Princess Health and Conference on cancer-causing HPV in Lexington June 21. Princessiccia

Princess Health and Conference on cancer-causing HPV in Lexington June 21. Princessiccia

cancer cervical cancer conferences HPV human papillomavirus immunizations

Gusty 03:50 Add Comment

The Kentucky Rural Health Association is sponsoring a summit on the human papilloma virus, "HPV - You ARE the Key!" June 21 at the Embassy Suites in Lexington.

The HPV vaccine is nearly 100 percent effective in preventing pre-cancers and noninvasive cervical cancers caused by two strains of the virus, but most parents in Kentucky and the nation are still not getting their adolescents vaccinated. Kentucky falls in the bottom 10 states for HPV vaccination, with 37.5 percent of its girls and 13.3 percent of boys aged 13-17 vaccinated as of 2014.

The conference will host several keynote speakers, including:

• Kirk Forbes, who co-founded the Kristen Forbes EVE Foundation in honor of his 23-year-old daughter, Kristen Forbes, who passed away after a yearlong battle with HPV caused cervical cancer;
• Dr. Daron G. Ferris, professor and director of the Gynecologic Cancer Prevention Center at the Medical College of Georgia;
• Dr. W. Michael Brown, associate director and the director of pediatrics at the Bayfront Family Medicine Residency Program in St. Petersburg, among other positions; and
• Dr. Alix Casler, medical director of the Department of Pediatrics for Orlando Health Physician Associates, among other positions.

The conference is also sponsored in collaboration with the Kentucky Immunization Program and the Division of Women's Health.

The event will last from 8 a.m. to 5 p.m. June 21 and costs $40 thru June 1, and $55 after that date. Continuing education credits will be offered. Click here to register and here for the draft agenda.

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

Princess Health and 1/2 of cancer deaths and maybe 1/2 of new cases could be prevented by exercise, watching food and drink, and not smoking. Princessiccia

cancer obesity prevention research smoking tobacco tobacco prevention

Gusty 08:31 Add Comment

Half of all cancer deaths could be prevented "by applying insights that we've had for decades � no smoking, drinking in moderation, maintaining a healthy body weight and exercising," Carolyn Y. Johnson reports for The Washington Post, about a study published in JAMA Oncology.

Those measures could also cut new cancer cases by 40 to 60 percent. Those are big numbers, and especially important for Kentucky, which has some of the nation's leading rates of cancer and death from it � and, not coincidentally, is among the national leaders in smoking and obesity.

"Some of the declines we have already seen in cancer mortality � the large decline in lung cancer � that was because of efforts to stop people from smoking," Siobhan Sutcliffe, an associate professor in the division of public health sciences at Washington University in St. Louis, told Johnson. "Even while we�re making new discoveries, that shouldn�t stop us from acting on the knowledge we already do have."

Sutcliffe was not involved in the study, which used "large ongoing studies that have closely followed the health and lifestyle habits of tens of thousands of female nurses and male health professionals," Johnson reports. "They divided people into two groups: a low-risk group that did not smoke, drank no more than one drink a day for women or two for men, maintained a certain healthy body mass index, and did two-and-a-half hours of moderate aerobic exercise a week or half as much vigorous exercise.

"The team compared cancer cases and cancer deaths between the low- and high-risk groups and found that for individual cancers, the healthy behaviors could have a large effect on some cancers: The vast majority of cases of lung cancer were attributable to lifestyle, as well as more than a fifth of cases of colon cancer, pancreatic cancer and kidney cancer.

"Then, they extrapolated those differences to the U.S. population at large, finding an even larger proportion of potentially preventable cancer cases and deaths. For women, they estimated 41 percent of cancer cases were preventable and 59 percent of cancer deaths. For men, 63 percent of cancer cases were potentially preventable and 67 percent of deaths."

The researchers at Massachusetts General Hospital and the Harvard T.H. Chan School of Public Health noted some caveats: "The high-risk group in the study is healthier than the general U.S. population, so there are reasons the numbers may be slightly overestimated," Johnson writes. "But Mingyang Song, the researcher who led the work, argues the numbers are a good approximation because they may be underestimating the effects of lifestyle, too, because they selected a narrow range of lifestyle factors."

Princess Health and Effects of new vaping regulations won't be felt immediately; American and British researchers have differing views of e-cigs. Princessiccia

Princess Health and Effects of new vaping regulations won't be felt immediately; American and British researchers have differing views of e-cigs. Princessiccia

cancer federal regulation lung disease research smoking tobacco vaping

Gusty 13:40 Add Comment

By Danielle Ray
Kentucky Health News

A long time coming, the U.S. Food and Drug Administration released new regulations this month for all tobacco products, including electronic cigarettes, vape pens, hookahs, dissolvables, and pipes. But the effects might not be felt for as long as two years.

Photo: excusemyvapes.com

The regulations require health warnings on packages and advertisements and ban sales to minors. Other regulations include reporting ingredients to the FDA, requiring photo identification to buy, banning free samples and banning the labeling of products as moderate, with words such as "light" or "mild,"

The FDA called the regulations a milestone in consumer protection. It believes the new rules will help prevent misleading claims by manufacturers moving forward and allow for review of new products not yet on the market. The agency already regulated traditional cigarettes, smokeless tobacco, and roll-your-own tobacco prior to the decision.

The new rules will take effect in stages. The ban on sales to minors begins Aug. 8, but according to Phil Galewitz of The Washington Post, the ban will primarily affect Michigan and Pennsylvania, as the other 48 states already ban sales of e-cigarettes to minors. Warning labels will take effect May 2018. The labels will read: �WARNING: This product contains nicotine. Nicotine is an addictive chemical.�

Don't expect changes overnight. Manufacturers have two years to submit products for review and another year for the agency to perform evaluations.

Why did the FDA take on vaping? For one thing, because the market has so far been unregulated, the ingredients in vaping liquid are largely a mystery. However, a 2015 Harvard University study found several dangerous chemicals present in these liquids. The chemicals can destroy tiny passageways in lungs, leading to scar tissue buildup and eventually respiratory disease, according to the study.

For another thing, adolescents and teenagers are vaping at unprecedented rates. More than 3 million middle and high school students used e-cigarettes in 2015, up more than 500,000 from the year before, according to the FDA.

E-cigarettes have been the most commonly used tobacco products among youth for two consecutive years. Sixteen percent of high schoolers and about 5 percent of middle schoolers were vapers of e-cigarettes in 2015, according to the FDA. More than 80 percent of them cited appealing flavors, which include "gummy bear" and "cotton candy," as their primary reason for use.

The science is still out on whether the harmful qualities of vaping negate any potential benefits. Some studies have found e-cigarettes to be less harmful than traditional cigarettes. For example, a 2015 Public Health England review concluded that e-cigarettes are about 95 percent less harmful than traditional cigarettes.

"E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm," said Professor Kevin Fenton, director of health and well-being at PHE, said in a news release. "The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting."

As noted in the Harvard study, e-cigarettes are not harmless. The question remains if vaping can be a tool to help current smokers quit, if they lure in kids who otherwise would not become smokers or if it's a little of both.

According to the British study, there is no evidence that vaping attracts non-smokers. Fewer than 1 percent of either adults or young people who have never smoked are becoming regular e-cigarette users, the study noted.

As for fears that vaping leads to traditional smoking, Linda Bauld, a cancer prevention expert at Cancer Research United Kingdom, said in a news release that those claims are unfounded.

"Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realized," Bauld said. "In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco."

Attitudes toward vaping have been much more favorable overall in the UK. Public health officials there seem more willing to accept e-cigarettes as a safer alternative and even a stop smoking tool than do U.S. officials.

For more background information on the FDA's new regulations, click here.

Princess Health and Kentucky is in the bottom 10 states for cancer-preventing HPV vaccination, probably because it has to do with sex. Princessiccia

Princess Health and Kentucky is in the bottom 10 states for cancer-preventing HPV vaccination, probably because it has to do with sex. Princessiccia

cancer cervical cancer HPV sexually transmitted diseases vaccinations

Gusty 09:16 Add Comment

The human papillomavirus vaccination is nearly 100 percent effective in preventing precancers and noninvasive cervical cancers caused by two strains of the virus, but most parents in Kentucky and the nation are still not getting their adolescents vaccinated.

HPV is a group of more than 150 related viruses, which together are the most common sexually transmitted infections in the U.S.

An estimated 79 million Americans are infected with HPV and about 14 million more become infected each year, according to the federal Centers for Disease Control and Prevention. And while most HPV strains cause no symptoms and go away on their own, 10 percent of HPV infections lead to cancers of the cervix, vagina, vulva, penis, anus and throat.

The HPV vaccination was approved by the federal government 10 years ago and is recommended for all adolescent girls and boys 11 and 12 years old. Nationwide, fewer than half of girls and only one-fifth of boys are getting immunized.

Kentucky falls in the bottom 10 states for HPV vaccinations, with 37.5 percent of its girls and 13.3 percent of boys aged 13 to 17 vaccinated as of 2014.

The vaccine can be given to females as old as 26 and males as old as 21, but early vaccination is important. The vaccine is less effective if a person has already been exposed to the virus, because it works to prevent HPV before exposure, and not to treat existing HPV infections or associated diseases. Vaccinating adolescents better protects them before they are likely to become sexually active and exposed to the virus.

And therein lies the key reason health experts say most parents don't get their children vaccinated and health providers are hesitant to push this potentially life-saving vaccine: It has to do with sex, Michael Ollove reports for Stateline.

But guess what? Almost 42 percent of Kentucky's high-school students say they have had sexual intercourse, and almost one-third of them say they are currently sexually active, according to the 2015 Kentucky Youth Risk Behavior Survey. And, almost 10 percent of the state's middle-school students say they have had sex.

Opponents of the vaccine being given to adolescents argue that it encourages them to engage in sex because it removes the fear of contracting HPV, but at least one study shows no increase in sexual activity in girls who have been immunized, Ollove reports.

Health officials often lament that the vaccine wasn't originally sold to the public as an anti-cancer vaccine rather than one to prevent a sexually transmitted disease, Ollove reports.

�It should have been pushed out as an anti-cancer drug,�Walt Orenstein, a professor of medicine at Emory University and the former director of the National Immunization Program at the CDC, told Ollove. �People didn�t understand why their children needed this drug when they were still years away from being sexually active.�

Ollove notes other reasons for low vaccination rates: Health-care providers often don't stress the importance of the vaccine; many don't promote the vaccine because they aren't comfortable talking about sex with their young patients or their parents; and many providers feel the vaccine is not urgent because most adolescents in middle school are not sexually active. Another barrier is that the the HPV vaccine requires three inoculations over several months; the CDC shows a dramatic drop-off between the first and last doses.

Citing Noel Brewer, who does research on immunizations at the University of North Carolina and has studied parental and provider attitudes toward HPV, Ollove writes, "Contrary to what doctors may believe, parents are interested in the vaccine and a strong recommendation from a physician correlates highly with youngsters getting the full course of vaccinations."

Ollove notes that mandatory HPV immunizations have not proven to be successful. �Mandates are a last resort after you�ve built consensus that they are a good thing to do,� Orenstein told him.

Health policy researchers say that "reminder and recall" notices are the best way to keep patients up to date on vaccinations, and yet this is not a common practice, Ollove reports.

Insurance will cover the cost of the HPV vaccine and the Vaccines for Children Program will cover the vaccine at no cost for children who don't have insurance and are younger than 19. Call 800-232-4636 for more details.

The Kentucky Rural Health Association in collaboration with the Kentucky Immunization Program and the state Division of Women's Health will be hosting Kentucky's HPV Summit, "HPV: You ARE the Key!," at the Embassy Suites in Lexington June 21. The cost is $40 until June 1 and $55 afterward. Click here to register.

Princess Health and Exercise can help prevent or slow cancer, study suggests. Princessiccia

Princess Health and Exercise can help prevent or slow cancer, study suggests. Princessiccia

cancer exercise prevention research

Gusty 02:43 Add Comment

Exercise may keep you from getting cancer and slow the growth of a tumor if you get one, according to a mouse-based study published in the journal Cell Metabolism by researchers at the University of Copenhagen in Denmark.

They report that training mice regularly on a wheel (the mouse version of a treadmill) decreased the growth of multiple types of tumors, including skin, liver, and lung cancers. Also, mice that exercised regularly had a smaller chance of developing cancer in the first place, and less cancer-associated weight loss.

The researchers linked the anti-cancer effects to the release of adrenaline (also called epinephrine), a hormone central to the mammalian �fight-or-flight� response. Exercise stimulates the production of adrenaline, which mobilizes immune cells, including one called a "natural killer." NK cells are recruited to the site of the tumor by the protein IL-6, which is secreted by active muscles. NK cells can then infiltrate the tumor, slowing or completely preventing its growth.

The researchers pointed out that injecting the mice with adrenaline or IL-6 without the exercise was not sufficient to inhibit cancer development, showing that regular exercise was needed to activate the hormone and the protein.

Princess Health and 10 common misconceptions about cancer and the environment . Princessiccia

Princess Health and 10 common misconceptions about cancer and the environment . Princessiccia

cancer Internet prevention World Health Organization

Gusty 09:30 Add Comment

With the advent of the internet, people are swamped with information about cancer and some of it is not based on "sound scientific evidence" or is "at best, anecdotal," which can "hamper efforts to prevent and treat" it, reports Curt DellaValle, a cancer epidemiologist and senior scientist at Environmental Working Group. He writes about some of the most common misconceptions about cancer:

Misconception #1: Getting cancer is almost completely out of your control: DellaValle recognizes that some cancers are caused by genetics and "bad luck" and notes that the World Health Organization reports that 20 percent of cancers are thought to be caused by environmental factors such as pollution, infections and radiation, but he also says "as many as half of cancers may be preventable," noting that smoking, poor diet and lack of exercise are major contributors.

Misconception #2: �Everything� causes cancer: "Not all chemicals, pollutants or guilty pleasures will lead to cancer," DellaValle writes, while also noting that the amount of exposure to the carcinogen plays a role. "The International Agency for Research on Cancer, a research arm of the WHO, has looked into nearly a thousand suspected causes of cancer. Of those suspicious substances and activities, they have concluded that just about half are known or potentially carcinogenic.

Misconception #3: Exposure to a known carcinogen will give you cancer: "Known carcinogens" are substances that have strong evidence that they can cause cancer, but  it is important to recognize that the risk between them differs. "A person exposed to a known carcinogen is not 100 percent certain to develop cancer, not by a long shot," DellaValle writes. For example, he writes that  there is a difference between asbestos exposure, a potent carcinogen, and eating processed meats, which is also a known carcinogen, but one that only modestly increases your chances of getting cancer.

Misconception #4: Natural products are safe and synthetic products are harmful: DellaValle writes that "arsenic, asbestos, formaldehyde, radiation and tobacco occur naturally and are known carcinogens." His advice is to "arm yourself with information" and "know what you're buying and don't assume everything that says 'natural' is harmless."

Misconception #5: Chemicals that the body absorbs and retains for a long time are more dangerous than those that are quickly excreted or metabolized: "The hazard of a substance is determined not just by the degree of exposure but also how it interacts with the body," he writes. For example, nitrates and nitrites in food and water can change into compounds that cause cancer in the body, while chemicals that are excreted quickly, like pesticides and heavy metals, can also cause cancer.

Misconception #6: The cancer risk you accumulate is irreversible: DellaValle writes that certain harmful exposures, like to radiation, does not allow full recovery, but damage from many environmental exposures can be partly reversed with elimination or significantly reducing the exposure. "The Surgeon General�s report on tobacco concluded that quitting smoking at any age reduces a smoker�s risk of cancer by up to 50 percent in just five to 10 years," he writes.

Misconception  #7: Mammograms cause breast cancer: "The risk with the very small amount of radiation emitted during a mammogram is minuscule for most patients," he writes. However, "women who are pregnant should avoid mammograms and X-rays that their doctors don�t consider necessary. Radiation could harm the developing fetus."

Misconception #8: Cell phones, wi-fi, microwaves, power lines and airport X-ray machines will cause cancer: DellaValle writes that cell phones, wi-fi, microwaves and power lines "emit non-ionizing radiation" and is less invasive than "ionizing radiation" that comes from  X-rays, sunlight and uranium. The WHO considers cell phone radiation a possible carcinogen "based on a suspected association between cell phone use and brain cancer,: DellaValle recommends holing your  phones a few millimeters away from your body to "drastically reduce exposure" or use hands-free devices and texting. He does say that it is a good idea to keep wireless routers a few feet from places where people spend long periods of time, though he notes that there is little or no evidence to support that wi-fi signals cause cancer. He also notes that it would take about 1,000 trips through an airport X-ray scanner to equal the radiation exposure from one medical chest X-ray.

Misconception #9: Artificial turf sports fields cause cancer: The jury is out on this one. DellaValle says, "No data exists at this time to say that artificial turf causes cancer, but scientists are just beginning to explore the question. In the meantime, you should play on artificial turf in well-ventilated areas, avoid hand-to-mouth contact while playing and limit direct contact between turf and skin."

Misconception #10: Residential pesticides are safe: DellaValle writes that many of the pesticides suspected to cause cancer in farm workers are being sold for residential use and notes that some evidence exists that they increase the risk of cancer. While recognizing that  homes would use these products less often and at a lower dose, he did caution to not use them around children or pregnant women. He noted that studies have found that children exposed to pesticides while in the womb and in infancy face an increased risk of childhood cancers like leukemia and brain tumors.

Princess Health and Legislature's many health bills include some with life-saving potential, better prevention, greater access and help for children. Princessiccia

Princess Health and Legislature's many health bills include some with life-saving potential, better prevention, greater access and help for children. Princessiccia

assisted living autism cancer drugs General Assembly health care access influenza legislation legislature pharmaceuticals pharmacies pharmacists physician assistants smoking state government

Gusty 13:57 Add Comment

By Melissa Patrick
Kentucky Health News

One paragraph in this story was incorrect and has been stricken.

FRANKFORT, Ky. -- Kentucky legislators have all but ended their regular session without agreeing on a budget, but were able to pass a wide range of health bills that await Gov. Matt Bevin's signature or veto.

Legislators can still pass more bills, including a budget, when they return for one day, April 12, and reconsider any bills the governor vetoes (except the budget, if one passes that day).

Many of the health bills deal with regulation, such as which agency oversees home medical equipment and licensing rules for physicians. Others, like SB 211, sponsored by Sen. Alice Forgy Kerr, R-Lexington, establish a special day to encourage research for amytrophic lateral sclerosis by officially naming Feb. 21 "ALS Awareness Day."

But several others will impact the daily lives of Kentuckians, directly or indirectly. Some have the potential to save lives.

Senate Bill 33, sponsored by Sen. Max Wise, R-Campbellsville, requires every Kentucky high-school student to receive compression-only CPR training. "Each year nearly 424,000 people have sudden cardiac arrest outside of the hospital and only 10 percent of those victims survive," Wise said at a Jan. 13 Senate Health and Welfare Committee meeting. "Yet when a CPR trained bystander is near, they can double or triple these victims survival rate."

Another bill with life-saving potential would let Kentuckians take time off work to be "living donors" or donate bone marrow without the risk of losing jobs or income. House Bill 19, sponsored by Rep. Ron Crimm, R-Louisville, requires paid leave of absence for such reasons, and offsets this cost to the employer with tax credits.

(An amendment to this bill, illustrating how legislation gets passed in unusual ways during the closing days, would allow Lexington to impose an additional 2.5 percent hotel-room tax to improve its convention center.)

A minor housekeeping bill had an important health amendment attached to it that mandates assisted-living communities to provide residents with educational information about the flu by Sept 1 of each year. SB 22 is sponsored by Sen. Ralph Alvarado, R-Winchester. The CDC estimates that between 80 and 90 percent of seasonal flu-related deaths occur in people over 65.

Colon cancer, which kills more than 850 Kentuckians a year, remained in the spotlight with passage of HB115, sponsored by Rep. Tom Burch, D-Louisville. It would expand eligibility for screenings to age-eligible, under-insured Kentuckians, or uninsured persons deemed at high risk for the disease. This bill is aimed at the 7 percent of Kentuckians who have remained uninsured since the state expanded Medicaid under federal health reform, and those who have insurance but can't afford deductibles or co-payments.

Other bills intended to create better access to care for Kentuckians would expand the duties of advanced practice registered nurses (SB114); decrease the oversight of physician's assistants (SB154); create a pilot program to study telehealth and how it's paid for (HB 95); and better define who can perform administrative duties in pharmacies (HB 527).

Children: "Noah's Law," or SB 193, sponsored by Alvarado, mandates the coverage of amino-acid-based formulas for eosinophilic esophagitis and other digestive disorders. It will have an impact on more than 200 Kentucky families. It is called "Noah's Law" after 9-year-old Noah Greenhill of Pike County who suffers from the disease, which requires him to get this formula through a feeding tube four times a day because of severe food allergies, at a daily cost of more than $40. This bill has already been signed by the governor and took effect immediately.

HB148, sponsored by Rep. Linda Belcher, D-Shepherdsville, allows day-care centers to be able to obtain and store epinephrine auto-injectors for emergency use. This bill was amended to include "participating places of worship" as a location that newborns up to 30 days old can be left without threat of prosecution to the parent or family member who leaves them there.

The latest Centers for Disease Control and Prevention study found that one in 68 of the nation's children have autism, and Kentucky legislators passed two bills this session to address their needs. SB 185, sponsored by Sen. Julie Raque Adams, R-Louisville, creates the Office of Autism and guidelines for an Advisory Council on Autism Spectrum Disorders. This bill has already been signed by the governor. HB 100, sponsored by House Minority Leader Rep. Jeff Hoover, R-Jamestown, requires insurers to maintain a website to provide information for filing claims on autism coverage and make autism-benefit liaisons available to facilitate communications with policyholders.

Big bills: One of the high-profile health bills that passed this session is SB20, sponsored by Alvarado, which creates a third-party appeals process for providers to appeal denied Medicaid claims. Alvarado has said that 20 percent of Medicaid claims are denied, compared to the national average of around 6 percent. He suggest that bringing this bill will help bring these numbers more in line with each other and thus will encourage more providers to participate in Medicaid.

A bill that will eventually increase accessibility to drugs made from living tissues that are very expensive, but also very effective, also passed. SB 134, sponsored by Alvarado, would allow pharmacists to substitute a less-expensive "interchangeable biosimilar" drug for its name-brand "biologic" one, even though the U.S. Food and Drug Administration hasn't approved these interchangeables yet. Humira and Remicade for arthritis, and Enbrel for psoriasis, are a few of the most common biologics on the market.

Another bill is aimed to help small-town pharmacies stay competitive with chains. SB 117, sponsored by Wise, allows the state Insurance Department to regulate pharmacy benefit managers, like Express Scripts, much like insurance companies. It would also provide an appeal mechanism to resolve pricing disputes between pharmacies and PBMs. The state has more than 500 independent pharmacists that will be affected by this law.

Bigger issues: Health officials say the single most important thing that Kentucky can do to improve the state's health at no cost is to pass a statewide smoking ban for workplaces. Rep. Susan Westrom, D-Lexington, filed a smoke-free bill late in the session that didn't even get a hearing in committee, despite having passed the House last year. Bevin opposes a statewide ban.

Adams and Alvarado filed a bill to require insurance companies to pay for all evidence-based smoking cessation treatments in hopes of decreasing the state's smoking rate, but it was filed late in the session and only brought up for discussion.

Democratic Rep. David Watkins, a retired physician from Henderson, filed three bills to decrease smoking in the state: one to increase the cigarette tax, one to raise the legal age for buying tobacco products to to 21, and one to require retail outlets to conceal tobacco products until a customer requests them. All were to no avail.

Rep. Darryl Owens, D-Louisville, filed bills to continue the Kynect health-insurance exchange and the state's current expansion of the federal-state Medicaid program. The bills passed mostly among party lines in the House, but the Senate has not voted on them as Senate President Robert Stivers said he would if the House did.