies the disease, according to new guidelines.

To reach that conclusion, an expert panel from the American Academy of Neurology reviewed more than 40 years of research on alternative medicine treatments for multiple sclerosis (MS).

In addition to the recommendations about medical marijuana use, the nine experts also found that ginkgo biloba might help with the fatigue of MS and reflexology may ease MS symptoms such as tingling, numbness and other unusual skin sensations. Bee sting therapy and omega-3 fatty acids, however, offer weak evidence supporting their use.

"It's a very common practice in the MS patient population to try alternative therapies," said the author of the guidelines, Dr. Vijayshree Yadav, clinical director of Oregon Health & Science University's MS Center, in Portland.

"The problem is there was never an evidence-based recommendation for MS patients or those taking care of patients," Yadav said. "This is a first step to educate each audience."

The guidelines are published in the March 25 issue of the journal Neurology.

Affecting more than 2.3 million people worldwide, MS causes a variety of symptoms such as loss of balance, vision loss, bowel problems, slurred speech and numbness, which can come and go. The disease of the central nervous system is thought to be caused by an inflammatory response of the immune system, which attacks nerve tissue in the brain and spinal cord.

According to the academy, two types of conventional drugs are available for the incurable disorder: disease-modifying therapies, which can slow progression and reduce the number of relapses, and symptomatic therapies, which relieve some symptoms but don't affect the course of the disease.

Of all the alternative therapies reviewed, the experts' strongest support was for medical marijuana pills and spray, which moderate evidence indicated could ease MS patients' pain, frequent urination and muscle rigidity known as spasticity. Not enough evidence showed whether smoking marijuana is helpful in treating MS symptoms, Yadav added.

The researchers said there can be serious side effects with medical marijuana, such as seizures, dizziness, thinking and memory problems, and depression. Since some people with MS face a higher risk for depression and suicide, patients should discuss the safety of medical marijuana with their doctor.

Between 33 percent and 80 percent of MS patients use various alternative therapies to treat their symptoms, especially women, those with higher education levels and those reporting poorer health, according to the academy. But the safety of most of these therapies is unknown, and most are not regulated by the U.S. Food and Drug Administration.

Timothy Coetzee, chief advocacy, services and research officer for the National MS Society, was not involved in crafting the guidelines, but said the potential of marijuana and its derivatives as a treatment for MS symptoms is important. "I think it really emphasizes our approach to support the rights of people with MS to work with their doctors, recognizing that they need to do this in the context of the legal regulations of the state they're in," he said.

Marijuana-based spray isn't legally available in the United States, Yadav said, but is sometimes obtained by U.S. patients from Canada, where the spray is legally available.

Man-made marijuana pills, known as dronabinol and nabilone, are FDA-approved for nausea and vomiting associated with chemotherapy. Yadav said MS patients can be prescribed the pills as an "off-label" use, at their doctors' discretion.

Yadav said she was surprised to find benefits from the use of an alternative treatment known as magnetic therapy, in which magnets are placed on the skin to produce a magnetic force that is thought to improve body function. Moderate evidence showed magnetic therapy reduced tiredness in MS patients, but it did not help with symptoms of depression.

Coetzee said the guidelines are important because they will help inform conversations between people with MS and their doctors about strategies they can employ to reduce symptoms, which are often a combination of conventional and alternative therapies.

"We're at a place where we need to continue to understand and better appreciate the benefits of what we know and don't know about [alternative medicine]," he said. "I view it as integrated care. It's important we continue to keep our options open so people with MS can live their best lives."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Vijayshree Yadav, M.D., clinical director, Oregon Health & Science University MS Center, Portland; Timothy Coetzee, Ph.D., chief advocacy, services and research officer, National Multiple Sclerosis Society; March 25, 2014, Neurology

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Many Don't Understand Obamacare or Health Insurance, Survey Finds

By Amy Norton
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- As the deadline looms for Americans to enroll in "Obamacare" this year, a new study finds that many people -- especially the uninsured and those with lower incomes -- know little about the new health care law, known as the Affordable Care Act.

Most significantly, researchers found, Americans show little understanding of the cornerstone of the reform -- the online marketplaces, or "exchanges," that have been set up to help people shop for an insurance plan, and find out if they're eligible for Medicaid or subsidies to help pay for their health insurance.

Overall, half of the 6,000 U.S. adults surveyed did not even know what an exchange was, and among the uninsured, a full 64 percent didn't know. In addition, over 40 percent of survey respondents did not know what an insurance deductible was, including nearly 60 percent of the uninsured.

Experts were concerned by the findings, reported in the March 24 online edition of the Proceedings of the National Academy of Sciences. But they were not shocked.

"No, this doesn't surprise me at all," said Dr. Kavita Patel, a fellow at the Washington, D.C.-based Brookings Institution.

Low "health literacy" -- people's understanding of health information and ability to use it -- is a well-known problem, and not limited to health care reform, noted Patel, who was not involved in the study.

To be fair, the new report is based on a survey done in August and September of last year -- before the state and federal exchanges were up and running, and before the troubled federal website was grabbing headlines everywhere.

By now, Americans may know more, according to Silvia Barcellos, an economist at the University of Southern California who led the study.

She said she and her colleagues are planning a follow-up survey in April to see if there has been a change.

Regardless, Barcellos said, the current findings are worrisome, especially the lack of awareness among the uninsured.

"These are the people everyone is counting on to enroll," she noted.

And the problems go beyond awareness of the exchanges. "Many people lack a basic understanding of how health insurance works," Barcellos said.

March 31 is the deadline for enrolling for insurance coverage for 2014 under the Affordable Care Act.

Of all survey respondents, 42 percent did not know what an insurance deductible was -- including 58 percent of the uninsured.

The same was true for 30 percent to 45 percent of those living between 100 percent and 400 percent of the federal poverty level. Many of those Americans are eligible for tax credits to help pay for insurance bought through the exchanges. They are another group that stands to benefit the most from the Affordable Care Act.

But if uninsured and lower-income people don't understand how health insurance works, Barcellos said, "how can you expect them to make informed decisions when they choose a plan?"

Sharon Long, of the Urban Institute's Health Policy Center in Washington, D.C., agreed.

"Health insurance is complicated, and we're talking about people who may never have had it in the past," said Long, who was not involved in the study. "It's ironic that we're asking people without that experience to make good choices."

Brookings' Patel pointed out that this problem was anticipated. Federal and state governments have so-called navigator programs to help applicants get through the enrollment process. Those navigators include individuals and groups -- from nonprofits to hospitals to church groups -- who are trained and certified (and paid) by the government.

"The role of the navigators is important," study author Barcellos said. But, she added, people also need to know the programs exist.

There are other potential ways to make the exchanges more user-friendly, according to Barcellos. One step, she said, could be to redesign the exchange websites to "nudge" people to the best plans -- by highlighting certain economical and better-quality plans on the first page of the site.

Barcellos said research has shown that when people have too many choices -- especially complex ones -- their tendency is to opt for whatever seems easiest.

"Or," she said, "they may make no choice at all."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Silvia Helena Barcellos, Ph.D., research scientist, University of Southern California Center for Economic and Social Research, Playa Vista, Calif.; Kavita Patel, M.D., managing director, clinical transformation and delivery, Brookings Institution, Washington, D.C.; Sharon Long, Ph.D., senior fellow, Health Policy Center, Urban Institute, Washington, D.C.; March 24, 2014, Proceedings of the National Academy of Sciences, online

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Violent Video Games Tied to Combative Thinking in Study

By Alan Mozes
HealthDay Reporter

MONDAY, March 24, 2014 (HealthDay News) -- Frequent exposure to violent video games increases the likelihood that children and teens will engage in aggressive behavior themselves, new research indicates.

The study of more than 3,000 children found that habitually playing games such as "Call of Duty" and "God of War" might alter their view of their real-world environment and peers, the researchers said.

"[Violent gaming] basically changes a child's or adolescent's personality in some sense, so that they start to see their world in a more aggressive way," said study co-author Craig Anderson, director of the Center for the Study of Violence at Iowa State University.

"They start to expect people to behave more aggressively toward them, and they tend to see aggressive solutions as being more appropriate for solving problems," Anderson said.

More than 90 percent of American kids play video games, many of which portray violence in a fun framework free of negative consequences, the researchers said. Because of these large numbers, research such as this has significant implications, they said.

Still, parents shouldn't panic, Anderson said.

"Playing a violent video game isn't going to take a healthy kid who has few other risk factors and turn him into a school shooter," he said. "But it is a risk factor that does drive the odds for aggression up significantly."

Anderson said there are many other known risk factors for aggression, such as growing up with parents who are visibly aggressive or living in a violent neighborhood.

The children enrolled in the study, which was published online March 24 in the journal JAMA Pediatrics, came from six primary and six secondary schools in Singapore. All were between 8 and 17 years old, and nearly three-quarters were boys.

For three years, the students were surveyed annually about the time they spent playing video games and about the nature of their favorite games.

In addition, the children discussed their feelings of empathy and aggression, and were asked about any past aggressive behaviors. For example, children were asked if they felt it was OK to respond to certain provocative situations by hitting someone, whether they ever thought about hurting a peer and whether seeing someone else who was upset bothered them.

By stacking violent video game habits up against aggressive thought patterns and behavior, the investigators determined that during the three-year study period kids with a lot of exposure to violent video games were more likely to engage in aggressive behavior.

This link seemed to result from a lasting increase in aggressive thinking, the researchers said. That included a rise in aggressive fantasies, and a growing tendency to attribute hostile motives to others.

The shifts in thinking associated with heavy use of violent games occurred for both girls and boys, even when parents monitored their child's gaming habits. The changes were also found to be independent of a child's initial aggressiveness, the study found.

The researchers also said having feelings of empathy didn't seem to dampen the link between violent gaming and aggression, and the link was seen more or less across all age groups.

The authors said more research is needed to better understand the effects of playing video games that glorify brutality. "[But] at least one major reason aggressive behavior went up in children is because violent video games seemed to increase a child's violent thought patterns," Anderson said.

Richard Gallagher, director of the Parenting Institute at the New York University Child Study Center, said he wasn't surprised by the findings.

"Research data with persons of all ages has consistently indicated that playing violent video games does change attitudes and does possibly alter behavioral tendencies," he said. "And it's looking like it shifts kids to what's considered to be a kind of disturbed and biased thinking."

This is important for people to know in terms of public policy and parenting, Gallagher said.

"These kinds of games are not benign," he said. "They might not cause all kids to get involved with negative and aggressive behavior, but they do push them more in that direction."

Copyright © 2014 HealthDay. All rights reserved. SOURCES: Craig Anderson, Ph.D., distinguished professor, psychology, and director, Center for the Study of Violence, Iowa State University, Ames, Iowa, and past president, International Society for Research on Aggression; Richard Gallagher, Ph.D., director, Parenting Institute, and associate professor, New York University Child Study Center, New York City; March 24, 2014, JAMA Pediatrics, online

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New Guidelines Might Limit Need for Lymph Node Removal for Breast Cancer

MONDAY, March 24, 2014 (HealthDay News) -- Biopsies of so-called "sentinel" lymph nodes under the arms should become more widespread among breast cancer patients, according to updated guidelines from the American Society of Clinical Oncology (ASCO).

The group, which represents cancer specialists, said the new recommendations should also restrict the number of women who will require further removal of multiple nodes after biopsy, cutting down on painful side effects.

In sentinel lymph node biopsy, a few lymph nodes are removed and checked for signs of cancer -- hence the name "sentinel." Usually, if these lymph nodes have no cancer, it means the remaining, unchecked lymph nodes should also be cancer-free.

The new ASCO recommendations expand eligibility for sentinel node biopsy and will reduce the number of patients who undergo a more invasive procedure called axillary -- underarm -- lymph node dissection, which carries a higher risk of complications, the group said.

In axillary lymph node dissection, most lymph nodes under the arm on the same side as the breast tumor are removed and examined for cancer. This procedure can cause long-term side effects such as pain and numbness in the arm and swelling due to a build-up of lymph fluid.

The new guidelines state that for women whose sentinel lymph nodes show no signs of cancer, removal of more underarm lymph nodes is not recommended.

The guidelines also addressed the case of women who undergo lumpectomy instead of full mastectomy and are also scheduled for whole-breast radiation therapy to help "mop up" residual cancer. If these patients have signs of cancer in only one or two sentinel lymph nodes upon biopsy, they too may opt to avoid further node removal, the ASCO experts said.

Women who have undergone mastectomy but show signs of cancer's spread in sentinel lymph nodes should be offered further node removal, the guidelines reaffirmed.

The ASCO also said women who are diagnosed with certain breast cancers while pregnant can skip sentinel node biopsy.

The ASCO issued initial guidelines on sentinel node biopsy in 2005. The new guidelines, published March 24 in the Journal of Clinical Oncology, are based on the findings of a panel of experts who reviewed studies published between 2004 and 2013.

"The updated guideline incorporates new evidence from more recent studies -- nine randomized controlled trials and 13 cohort studies since 2005," panel co-chairman Dr. Armando Giuliano said in an ASCO news release.

"Based on these studies, we're saying more patients can safely get sentinel node biopsy without axillary lymph node [removal]," he said. "These guidelines help determine for whom sentinel node biopsy is appropriate."

Panel co-chairman Dr. Gary Lyman said, "We strongly encourage patients to talk with their surgeon and other members of their multidisciplinary team to understand their options and make sure everybody is on the same page."

"The most critical determinant of breast cancer prognosis is still the presence and extent of lymph node involvement," he said. "Therefore, the lymph nodes need to be evaluated so we can understand the extent of the disease."

Two breast cancer specialists welcomed the new guidelines.

"Over the past few years, there has been a movement to limit the amount of axillary [lymph node] surgery in patients undergoing breast conservation," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

Bernik said the new guidelines are important because some doctors have been reluctant to move away from further underarm node removal when a patient has even one affected sentinel node. "This update will give surgeons the confidence to tell patients that a sentinel lymph node biopsy may be enough, even if there is evidence of spread, in patients undergoing [lumpectomy]," Bernik said.

"However, it is still important for surgeons to discuss the pros and cons with a patient, as not all [real-world] patients fit the study criteria," she said. "Furthermore, it needs to be stressed that the more limited surgery does not apply to women undergoing mastectomies."

Dr. Debra Patt is the medical director of an expert panel that assesses cancer care guidelines for the US Oncology Network. She said she was "thrilled" at the new ASCO guidelines because they seem to echo the results of recent studies.

"In 2010, a study presented at the ASCO annual meeting showed that women undergoing breast-conservation surgery with clinically node-negative small breast cancers could safely avoid removing all the lymph nodes from under the arm in most cases," Patt said. "There has been greater variance in treatment patterns in my community practice, and I believe these updated guidelines will direct practitioners to evidence-based patient care."

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Debra Patt, M.D., medical director, Pathways Task Force and Healthcare Informatics, US Oncology Network; American Society of Clinical Oncology, news release, March 24, 2014

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New Therapy May Shrink Enlarged Prostate With Fewer Side Effects: Study

MONDAY, March 24, 2014 (HealthDay News) -- A new noninvasive procedure may bring long-term relief from symptoms caused by an enlarged prostate, a new study suggests.

As men age, the prostate gland grows larger and may begin to press on the urethra. Enlarged prostate affects more than half of men by age 60 and causes symptoms such as frequent urination, weak urine stream and a persistent feeling of having to urinate.

Surgery is the standard treatment for the condition, but can cause complications such as sexual dysfunction and impotence, experts note.

The new treatment is called prostate artery embolization. "Prostate artery embolization is a promising therapy that has been performed outside the United States to improve men's symptoms," explained Dr. Man Hon, chief of interventional radiology at Winthrop University Hospital in Mineola, N.Y.

"This procedure works by closing the blood supply to the prostate," said Hon, who was not involved in the new study. "As a result, the prostate shrinks in size, causes less blockage, and the symptoms improve."

The study was conducted in Portugal and included nearly 500 men, aged 45 to 89, with enlarged prostate -- formally called benign prostatic hyperplasia -- who underwent prostate artery embolization.

Improvements in symptoms were reported by 87 percent of men three months after the procedure, 80 percent after 18 months, and 72 percent after three years. The procedure did not cause sexual dysfunction or impotence, according to the findings, which were slated for presentation on Monday at the annual meeting of the Society of Interventional Radiology (SIR), in San Diego.

"The results of prostate artery embolization (PAE) are similar to surgery but with fewer complications," study author Dr. Martins Pisco, director of radiology at Saint Louis Hospital in Lisbon, said in a meeting news release. "Patients are discharged three to six hours after the treatment with most of the individuals we've treated noting almost immediate symptom relief."

"I believe PAE could eventually become standard treatment for enlarged prostate," he added.

However, Dr. James Spies, president elect of SIR, stressed that further studies are needed before the procedure could become widely available. Also, studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Another expert agreed that more study is needed. Dr. Manish Vira is director of the Fellowship Program in Urologic Oncology at The Arthur Smith Insitute for Urology in New Hyde Park, NY. He pointed out that the Portuguese study was not designed to compare the success rate of embolization to that of other treatments.

However, Vira added that "the results are especially significant given the very low complication rate and no incontinence. If these results are replicated in the ongoing U.S. trials, then prostate artery embolization will become an attractive treatment option" for men with enlarged prostate who have not responded well to other treatments.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Manish A. Vira, M.D, director, Fellowship Program in Urologic Oncology, The Arthur Smith Institute for Urology, New Hyde Park, NY; Man Hon, M.D, chief, interventional radiology, Winthrop University Hospital, Mineola, NY; Society of Interventional Radiology, annual meeting news release, March 24, 2014

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Targeted Radiation Might Help Fight Advanced Breast Cancer: Study

MONDAY, March 24, 2014 (HealthDay News) -- A minimally invasive treatment that delivers radiation directly to tumors may slow progression of breast cancer that has spread to the liver, a new study suggests.

The treatment is called yttrium 90 (Y-90) radioembolization. Doctors insert a catheter through a tiny cut in the groin and guide it into the artery that supplies the liver. Radiation-emitting micro beads are then sent through the catheter and float out to kill small blood vessels that feed the tumor.

Researchers led by Dr. Robert Lewandowski, an associate professor of radiology at Northwestern University Feinberg School of Medicine in Chicago, looked at the outcomes of 75 patients. The women ranged in age from 26 to 82, and had chemotherapy-resistant breast cancer that had spread to the liver ("metastatic" disease). Their liver tumors were too large or too numerous to be treated with other methods, the authors noted.

Y-90 radioembolization therapy stabilized 98.5 percent of the treated liver tumors, according to the study, which was to be presented Monday in San Diego at the annual meeting of the Society of Interventional Radiology.

In addition, 24 of the women experienced a more than 30 percent shrinkage in tumor size after treatment, which caused few side effects.

"Although this is not a cure, Y-90 radioembolization can shrink liver tumors, relieve painful symptoms, improve the quality of life and potentially extend survival," Lewandowski said in a society news release.

"While patient selection is important, the therapy is not limited by tumor size, shape, location or number, and it can ease the severity of disease in patients who cannot be treated effectively with other approaches," he added.

Two breast cancer experts were cautiously optimistic about the findings.

According to Dr. Neelima Denduluri, "while these results appear promising, this is a very small retrospective study," meaning that it fell short of the "gold standard" type of prospective trial that tracks patients going forward over time. "Randomized controlled prospective studies addressing this issue are necessary before radioembolization can be incorporated routinely," she believes.

For now, "in women that cannot receive systemic therapy due to toxicities [side effects], are not eligible for clinical trials that utilize new agents, or have exhausted conventional chemotherapy options, radioembolization may be a choice," said Denduluri, a medical oncologist with Virginia Cancer Specialists in Arlington, Va., a US Oncology Network affiliate.

Dr. Stephanie Bernik is chief of surgical oncology at Lenox Hill Hospital in New York City. She said that while this type of therapy has been used to fight liver tumors, "the ability to use this therapy in treatment of metastatic breast cancer to the liver offers some hope to patients with the disease."

Bernik stressed that, right now, the treatment can only extend survival for women with advanced breast cancer, it is not a cure. However, "as the technique is modified and perfected, it is hoped the [treatment] can help achieve remission in women with advanced disease."

Each year in the United States, about 117,000 patients are diagnosed with breast cancer that has spread to the liver. Chemotherapy is the standard treatment in such cases, but is not effective in, or suitable for, all patients.

Experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCES: Neelima Denduluri, M.D., medical oncologist, Virginia Cancer Specialists, Arlington, Va., a US Oncology Network affiliate; Stephanie Bernik, M.D., chief of surgical oncology, Lenox Hill Hospital, New York City; Society of Interventional Radiology, news release, March 24, 2014

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