Health Newsfeed – Johns Hopkins Medicine Podcasts Johns Hopkins Medicine

Women who used talc-containing products genitally may be at increased risk for ovarian cancer, but not for breast cancer, a new study finds. Kimmel Cancer Center director William Nelson at Johns Hopkins says this study attempted to eliminate certain biases from women’s recall in order to more clearly identify an association. 

Nelson: In this study there was an association of talc use with ovarian cancer and it was substantial. Ovarian cancer of course is not a cancer that arises in the ovary, it arises in the fallopian tube. We now know, that was not known when all this was happening before. If there's anything in the fallopian tube that causes irritation or chronic inflammation leads to cancer rarely but is at the root of almost all cancers of epithelial cells, so that's what's going on I suspect that would be the mechanism.   :29

Nelson notes that Johnson and Johnson has just agreed to a settlement with some women with ovarian cancer, and about 9000 lawsuits remain, all linking cancer to genital use of baby powder. He says it may not be the talc itself but another contaminant but recommends against using it. At Johns Hopkins, I’m Elizabeth Tracey.

Women should undergo screening for breast cancer using mammography every two years from age 40 until 74, the most recent United States Preventive Services Task Force recommendations state. Yet now that life expectancies are increasing, should all women observe the guideline? William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says maybe.

Nelson: Well unfortunately I think it's complicated, it's one of these things where you have to consider all you're doing in the context of what the current state is. So what are the other illnesses and conditions, basically have to inventory the health and then start to think about what kinds of things you can do to promote a healthy existence for as long as you can. And that may or may not include breast cancer screening. I think it has to be something that is more thought through than a single recommendation from the US preventive services task force. If you're going to screen what are you going to do if you find an abnormality.     :31 

Nelson says research is ongoing on treatment of breast cancer in older women. At Johns Hopkins, I’m Elizabeth Tracey.

If you’re a woman between the ages of 40 and 70, you should undergo screening mammography for breast cancer every two years, the United States Preventive Services Task Force has just recommended. Johns Hopkins Kimmel Cancer Center director William Nelson explains.

Nelson: The big news in this is they now assign a grade B to the idea that one can undergo a screening with mammography every other year beginning at age 40 rather than at age 50 to 74, so you stop screening at 74. They looked at the regular digital mammography. There are new tools out there, tomosynthesis,, they're basically 3D mammography. They argue that the 3D mammography needs to be accompanied by a 2D representation and they're not sure what the benefit of 3D mammography is.    :30

Nelson says several trials have found a benefit with 3D mammography in correctly identifying cancerous lesions versus those that are not, but says the task force requires abundant evidence before changing guidelines, so that may be upcoming. At Johns Hopkins, I’m Elizabeth Tracey.

There may be no benefit to taking a drug that’s approved already for treating cancer in a clinical trial versus just receiving treatment, a new study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says benefits of clinical trials may include access to drugs that are not approved yet.

Nelson: This one also largely focused on clinical trials to the comparison where you got the same drug that's often a more advanced stage clinical trial opposed to getting a drug which is being newly introduced, it undergoes an evaluation to assess what the side effects are, how well it likely works. Ultimately is it better than the best we've got, if we add it to the best we've got of treatment of a particular condition is there any improvement? These drugs are not available until they've met that standard of improving outcomes and so that's a little bit different also.     :31

Nelson notes that the study didn’t find a benefit while comparing known and approved drug treatment within and outside of trials. At Johns Hopkins, I’m Elizabeth Tracey.

People with cancer who enroll in clinical trials do better. That wisdom appears to have been dashed with results of a new study showing no survival benefit or any other positive outcome related to clinical trial participation. Johns Hopkins Kimmel Cancer Center director William Nelson looks at the study.

Nelson: They did some kind of meta analysis and looked if you received the drug and you received the same drug in a clinical trial you did about the same. The thought is that people who enroll in clinical trials are generally younger and somewhat healthier despite having cancer. You know more likely to participate in the trials and there are other things that I'm not sure that they have completely accounted for which is there's a striking differential. I think in the propensity to make an accurate diagnosis and stage which is required for participation in a clinical trial.    :31

Nelson says this study only examined one clinical trial scenario and there are many other types of trials. At Johns Hopkins, I’m Elizabeth Tracey.

If you wear contact lenses you may be at particular risk to develop the condition known as dry eye, where your eyes may feel dry and scratchy. Lauren Gormley, an optometrist at Johns Hopkins, describes why wearing contacts may precipitate the condition.

Gormley:  Where contact lenses become a cause for dry eye is that your natural tear film is meant to support your cornea, so when you put a contact lens on the eye, especially soft contact lenses, they also need your tear film in order to stay hydrated. They will grab those tears before the cornea can get what it needs. But when you think about lubrication would you say contact lens rewetting drops which are eye drops over the counter usually where the contact lens solutions are that are meant to lubricate the contact lenses.  :29

Gormley notes that manufacturers of contact lenses are aware of the relationship between dry eye and wearing contacts, and are always investigating new materials that may remain hydrated on their own for longer periods of time. She notes that not wearing lenses for extended periods is also a good idea. At Johns Hopkins, I’m Elizabeth Tracey.