If you can’t have a loved one with you during a painful procedure, just looking at your partner’s picture may make it hurt less.

The American Society for Radiation Oncology has a new website for patients, and open enrollment for Medicare plan coverage begins on November 15 and extends through the end of the year.

Research News

• African Americans were more likely to die of colorectal cancer in a study of over 13,000 patients.  They were more likely to have stage IV disease when diagnosed and less likely to have surgery.   But after late stage and lack of surgery were taken into account, racial differences in survival disappeared.  Writing in the November 2009 issue of the Journal of the American College of Surgeons, Dr. Timothy L. Fitzgerald and team said, “These data suggest that improvements in screening and rates of operation may reduce differences in colorectal cancer outcomes between African-American and Caucasian patients.”
• Canadian women were more likely than men to be diagnosed with an early colorectal cancer in the three years after a negative colonoscopy.  Researchers in Manitoba studied billing records for nearly 46,000 patients who had a clear colonoscopy and found that women with a negative colonoscopy were about as likely as women in the general population to develop colon cancer during the first three years after their test.  Then their risk dropped to about 40 to 50 percent lower.  The men’s  risk was 40 to 50 percent lower throughout the follow-up period.  Older women and those whose colonoscopy wasn’t done by a gastroenterologist were the most likely to have a missed or early colorectal cancer.   Harminder Singh MD, MPH and his team at the University of Manitoba reported their results in the American Journal of Gastroenterology online November 10, 2009.
• Looking at the picture of a loved one or holding your boyfriend’s hand reduces painful feelings, according to a study done by psychologists at UCLA. Women reported less pain when heat was applied to their forearm if they were holding their partner’s hand rather than a stranger’s hand or a ball during the experiment.  Just looking at a picture of their loved one also reduced the amount of pain they said they had.  Sarah Master PhD led the study.

Other Headlines

• The American Society for Radiation Oncology (ASTRO) has launched a newly designed patient website RT Answers. The new site is easier to navigate and includes more pictures.  The front page helps patients search for a radiation oncologist and provides a gateway to treatment information.
• Medicare beneficiaries can make new coverage choices during the annual open enrollment period from November 15 through December 31.   Online comparisons of original Medicare, Medicare Advantage, and supplemental Medigap policies are available from CMS.  Also changes in Part D Prescription Drug coverage plans can be made during open enrollment.

The guide includes information about over-the-counter (OTC) and prescription pain medicine.  It includes some of the problems that can occur when acetaminophen, NSAIDS, or opiates are not used as directed.  Knowing the active ingredients in a pain reliever is important so that patients won’t use several different medicines with the same ingredient at the same time.

In addition, patients who are using opiates prescribed for pain need to take care that they don’t get misused or abused by other people.  They need to be stored carefully and protected against being stolen.

From A Guide to the Safe Use of Pain Medicine:

USE OPIOIDS SAFELY: 3 KEY STEPS

1. Keep your doctor informed. Inform your health care professional about any past history of substance abuse. All patients treated with opioids for pain require careful monitoring by their health care professional for signs of abuse and addiction, and to determine when these analgesics are no longer needed.
2. Follow directions carefully. Opioids are associated with significant side effects, including drowsiness, constipation, and depressed breathing depending on the amount taken. Taking too much could cause severe respiratory depression or death. Do not crush or break pills. This can alter the rate at which the medication is absorbed and lead to overdose and death.
3. Reduce the risk of drug interactions. Don’t mix opioids with alcohol, antihistamines, barbiturates, or benzodiazepines. All of these substances slow breathing and their combined effects could lead to life-threatening respiratory depression.

A system that combines magnetic resonance imaging (MRI) with ultrasound treatment to destroy bone tumors and treat pain is being evaluated in a randomized Phase III clinical trial at a number of centers in the United States, Canada, and Israel.

BM004: A Pivotal Study to Evaluate the Effectiveness and Safety of ExAblate Treatment of Metastatic Bone Tumors for the Palliation of Pain in Patients Who are not Candidates for Radiation Therapy is sponsored by InSightec Ltd.

ExAblate 2000, magnetic resonance guided focused ultrasound (MRgFUS) was developed by Insightec and has been used to treat uterine fibroids since 2004.  Magnetic resonance imaging focuses high-intensity ultrasound waves on tumor tissue to destroy it and relieve pain.  Doctors can measure and adjust increasing temperature in tumors being treated during therapy.

Patients eligible for the trial include those

• with 1 to 3 painful metastases to their bones.
• whose pain has not improved despite radiotherapy or who are unable to use radiotherapy.
• with pain scores at least 4 or higher.
• whose bone tumors are less than 8 centimeters.
• who are able to communicate sensations during the ExAblate treatment
• have tumors clearly visible on MRI and accessible to MRgUS

Ineligible patients

• have more than 3 painful bone tumors
• are unable to remain in a stationary position for up to 2 hours
• have metal stabilization of bones at the treatment site
• need surgical or other treatment to prevent fractures at the treatment site
• have medical conditions that don’t allow MRgUS treatment

The trial will be randomized, with some patients receiving a sham treatment.   The primary outcome of the trial will be a change in pain scores over the three months after treatment.  In addition, adverse events from use of the ExAblate device and reduction in the need for pain medicine will be measured.

To find a contact at a site where the trial is being offered go to the bottom of the study information page at ClinicalTrials.Gov.  The clinical trials identifier is NCT00656305.

Insightec Ltd. has additional information about ExAblate and the trial.