Can Marijuana Be Moved To The Less Restricted List For Chronic Pain Patients

Today's post from webmd.com (see link below) takes the discussion about medical marijuana a little further and looks at the dilemmas doctors face when confronted by patients' valid questions regarding their pain treatment and the laws that cloud the picture and make them uncertain as to whether they're doing the right thing. It's a call for considerably more research to be done at official drug-enforcement levels and asks for a further loosening of restrictions to enable an unbiased and science-based evaluation of the benefits of marijuana for various conditions. It's a valid point because we already allow several drugs which have the potential to be far more addictive (oxycodon, morphine and many others) to help patients with chronic pain but it seems that marijuana has so many pre-judged labels attached that law enforcers just can't see beyond the decades-old criminality issues. Worth a read.

What DEA Pot Rule Change May Mean for Research WebMD News from HealthDay
By Dennis Thompson HealthDay Reporter TUESDAY, May 10, 2016
 
Agency could move marijuana to a less strictly regulated class of drugs

 (HealthDay News) -- Most doctors approach medical marijuana with a great deal of uncertainty, because drug laws have hindered researchers' ability to figure out what pot can and can't do for sick patients.

That could soon change.

The U.S. Drug Enforcement Administration (DEA) is weighing whether to loosen its classification of marijuana, which would remove many restrictions on its use in medical research.

If that occurs, doctors could start getting answers to the questions they regularly receive from patients regarding marijuana's clinical benefits.

"I am asked as a practicing doctor even in a rural area about medical marijuana use, and I want to make sure I can give patients advice that's evidence-based," said Dr. Robert Wergin, board chair of the American Academy of Family Physicians. "We need those kinds of studies to help us give informed advice to our patients who ask about it now," he explained.

The DEA has said it will decide this summer whether marijuana should be lowered from a Schedule I drug to a Schedule II drug, according to an April memo from the agency to Congress.

Schedule I drugs are considered drugs "with no currently accepted medical use and a high potential for abuse," the DEA says on its website. Heroin, LSD and ecstasy stand alongside marijuana on the DEA's Schedule I list.

On the other hand, Schedule II drugs have a high potential for abuse, but "there is the recognition that they have some medical value as well," said Dr. J. Michael Bostwick, a professor of psychiatry at the Mayo Clinic, in Rochester, Minn.

"This could be an important softening of regulations that make it difficult to do marijuana or cannabis research in this country," Bostwick said.

Morphine, methamphetamine, cocaine and oxycodone are all Schedule II drugs, "because they have medical applications," Bostwick said. "So, it's not as if we don't have precedent for substances that are dangerous from an addictive point of view being useful in certain medical situations."

Studies have shown that marijuana might help decrease chronic pain and nausea, ease seizures, improve the appetite or be useful in psychiatric treatment, Wergin and Bostwick said.

But none of those studies has been large-scale and a definitive clinical trial. The reason: because marijuana's DEA drug status prevents scientists from using large quantities of the plant in medical research, Wergin and Bostwick said.

All marijuana available for research purposes in the United States is grown at the University of Mississippi, which has an exclusive contract with the U.S. National Institute on Drug Abuse (NIDA) to provide the nation's entire research supply, according to the DEA's memo to lawmakers.

In any given year, NIDA sends shipments of marijuana to a small handful of researchers, usually eight or nine, but sometimes as many as 12, the memo states. Researchers must go through a detailed registration process to gain access to the pot.

The American Medical Association (AMA) has come out in favor of loosening drug laws to "develop a special schedule for marijuana to facilitate study of its potential medical utility in prescription drug products," according to a statement its officials provided ABC News.

"While studies related to a limited number of medical conditions have shown promise for new cannabinoid-based prescription products, the scope of rigorous research needs to be expanded to a broader range of medical conditions for such products," the AMA added.

Back in December 2014, the American Academy of Neurology lamented the lack of solid marijuana research in a position paper.

Due to strict drug laws, researchers have not been able to determine whether medical marijuana could help treat neurological disorders such as epilepsy, multiple sclerosis and Parkinson's disease, the academy said.

The academy's paper concluded with a call to deschedule marijuana and open it up to more research.

Expanded research wouldn't necessarily lead to more people smoking pot for medical purposes, Wergin and Bostwick said.

Instead, it's more likely that researchers would focus on how the components of marijuana, such as THC or cannabidiol, interact with the body in ways that might help ease symptoms or illness.

An entire system of receptors has been discovered throughout the body that responds to different components of cannabis, Bostwick said.

"Almost any system you name in the body has a potential cannabinoid receptor that could be manipulated in a way that could be useful," he said. "When the drug was outlawed in 1970, we knew almost nothing about it. In the intervening 45 years, science has shown this endocannabinoid system actually exists. None of that was known when the drug was made illegal."

Such research could result in medications derived from marijuana that would treat conditions without a "high," Wergin said.

Wergin sees two main potential benefits from the descheduling of marijuana and any resulting boom in research.

First, he'd know what to tell patients about pot's particular benefits. And second, he'd feel confident issuing a prescription for a marijuana-based medication, knowing that it's a drug regulated by the U.S. Food and Drug Administration.

"This would result in higher-quality standardized product that's FDA-approved," Wergin said. "If I prescribe you an antibiotic, I'm very confident of what's in it because of the FDA regulations on it. I don't know how to prescribe marijuana to you, or what's even in it."

Paul Armentano, deputy director of the marijuana legalization group NORML, said that at this point a reclassification by the DEA would fall "well short of the sort of federal reform necessary to reflect America's emerging reefer reality."

Armentano added that even with descheduling, federal law still would require researchers to buy pot from NIDA's University of Mississippi marijuana cultivation program.

"Simply rescheduling cannabis from I to II does not necessarily change these regulations, at least in the short-term," Armentano said.

View Article Sources

http://www.webmd.com/mental-health/addiction/news/20160510/what-a-change-in-deas-pot-rules-might-mean-for-medical-research

Will Endomorphin Be The Replacement For Opioids For Neuropathy Patients

Today's post from sciencedaily.com (see link below) follows on from yesterday's post about endomorphin and its potential for chronic pain patients but whereas yesterday's post was from a national newspaper, this one is from the ever-reliable Sciencedaily.com and confirms what you may have read yesterday. If the predictions are correct, then commercially produced endomorphin may replace opioids as the pain killers of choice for those who've tried everything else and as a bonus, will deliver none of the side effects associated with opioids. This is fantastic news for long-term pain patients who not only have to manage their opioid prescriptions properly but have to face the wagging finger of media stigma, however unjust that may be. We still have to wait two years before the first human trials but the eventual benefits may make the wait easier.

New drug could be safer, non-addictive alternative to morphine
 January 28, 2016 Source: Tulane University
The peptide-based drugs, which mimic a natural brain chemical, target the same pain-relieving opioid receptor as morphine

Researchers at Tulane University and Southeast Louisiana Veterans Health Care System have developed a painkiller that is as strong as morphine but isn't likely to be addictive and with fewer side effects, according to a new study in the journal Neuropharmacology.

Using rats, scientists compared several engineered variants of the neurochemical endomorphin, which is found naturally in the body, to morphine to measure their effectiveness and side effects. The peptide-based drugs target the same pain-relieving opioid receptor as morphine.

Opium-based drugs are the leading treatments for severe and chronic pain, but they can be highly addictive. Their abuse results in thousands of overdose deaths in the United States annually. They can cause motor impairment and potentially fatal respiratory depression. Patients also build up tolerance over time, increasing the risk for abuse and overdose.

"These side effects were absent or reduced with the new drug," said lead investigator James Zadina, VA senior research career scientist and professor of medicine, pharmacology and neuroscience at Tulane University School of Medicine. "It's unprecedented for a peptide to deliver such powerful pain relief with so few side effects."

In the study, the new endomorphin drug produced longer pain relief without substantially slowing breathing in rats; a similarly potent dosage of morphine produced significant respiratory depression. Impairment of motor coordination, which can be of particular importance to older adults, was significant after morphine but not with the endomorphin drug.

The new drug produced far less tolerance than morphine and did not produce spinal glial cell activation, an inflammatory effect of morphine known to contribute to tolerance.

Scientists conducted several experiments to test whether the drug would be addictive. One showed that although rats would spend more time in a compartment where they had received morphine, the new drug did not affect this behavior. Another test showed that when the press of a bar produced an infusion of drug, the rats only increased efforts to obtain morphine and not the new drug. The tests are predictive of human drug abuse, Zadina said.

Researchers hope to begin human clinical trials of the new drug within the next two years.

Story Source:

The above post is reprinted from materials provided by Tulane University. Note: Materials may be edited for content and length.


Journal Reference:
James E. Zadina, Mark R. Nilges, Jenny Morgenweck, Xing Zhang, Laszlo Hackler, Melita B. Fasold. Endomorphin analog analgesics with reduced abuse liability, respiratory depression, motor impairment, tolerance, and glial activation relative to morphine. Neuropharmacology, 2016; 105: 215 DOI: 10.1016/j.neuropharm.2015.12.024

Tulane University. "New drug could be safer, non-addictive alternative to morphine: The peptide-based drugs, which mimic a natural brain chemical, target the same pain-relieving opioid receptor as morphine." ScienceDaily. ScienceDaily, 28 January 2016. .

http://www.sciencedaily.com/releases/2016/01/160128155006.htm

STILL MORE BLIND CAN BE CURED

A number of illnesses causing blindness can be cured from transplanting cells from the oral cavity. New findings make the treatment accessible to the places where the condition strikes the most frequently: in developing countries.

Researchers at the University of Oslo have made discoveries that can have great consequences for the treatment of blindness caused by so-called limbal stem cell deficiency.

The condition is curable through transplantation of stem cells that are cultivated from tissue obtained from different parts of the body. In recent years, interest has been pointed increasingly more in direction of the use of oral cells to prepare new tissue. This makes possible treatment of patients suffering from limbal stem cell deficiency on both corneas, with cells from their own body.

The patients are thus spared from using strong immunosuppressive drugs that can bring about serious side effects. The main focus of the researchers now lies on optimizing the storage and transport conditions for the cultivated tissue, in order to make the treatment accessible to the areas with the greatest needs.

"Today, cells from the oral cavity are being cultivated for treatment of blind at a few specialized centers in the world. By investigating the most optimal conditions for storing and transporting the cultivated tissue, we will be able to make this treatment available worldwide, and not just close to the cultivation centers," explains Rakibul Islam, a PhD-candidate at the Faculty of Dentistry. He has recently published findings essential to exporting the method of treatment beyond the immediate proximity of the laboratories.

Investigate improved storage conditions

Until now, no procedure has been described on how to store the cells that are extracted from the oral mucosa, in order to keep and transport them in a simple way. In his PhD-project, a collaboration with Harvard Medical School among others, Islam has defined the temperature interval that best takes care of the viability of the cultivated stem cells before they are transplanted onto the damaged eye. -- One could perhaps picture that 37 degrees Celsius is the optimal storing temperature for the quality of the cells. But it is rather at temperatures between 12 and 16 degrees that the stem cells keep their most essential features the best, says Islam. He has also found that the location from where the cells in the oral cavity are extracted has significance for the quality of the stem cells about to be cultivated.

Islam's results are important to the opportunity to transfer this method of treatment. -- By storing the cultivated tissue in a small sealed container for a week, the flexibility of the treatment is significantly improved. It makes it easier to plan the operation and allows for quality assurance through microbiological testing in advance of the transplantation, he explains.

Promising prospects

This far, nearly 250 people suffering from limbal stem cell deficiency have received treatment involving transplantation of stem cells cultivated from the patients' own mouth cells. Approximately three out of four of these have been successful, according to Tor Paaske Utheim, ophthalmologist and researcher at the Faculty of Dentistry and Oslo University Hospital. -- The treatment can both give better vision and reduce the pain. Several patients suffering from limbal stem cell deficiency are tormented by strong pains, he explains. For the time, Utheim is supervising 18 PhD-candidates and research group students, among them Islam. The latest discovery of the research group is an important contribution to the development of this method of treatment.

"We have revealed which locations in the oral cavity that may be best suited to store and transport the tissue from centralized, highly specialized cultivation centers, to clinics all over the world. Our findings contribute to making the clinical procedures simpler and more efficient, leading to a far more accessible treatment than what is the case today," says Islam.

Towards general accessibility

Earlier this year, the European Medicine Agency (EMA) approved the method ivolving cultivating stem cells from the cornea in a laboratory, within the EU. That makes it the first stem cell treatment to be approved by the EMA. In an interview recently published in Nature Biotechnology, Utheim remarked that the approval is a further step towards implementing the stem cell technology across a larger geographical area.

Background

Limbal stem cell deficiency can occur after vigorous and prolonged ultraviolet radiation, caustic burn from use of chemicals, powerful infections like trachoma and as parts of various illnesses, among them some that are inheritable. It is not known how many people suffer from the eye injury worldwide but in India there is an estimation of 1,5 million people.

A cure against limbal stem cell deficiency through the use of cultivated stem cells has existed since the late 90s, but that treatment depended on that the patient still had a healthy eye available to obtain cells from. Alternatively, one could harvest cells from a relative or a deceased, but this variant presupposed the use of powerful immunosuppressive drugs, that could cause strong side effects. Thus, ten years ago there was a breakthrough in the field, when Japanese researchers showed that cells from the oral mucosa could replace the cells from the healthy eye of the patient.

Be Back Soon

August 3rd 2016

To regular readers and casual visitors...

Apologies for the non-appearance of daily posts since Sunday (first time in 1950 days!). Sometimes life gets in the way of even neuropathy! Be back very soon with new daily posts.

Its Sensible To Be Wary Of Supplements

Today's post from health.com (see link below) is an important article for most people taking any form of supplements but especially for neuropathy patients, who resort to supplements largely because they've heard they may help when regular medicine fails (all too often the case with nerve pain!). The article is a warning to be careful about which supplements you choose and certainly which supplements you combine. As far as I can see, there are no supplements here that are commonly used to relieve nerve pain symptoms however, to ignore it for that reason, is missing the point. We tend to rely on the internet and hopefully do our research about anything we take but it's so easy to get caught up in the supplement spiral and let them mount up in our medicine cupboards, so that we end up taking massive amounts of things without really knowing if they're doing any good or not. Far more important is the fact that we aren't aware of the dangers of supplements maybe doing us harm! It's vitally important that you read as much as possible about any individual supplement and certainly don't rely on advertising blurb, or recommendations via e-mail of a 'doctor' who can perform wonder cures. It's a given that if we're taking supplements, our normal prescriptions aren't working, or we've been tested to show a deficiency somewhere but I can't over stress the dangers of randomly taking supplements based on the slightest of evidence, or worse, hearsay. Remember, just because a product is 'herbal' or 'natural' doesn't mean that it doesn't contain powerful ingredients!
 

These 15 Supplement Ingredients Carry Serious Health Risks, According to a New Report: Think cancer, cardiac arrest, liver damage, and more.
By Amanda MacMillan   Last updated: Jul 27, 2016

Despite their popularity in pharmacies, health food stores, and even hospitals, over-the-counter dietary supplements are not regulated in a way that ensures their safety and efficacy, says a new article published today by Consumer Reports. These products have the potential to be contaminated with dangerous bacteria or to differ widely from what their labels claim them to be. And in some cases, they deliberately contain ingredients that can cause cancer, organ damage, cardiac arrest, and other serious health problems.

The report warns consumers to stay away from 15 such ingredients, found in supplements sold in major retail stores across the United States. These products may be especially harmful for people with pre-existing medical conditions, the authors say, or who take other supplements or drugs (prescription or over-the-counter) that could trigger dangerous interactions.

The ingredients, and their claimed benefits, include:
Aconite, used for inflammation, joint pain, or gout
Caffeine powder, used for weight loss, increased energy, and athletic performance
Chaparral, used for weight loss, inflammation, colds, rashes, and infections
Coltsfoot, used for cough, sore throat, laryngitis, and asthma
Comfrey, used for cough, heavy periods, stomach problems, and chest pain
Germander, used for weight loss, fever, arthritis, gout, and stomach problems
Greater Celadine, used for stomach aches
Green tea extract powder, used for weight loss
Kava, used for anxiety and insomnia
Lobelia, used for respiratory problems and for quitting smoking
Methylsynephrine, used for weight loss, increased energy, and athletic performance
Pennyroyal oil, used for breathing problems and digestive disorders
Red yeast rice, used for high cholesterol and heart disease
Yohimbe, used for low libido, erectile dysfunction, depression, and weight loss

RELATED: 9 Things to Know Before Buying Another Supplement

These ingredients can also be listed by other names. Their aliases, and the specific risks associated with each ingredient, are published on ConsumerReports.org and available free of charge.

Some of the ingredients have been shown to cause side effects such as vomiting, nausea, dizziness, impaired driving, and breathing problems. Others have been associated with liver damage, cancer, and serious heart problems. And several of them can interact with other medications, says Ellen Kunes, Consumer Reports Health Content Team Leader. The quality of the ingredients and the length of time they’re taken for can also affect the severity of these risks.

“Say I want to lower my cholesterol, and I’ve read that red yeast rice can help do that,” Kunes told Health.com. “But I may already take a prescription statin for that. If I take both of them together, the effects can be magnified—and the results can be dangerous. That’s the bottom line we want to get across to consumers.”

The report also found that shoppers can’t trust pharmacists or retail staff to alert them to the potential harms of these products: When the Consumer Reports staff sent secret shoppers into 60 stores around the country to ask about these ingredients, many store employees gave information that was “either misleading or flat-out wrong.”

RELATED: Warning: Do Not Mix These Supplements

And even if you avoid these 15 most alarming ingredients, there’s no guarantee that any over-the-counter supplement is safe, or that it contains what it’s supposed to. Many consumers don’t realize that supplements are regulated by the government as a food and not as a drug, says Kunes—which means that companies don’t have to go through stringent tests before putting their products on shelves.

“These products don’t always contain what they claim to,” she says. “That could mean you’re just wasting your money on something harmless—but the reality is, a lot of it is not harmless.” The industry is much larger than government inspections can keep up with, she adds. “Many times, the FDA only gets involved after they get a report that there’s a problem.”

In the article, Consumer Reports’ chief medical adviser notes that there are certain situations in which a person might truly benefit from a supplement—including those who are pregnant, have dietary restrictions, take certain drugs, or have chronic health conditions. But these people should only take the type and dosage recommended by their doctor. They may even be able to take a prescription-strength supplement, which must meet the same safety and efficacy standards as other prescription drugs.

RELATED: Best Foods for Every Vitamin and Mineral

In most other cases, says Kunes, supplements aren’t necessary. “Eating a balanced diet, getting lots of fruit and vegetables, exercising regularly and getting enough sleep, lowering stress—these are the things that are going to truly help you feel healthier,” she says. “We recommend getting your health from food and from healthy habits, rather than popping a pill.”

http://www.health.com/nutrition/supplement-ingredients-to-avoid

SKIN CELLS CAN BE ENGINEERED IN TO PULMONARY VALVES FOR PEDIATRIC PATIENTS

Researchers have found a way to take a pediatric patient's skin cells, reprogram the skin cells to function as heart valvular cells, and then use the cells as part of a tissue-engineered pulmonary valve. A proof of concept study published in the September 2014 issue of The Annals of Thoracic Surgery provides more detail on this scientific development

"Current valve replacements cannot grow with patients as they age, but the use of a patient-specific pulmonary valve would introduce a 'living' valvular construct that should grow with the patient. Our study is particularly important for pediatric patients who often require repeated operations for pulmonary valve replacements," said lead author David L. Simpson, PhD, from the University of Maryland School of Medicine in Baltimore.

Dr. Simpson, senior co-author Sunjay Kaushal, MD, PhD, and colleagues designed a process to transform skin cells from a simple biopsy into cells that become an important ingredient in a tissue-engineered pulmonary valve.

The pulmonary valve is a crescent-shaped valve that lies between the heart's right ventricle and pulmonary artery. It is responsible for moving blood from the heart into the lungs.

While the study was conducted in vitro (outside of the body), the next step will be implanting the new valves into patients to test their durability and longevity.

"We created a pulmonary valve that is unique to the individual patient and contains living cells from that patient. That valve is less likely to be destroyed by the patient's immune system, thus improving the outcome and hopefully increasing the quality of life for our patient," said Dr. Kaushal. "In the future, it may be possible to generate this pulmonary valve by using a blood sample instead of a skin biopsy."

Dr. Simpson added that he hopes the study will encourage additional research in tissue engineering and entice more people to enter the field, "Hopefully, growing interest and research in this field will translate more quickly into clinical application."

It is estimated that nearly 800 patients per year could potentially benefit from bioengineered patient-specific pulmonary valves, according to data from the STS Congenital Heart Surgery Database. The Database, which collects information from more than 95% of hospitals in the US and Canada that perform pediatric and congenital heart surgery, shows that approximately 3,200 patients underwent pulmonary valve replacement during a 4-year period from January 2010 to December 2013.

Opioids It Can Be A Matter Of Semantics For Chronic Pain Sufferers

Today's short post from health.economictimes.indiatimes.com (see link below) has implications for neuropathy patients who have been forced to take opioids in order to control their pain. The current hoo-ha about opioids presents a real danger to patients who genuinely need them because literally nothing else works! This article takes the view that opioid prescription is questionable if there are no ensuing physical function benefits. However, you have to ask whether opioids were ever thought to improve physical function - they're not steroids after all. The point of opioids is that they dampen pain signals and if used properly, they're very effective indeed, so improved physical function is of secondary importance to neuropathy patients - the fact that their pain is reduced to a point where they can live more or less normal lives, is the priority. Physical function improvement can come from other sources. 

Opioids don't guarantee improvement in physical function IANS 24 January 2016

 Patients who were not prescribed any opioids had statistically lower disability and higher physical functioning scores.

People suffering from neuropathic pain complex, chronic pain that usually is accompanied by tissue injury report no improvement in physical functioning after taking opioids that tackle pain, researchers said.

"Even though opioid medications can be a powerful pain killer, it does not necessarily mean improved function will follow," said lead author Geoff Bostick, associate professor at the University of Alberta in Canada.

Patients who were not prescribed any opioids had statistically lower disability and higher physical functioning scores, the findings showed.

Opioids can help people with severe pain be more comfortable, but if they are not facilitating improved physical function, the impact of these medications on quality of life should be questioned, the researchers said in the study published in the journal Pain Medicine.

Stressing the importance of physical function, the researchers suggested that patients who are experiencing chronic pain and are medically cleared for physical activity should find a way to promote movement, even if it is painful.

The study looked at 789 patients across Canada who provided baseline measures of self-reported function, and again at six and 12 months after treatment.

These patients suffered with neuropathic pain from nerve injuries such as diabetic neuropathy and pinched nerves.

http://health.economictimes.indiatimes.com/news/industry/opioids-dont-guarantee-improvement-in-physical-function/50703209

DRINKING TOO MUCH WATER CAN BE FATAL TO ATHLETES

The recent deaths of two high school football players illustrate the dangers of drinking too much water and sports drinks, according to Loyola University Medical Center sports medicine physician Dr. James Winger.

Over-hydration by athletes is called exercise-associated hyponatremia. It occurs when athletes drink even when they are not thirsty. Drinking too much during exercise can overwhelm the body's ability to remove water. The sodium content of blood is diluted to abnormally low levels. Cells absorb excess water, which can cause swelling -- most dangerously in the brain.

Hyponatremia can cause muscle cramps, nausea, vomiting, seizures, unconsciousness, and, in rare cases, death.

Georgia football player Zyrees Oliver reportedly drank 2 gallons of water and 2 gallons of a sports drink. He collapsed at home after football practice, and died later at a hospital. In Mississippi, Walker Wilbank was taken to the hospital during the second half of a game after vomiting and complaining of a leg cramp. He had a seizure in the emergency room and later died. A doctor confirmed he had exercise-associated hyponatremia.

And in recent years, there have been more than a dozen documented and suspected runners' deaths from hyponatremia.

Winger said it's common for coaches to encourage athletes to drink profusely, before they get thirsty. But he noted that expert guidelines recommend athletes drink only when thirsty. Winger said athletes should not drink a predetermined amount, or try to get ahead of their thirst.

Drinking only when thirsty can cause mild dehydration. "However, the risks associated with dehydration are small," Winger said. "No one has died on sports fields from dehydration, and the adverse effects of mild dehydration are questionable. But athletes, on rare occasions, have died from over-hydration."

Winger is co-author of a 2011 study that found that nearly half of Chicago-area recreational runners surveyed may be drinking too much fluid during races. Winger and colleagues found that, contrary to expert guidelines, 36.5 percent of runners drink according to a present schedule or to maintain a certain body weight and 8.9 percent drink as much as possible.

"Many athletes hold unscientific views regarding the benefits of different hydration practices," Winger and colleagues concluded. Their study was published in the British Journal of Sports Medicine.

PEOPLE WITH MULTIPLE SCLEROSIS MAY BE AT INCREASED RISK OF DEVELOPING CANCER

Individuals with multiple sclerosis may have an increased risk of developing any type of cancer, with an especially high risk of developing breast cancer. That is the conclusion of a recent study published inEuropean Journal of Neurology. Because the findings contradict earlier studies, additional research is needed to determine whether a true link exists between multiple sclerosis and cancer

Previous research suggests that some individuals with autoimmune diseases may have an increased risk of developing cancer, but most studies have found no link between cancer and multiple sclerosis, an autoimmune disease that involves the central nervous system.

To investigate further, Li-Min Sun, MD, of the Zuoying Branch of Kaohsiung Armed Forces General Hospital in Kaohsiung, Taiwan, and his colleagues assessed data from the National Health Insurance System of Taiwan, including information on 1292 patients who were diagnosed with multiple sclerosis between 1997 and 2010. Each patient was matched with four participants without the condition.

"Our study was a nationwide population-based cohort study, and it revealed unexpected findings," said Dr. Sun. Specifically, the team found that individuals with multiple sclerosis were 85% more likely to develop cancer than the controls. Their risk of developing breast cancer was especially high, with more than a 2-fold increased risk over controls.

The findings suggest that patients with multiple sclerosis patients may need to be monitored closely to ensure early detection of cancer. Dr. Sun notes that it is unclear why his team's results are not consistent with most other studies. "The underlying genetic and environmental factors in Taiwan, which differ from those of western countries, might play an undetermined role. Additional large-scale studies will help improve our understanding," he said.

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A New Book About Neuropathy May Be Worth A Read

Today's post from press.jhu (see link below) is basically a book review via an interview with the author but a very useful one nevertheless. Despite the seeming growth of neuropathy as a 'coffee table topic' and more and more people understanding what happens to millions of people across the world with nerve damage; there are still relatively few good books on the subject available. By good books, I mean books about nerve damage that everybody can relate to without being bogged down by impossible neural science. Dr Janice Wiesman has written 'Peripheral Neuropathy: What It Is and What You Can Do to Feel Better​.' and it seems very promising indeed for the average person who is battling the disease daily. We need objectivity; no hidden commercial agendas and plain well-explained facts that don't try to blind us with science. This book may go some way to providing us with exactly that. Objective, factual information is like gold-dust, so it may be worth while keeping an eye out for this publication.

Q&A with Dr. Janice Wiesman 
Submitted by krm on Tue, 2016-10-25

With her new book coming out soon, Dr. Janice Wiesman has stopped by the JHUP blog to answer a few questions about Peripheral Neuropathy.

Q: Why did you decide to write this book?

For the past 20 years I have been educating patients and families about neuropathy in the office. For the past 10 years I have been speaking at neuropathy support group meetings and patients and families have asked me to make my slides available. So, after 20 years of educating patients and families a few at a time, I decided to listen to my patients and write the book. The last such book written for patients and families was publish in 2006. A lot has changed since then. In addition, I noticed that all of the other books out there on peripheral neuropathy are written by non-physicians: patients, therapists, chiropractors etc. Some of them seen to have a hidden, commercial agenda that I think is not appropriate for a book intending to inform and advise people who have an illness. In addition to providing information regarding neuropathy and a guide through the process of being examined, tested and evaluated in the neurologist’s office, this book is intended to empower patients during their office visit. They have to make sure that the neurologist is explaining things to them to their satisfaction and providing the information and services they need to live the best life possible.

Q: What were some of the most surprising things you learned while writing/researching the book?

It reminded me of what a truly miraculous structure is a nerve cell. A nerve cell, called a neuron, is 50 microns in diameter. That is 50 millionths of a meter. It maintains an arm-like structure that can be up to 3 feet long. That is like a man who is 6 feet tall maintaining an arm that is 20 miles long! This nerve cell and its long arm have to work for 120 years. New nerve cells and nerves are not made; you have to maintain the ones you are born with.

Q: What is new about your book/research that sets it apart from other books in the field?

It is the only up-to-date, consumer-targeted book about neuropathy written by a neurologist on the market. The last such book was published 10 years ago. There has been a lot of progress in the last 10 years in the diagnosis and treatment of neuropathy.

The book walks the reader through the anatomy and function of nerves, the ways that nerves are damaged, decodes the neurological exam, explains common tests and why they are performed, describes treatment with and without medication and ends with a discussion of lifestyle issues that affect, and are affected by, nerve damage.

Q: Did you encounter any eye-opening statistics while writing your book?

It is estimated that 20 million Americans have neuropathy – that is a staggering number. For a third of these people, a cause is not found. While diabetes mellitus is currently the most common cause of neuropathy in the world, until recently, it was leprosy.

Q: Does your book uncover and/or debunk any longstanding myths?

Persons with neuropathy have no barrier to exercise or to a fully satisfying sex life! Neuropathy symptoms are due to damage to the physical structures called nerves and not to “being nervous” or “having nerves”.

Q: What is the single most important fact revealed in your book and why is it significant?

That for many people with neuropathy, the path to symptoms relief is in their own hands. This is particularly true of neuropathy caused by diabetes mellitus and alcohol use. Patients who are empowered to control their illness will be more successful in leading the fullest possible life.

Q: How do you envision the lasting impact of your book?

I hope the book serves as a reference for people with neuropathy and their families. My goal is to educate patients about this one aspect of their own bodies. I hope the book is something they will use to “look up” information about their illness. In addition, I hope it will give them “permission” to question their physicians and make sure all of their questions are answered to their satisfaction.

Q: What do you hope people will take away from reading your book?

I would like patients to know that there is a reason the doctor asks certain questions, performs the physical examination in a certain way and orders certain tests. I want patients to know “what the doctor is thinking’ at each step of the office visit. There is a lot an individual can do to prevent, mitigate and alleviate symptoms of neuropathy. Individuals with neuropathy can lead full and happy lives.

Janice F. Wiesman, MD, FAAN, is an associate clinical professor of neurology at New York University School of Medicine and an adjunct assistant professor of neurology at Boston University School of Medicine. She is the author of Peripheral Neuropathy: What It Is and What You Can Do to Feel Better​.

https://www.press.jhu.edu/news/blog/qa-dr-janice-wiesman