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Rheumatoid arthritis (RA) strikes three times more women than men and researchers in Europe may have found a clue.   Scientists at the Arthritis Research UK Epidemiology Unit at the U of Manchester have discovered 14 new genes that can lead to RA, adding to the 32 other genes that have already been identified.  The researchers latest study published in Nature Genetics, has reported genes that are specific to the female X-chromosome.  According to Professor Alan Silman, medical director at the Research Unit, “This is the first time that a genetic association has been established between RA and the X chromosome.”
 

When people with Type 2 diabetes are diagnosed with cancer – a disease for which they are at higher risk – they ignore their diabetes care to focus on cancer treatment, according to new Northwestern Medicine® research. But uncontrolled high blood sugar is more likely to kill them and impair their immune system’s ability to fight cancer.
However, people with Type 2 diabetes who received diabetes education after a cancer diagnosis were more likely to take care of their blood sugar. As a result, they had fewer visits to the emergency room, fewer hospital admissions, lower health care costs, and they tested their blood sugar levels more often than people who didn’t have the education. They also had more hemoglobin a-1c level tests at their doctor’s offices. The latter is a critical marker of how well someone has managed their diabetes and blood sugar over the last three months.
“People with diabetes hear cancer and they think that it is a death sentence, so who cares about diabetes at this point?” said June McKoy, MD, director of geriatric oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “But if they’re not careful, it’s the diabetes that will take them out of this world, not the cancer. That’s why this education is so critical when cancer comes on board. Patients must take care of both illnesses.”
McKoy is the senior author of the study recently published in the journal Population Health Management. Lauren Irizarry, a fourth-year medical student at Feinberg, is the lead author.
Uncontrolled high blood sugar can result in kidney damage and failure as well as blindness and amputation of the feet as blood vessels are damaged by excess sugar. In addition, Type 2 diabetes dampens the immune system and hampers the body’s ability to fight cancer.    People with diabetes have a higher incidence of liver cancer, pancreatic cancer, colon cancer, breast cancer, bladder cancer, and endometrial cancer.
Source:   Northwestern NewCenter
 

Cancer during pregnancy is rare, occurring in approximately one out of every 1,000 pregnancies, with breast cancer being the most commonly diagnosed. In the past, both healthcare providers and women were often unclear about how to proceed with a pregnancy after a cancer diagnosis without jeopardizing either the mother or the fetus; however, as more women with cancer are deciding to start or continue cancer treatment while pregnant, more information about treating and living with cancer during pregnancy is available.  Oncofertility Consortium member Eileen Wang, MD, an OB/GYN who specializes in maternal fetal medicine (MFM) provides an overview of the management of women who are diagnosed with cancer during pregnancy in, “Pregnancy in Cancer Patients and Survivors,” a chapter in Oncofertility Medical Practice: Clinical Issues and Implementation.

Pregnancy can often delay a cancer diagnosis because some cancer symptoms, such as fatigue, nausea, or anemia, are common during pregnancy and are not considered suspicious. On the other hand, pregnancy can sometimes uncover cancer that has previously gone undetected. For example, a Pap test done as part of standard prenatal care can detect cervical cancer. Similarly, an ultrasound performed during pregnancy can find ovarian cancer that might otherwise go undiagnosed. According to Dr. Wang, “Once a woman receives a diagnosis of cancer during pregnancy, this should trigger a multidisciplinary approach to her care.”

When making treatment decisions for cancer during pregnancy, health care providers should consider the best treatment options for the mother and the possible risks to the developing fetus. The type of treatment chosen depends on many factors, including the stage of the pregnancy; the type, location, size, and stage of the cancer; and the wishes of the expectant mother and her family. Some cancer treatments can harm the fetus, especially during the first trimester, so treatment may be delayed until the second or third trimesters. When cancer is diagnosed later in pregnancy, doctors may wait to start treatment until after the baby is born, or they may consider inducing labor early. In some cases, such as early-stage cervical cancer, doctors may wait to treat the cancer until after delivery.

The prognosis for a pregnant woman with cancer is often the same as other women of the same age with the same type and stage of cancer; however, if a woman’s diagnosis or treatment is delayed during pregnancy, the extent of the cancer may be greater. In addition, because of the amount of hormones produced during pregnancy, they have the potential to affect the growth and spread of some types of cancer. Dr. Wang concludes, “A multidisciplinary approach involving the patient and her support network, the oncology and surgery teams, and the obstetrical and MFM team is required to give the patient the best medical counseling and care and to manage her expectations during the pregnancy regarding her future child in the context of treatment and prognosis.” Read “Pregnancy in Cancer Patients and Survivors.”

In January 2013, the American College of Obstetricians and Gynecologists (ACOG), which is the nation’s leading group in the field of obstetrics and gynecology, released an opinion on a lesser known form of abuse called reproductive coercion. Reproductive coercion occurs whenever a woman’s partner tries to stop her from making her own decisions regarding pregnancy. This includes pressuring a woman to have an abortion she doesn’t want, using threats to stop a woman from having an abortion she does want, and attempting to impregnate a woman against her will. This can include a man hiding his partner’s birth control pills, removing a condom in the middle of sex, or even removing a woman’s intrauterine device (IUD) or other internal contraceptive.
Rebekah Gee, an obstetrician and gynecologist who has studied this issue, believes that for men, reproductive coercion is often, “about taking away choices, taking away freedom, control and self-esteem.” She also points out that a man may attempt to get his partner pregnant to tie her to him, and prevent her from leaving him.
Researchers believe that this form of abuse, also called “birth control sabotage,” is more common among women who are abused by their partners in other ways. One study indicates that 25% of teenage girls and 15% of women with abusive partners reported experiencing reproductive coercion. Although researchers involved in the ACOG report are unsure exactly how prevalent this form of abuse is, they believe it is common enough that physicians and other healthcare providers should screen women and check for signs of reproductive coercion during routine visits.
If physicians do not ask questions, women who undergo abuse may not realize that something can be done to improve or resolve the situation they are in. Doctors can take direct steps to help these women by providing difficult to detect birth control, such as IUDs with shortened strings, or emergency contraceptives in unmarked packaging. Additionally, they can direct women to assistance hotlines or agencies, such as the National Domestic Violence Hotline. Simply providing information can also make a difference. In one small study, women in clinics were given small cards with information and a questionnaire about reproductive coercion. Reports of coercion dropped 71% among women who received this information.
While increasing awareness about reproductive coercion and providing immediate help to women experiencing this type of abuse is critical, implementing education and prevention programs will be an important step in stopping reproductive coercion in the future.
Source: Painter, Kim. “Abusive Partners can Sabotage Contraception.” USA Today. 23 January 2013.