In this issue we look at various ways to look and feel younger. And for tobacco smokers, we present a new risk-assessment tool. Predicting Lung Cancer Risk Delusions of Feeling Better Book Review: Cosmetic Surgery New Study Touts Breakfast New Wrinkle Eraser

We may use this format once and awhile when we want to discuss a particularly interesting topic. This gives us the opportunity to go into much more detail than we can in the time allotted on the radio show.

Predicting Lung Cancer Risk

Lung cancer is the most common form of cancer and smoking is the No. 1 cause of preventable deaths in the United States. Cancer researchers have developed a new predictive tool to determine which smokers are at highest risk for lung cancer and who would benefit most from screening for the disease. Smokers and ex- smokers can predict their risk of lung cancer by using a mathematical formula. The formula takes into account how long and how much they smoked, and, in the case of ex-smokers, how long it has been since they quit.

Medical scientists at Memorial Sloan-Kettering Cancer Center in Manhattan, and a second team at the Fred Hutchinson Cancer Research Center in Seattle, have developed this mathematical model to determine a smoker's risk. Scientists say it can help determine which smokers would most benefit from getting a spiral CT. This is currently the test we use to rule out acute pulmonary embolism. "Spiral CT," said Dr. Peter Bach, a cancer epidemiologist at Memorial Sloan- Kettering, "can be considered when the formula predicts a high risk of lung cancer."

Researchers have posted an easy-to-use version for consumers on the web. Dr. Bach said, "The risk assessment tool should help physicians and patients balance the possible risks and benefits of screening." It is designed for people who are 50 years of age and older.

"For example," Bach said, "a 51-year-old woman who smoked a pack a day for 29 years but hasn't smoked for the last nine had a 0.8 percent risk of lung cancer, less than 1 in 100 over the next decade. By comparison, a 68-year-old man who has smoked two packs a day for 50 years - and continues to smoke - has a 1 in 7 risk."

Check out this tool on the web.

	Delusions of Feeling Better
According to the NY Times on 3/19/03: "Bit by bit the evidence is accumulating that most women are foolish if they keep taking hormone pills for years at a time. Last year federal health officials halted a large study of hormone replacement therapy because the pills used, a combination of estrogen and progestin, were causing more harm than good. Women taking the pills had a greater risk of breast cancer, heart attacks, strokes and blood clots than other women, and the damage was not offset by a small beneficial effect in reducing the risk of colon cancer and hip fractures. Even so, many women have been reluctant to abandon the hormone therapy because it makes them feel better, more energetic, mentally sharper and more sexually responsive. Or so they have thought." The article continues: "Now comes the bad news that they have most likely been mistaken. New study results just released by The New England Journal of Medicine show that the pills had no significant effect on the quality of life of a large group of postmenopausal women. Women who took the pills did not feel any healthier or more vital than comparable women who took placebos, nor did they have more sexual pleasure. Compared with those in the placebo group, their minds were no clearer, their memories no better, and their mental health no different. The pills did have marginal effects on sleep disturbances, physical functioning and pain, but these were not clinically significant and disappeared after a year or so of use." "This is a stunning reversal of fortune for drugs that have been widely used by many women not just to treat the hot flashes and night sweats of menopause, a well-established use, but also as a long-term elixir to ward off aging. So engrained is the belief in hormone therapy that many women and many doctors refuse to believe the mounting evidence against it." "But the findings were generated by the respected Women's Health Initiative, which randomly assigned more than 16,000 women to take either the hormones or a placebo. The results ought to embarrass Wyeth, the manufacturer of the pills tested, which has long implied that hormone therapy is a virtual fountain of youth. They should also shake the confidence of everyone who has believed, on the basis of anecdotal reports and less rigorous scientific studies, that hormone treatments made women feel better. A lot of the presumed benefit may have been a placebo effect." Read on... "The Hormone Myth" »

	Book Review: Cosmetic Surgery
"Turn Back the Clock Without Losing Time," by Dr. Rhoda S. Narins and Dr. Paul Jarrod Frank. Three Rivers Press, $14. This is an easy to read and concise guide that weeds through all the media hype related to beauty and the fountain of youth creams and procedures out there. The authors give a detailed review of all of the options for every problem area in order to look your best. Everything from prices, to risks, to real expected outcomes are included--with dozens of beauty tips. Not so long ago, cosmetic surgery was primarily invasive, a sometimes painful experience reserved for the socially elite and requiring a long hospital stay and weeks of seclusion. Today, as the authors of this guide to "cosmetic rejuvenation" point out, there is a far wider choice of easily accomplished treatments, sometimes performed over a lunch hour. Gone, too, is the perception of a makeover as a celebrity-only procedure or a sign of superficiality. Proof of that is the estimated 2.7 million procedures, like peels and dermabrasions, to erase facial wrinkles and the 300,000 liposuctions, the removal of fat through tiny incisions in the skin with long, slim tubes. "The only tip-off," say the authors, New York dermatologic surgeons, "may be that they look rested, more youthful, or more fit and shapely, depending on what they've had done." The treatments they discuss include chemical peels and wrinkle-erasing Botox, each taking only minutes, along with minilifts and liposuctions, which can be done in a doctor's office.There is a combination procedure known as Lilax, a three-pronged approach that shrinks that plague of aging, "turkey neck." It employs liposuction to remove fat around the neck, laser resurfacing under the skin to tighten it, and excision of a small piece of skin under the chin in a natural crease so the loose skin can be lifted. The procedure is done under local anesthesia and requires only three days of recuperation. (Contents of the above review are based in part on a customer review found at amazon.com.) Amazon link »

	New Study Touts Breakfast
Those who regularly eat breakfast are less likely to develop problems such as diabetes or obesity than people who rush out the door on an empty stomach, a new study shows. Breakfast eaters are 55 % less likely to have problems with insulin resistance or become obese than their non-breakfasting counterparts, the research suggests. Although the best results came from eating whole-grain cereals and other nutritious breakfast items, "eating breakfast at all was preferential to not eating," says Linda Van Horn, a professor of preventive medicine at Northwestern University and one of the authors of the study. It was presented March 6 at the American Heart Association's annual conference on cardiovascular disease, in Miami. Someone who eats early in the morning is less likely to fill up on sweet treats later in the day, Van Horn says. The researchers used data from people enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which started in 1992. Those enrolled in the study were 25 to 37 years of age. The study included 1,884 black and 2,059 white people who reported on their breakfasting (or lack thereof), and who were tested for insulin resistance. The participants were assessed for obesity, abnormal glucose, elevated blood pressure and lipid values over an eight-year period.Participants were asked how often they ate breakfast, and to identify what they ate by groupings, such as hot cereal, processed cold cereals and the like. 47% of whites and 22% of blacks reported regularly eating breakfast. When compared to those who did not breakfast regularly, those who did were 37 to 55% less likely to develop insulin resistance syndrome - frequently a precursor to diabetes - and to become obese. They are also less likely to develop heart disease, since diabetes often leads to heart disease. This study confirms the widely-held belief that eating in the morning prevents binge eating later in the day. The study has been hyped with the conclusion that: "One simple thing you can do to cut heart risk in half is eat breakfast." While this overstates their case, the study certainly provides strong evidence that eating breakfast confers tremendous health benefits.

	New Wrinkle Eraser
Since 1994, over 200,000 women around the world have used a product that is said to permanently erase facial wrinkles. It is called Artecoll and Dermatologists say it can out-do Botox by smoothing out wrinkles in many areas. They also say it is better than standard collagen because it doesn't fade away. Women who took part in a clinical trial more than two years ago say their lines haven't re-appeared. The product is made out of special Bovine collagen. The results are said to be instant and only get better with time. Artecoll is scheduled to go before the Food and Drug Admisitration for approval on March 21, 2003. Treatments range from $600 to $3,000.   Wrinkle eraser web site »