NEW HAVEN — A faster and less expensive form of radiotherapy for treating prostate cancer may come at a price, according to a new study by Yale School of Medicine researchers — a higher rate of urinary complications.
The standard external beam radiation therapy for prostate cancer is called intensity modulated radiation therapy (IMRT). Stereotactic body radiotherapy (SBRT) is a newer treatment that delivers a greater dose of radiation per treatment than IMRT. As a result, patients receiving SBRT can complete an entire course of treatment in one to two weeks, compared to seven to nine weeks for IMRT. There have been few studies comparing the costs of these treatments, and their toxicity.
Published March 10, the new study by researchers at the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center at Yale Cancer Center— compared IMRT to SBRT in a national sample of 4,005 Medicare patients aged 66 and older receiving prostate cancer treatment. Participants received either SBRT or IMRT as a primary treatment for prostate cancer during 2008 to 2011.
“All the reports we have about the toxicity of SBRT comes from pioneering institutions,” said first author James Yu, MD, assistant professor of therapeutic radiology at Yale Cancer Center. “But now that SBRT is being used nationally, it is important to determine the costs and complications on a national level.”
Yu, senior author Cary Gross, MD and their colleagues found that the mean per-patient cost to Medicare for a course of SBRT was about $13,600, compared to $21,000 for IMRT. The team found that at 24 months after the start of the treatment, there were increased side effects for SBRT compared to IMRT, due to urethral irritation, urinary incontinence, and obstruction. However, even when including the cost of treating complications, the overall medical costs due to SBRT were still lower than that of IMRT.
WALLINGFORD — Gaylord Specialty Healthcare, a long-term acute care hospital, has formed a five-year clinical affiliation with the Frank H. Netter MD School of Medicine at Quinnipiac University. Under terms of the agreement, Gaylord staff will work with the leadership of the new QU medical school to recruit physicians as teachers, design clinical components of the curriculum, and create academic policies and procedures.
“We are honored to be part of this new education affiliation agreement with Quinnipiac University School of Medicine,” said Steve Holland, MD, chief medical officer at Gaylord Hospital. “We look forward to this exciting opportunity to partner with Quinnipiac as we collectively work together to create a new approach to medical education.”
"Gaylord Hospital shares our commitment to primary care and medical education,” said Bruce Koeppen, MD, founding dean of the School of Medicine. "I am confident that the physicians and staff at Gaylord Hospital will provide our students with a high quality clinical experience.”
BRANFORD — A Shoreline Eating Disorder Presentation will be held from 6 to 7:30 p.m. March 18 at Blackstone Memorial Library,758 Main Street. This year’s speaker is Margo Maine, founder and advisor of the National Eating Disorders Association and founding fellow of the Academy for Eating Disorders. Author of The Body Myth: Adult Women and the Pressure To Be Perfect, the first book to address eating disorders at or beyond mid-life, Maine will discuss the many contributing factors, the unique characteristics and needs of adults, and the importance of identifying the problem and accessing care. Maine is also senior editor of Eating Disorders: The Journal of Treatment & Prevention, has numerous other books on the topic of eating disorders, lectures widely and maintains a private practice in West Hartford. The program is free and open to the public. To learn more phone 203-710-6665 or visit blackstonelibrary.org.
BRIDGEPORT — A new Doctors Express Urgent Care Center has opened for business at 161 Boston Avenue, effective March 3. A fully staffed patient-care facility catering to any age, from pediatric to geriatric, Doctors Express says it is equipped to handle all types of medical emergencies from life threatening and painful physical conditions to pre- and post-treatment assessments and follow-up attention.
Led by veteran Greenwich Hospital emergency room physician Steven Heffer, MD, the first Bridgeport office of the nation’s largest urgent-care franchise positions itself in the market as a quicker, easier, more convenient and affordable alternative to large hospital emergency rooms.
“Not only will Doctors Express help reduce the burden at our area’s busiest emergency rooms, like Bridgeport Hospital and St. Vincent’s, but our services can greatly decrease the wait time for patients and meet their most immediate medical needs,” said Heffer. “Our objective is to help our patients quickly and effectively. The Doctors Express goal is to have all patients treated in 30 to 60 minutes.”
The Bridgeport Doctors Express is open 8 a.m. to 8 p.m. weekdays and 8 a.m. to 5 p.m. weekends.
NORTH HAVEN — Holly Atkinson, MD, medical correspondent and editor at HealthiNation, a digital health network, will deliver a lecture, “The Five Keys to Optimal Health,” in the Center for Medicine, Nursing and Health Sciences at Quinnipiac University’s North Haven Campus. Atkinson will explore five dimensions of optimal well-being, offering practical advice from recent medical research mixed with advice for improving one's emotional, social, intellectual, physical and spiritual well-being.
An assistant professor of medicine at the Mt. Sinai School of Medicine who holds degrees in both medicine and journalism, Atkinson has written the best-selling book Women and Fatigue. She wrote a regular health column for New Woman magazine and feature pieces for the South Beach Diet Newsletter.
Atkinson earned her medical degree from the University of Rochester School of Medicine & Dentistry and a master’s degree in journalism from the Columbia University Graduate School of Journalism. She was graduated Phi Beta Kappa from Colgate University with a bachelor’s degree in biology.
The talk will take place at 1 p.m. on Wednesday, April 8. Part of Quinnipiac’s Campus Cross Talk series, the event is free and open to the public. To learn more phone 203-582-8652.
HARTFORD — Gov. Dannel P. Malloy wants to ban the sale of e-cigarettes to minors in Connecticut.
Introduced March 11, Senate Bill 24 would also set fines for violations: up to $200 for the first offense, up to $350 for the second within 24 hours, and up to $500 for any further violation within 24 hours of the first offense.
Electronic cigarettes are not currently regulated in Connecticut.
"Connecticut should join the 27 states that have already prohibited the sale of e-cigarettes and other related devices to minors to continue our progress towards achieving long-term reductions in tobacco use and tobacco-related illnesses," Malloy said in a statement. "More than 75 percent of young people who have tried e-cigarettes also report smoking conventional cigarettes. This legislation will strengthen our prevention efforts and help reduce tobacco use among young people."
A Yale study estimates that eight million lives have been saved in the United States as a result of anti-smoking measures that began 50 years ago with the pathbreaking report from the Surgeon General outlining the deadly consequences of tobacco use. The Yale School of Public Health-led analysis was published in the Journal of the American Medical Association.
The study used mathematical models to calculate the long-term effect of the seminal report, and subsequent anti-smoking measures, over the past half-century. These cumulative efforts have significantly reshaped public attitudes and behaviors concerning cigarettes and other forms of tobacco, the researchers say.
First author Theodore R. Holford, professor of biostatistics and member of Yale Cancer Center, and six other researchers who are part of the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network, found that while some 17.6 million Americans have died since 1964 due to smoking-related causes, eight million lives have been saved as a result of increasingly stringent tobacco-control measures that commenced with the report’s 1964 release.
Of the lives saved, approximately 5.3 million were men and 2.7 million were women. The total number of saved lives translates into an estimated 157 million years of life, a mean of 19.6 years for each beneficiary, report the researchers.
“An estimated 31 percent of premature deaths were avoided by this effort, but even more encouraging is the steady progress that was achieved over the past half-century, beginning with a modest 11 percent in the first decade to 48 percent of the estimate what we would have seen from 2004 to 2012 in the absence of tobacco control,” said Holford. “Today, a 40-year-old man can expect on average to live 7.8 years longer than he would have in 1964, and 30 percent of that improvement can be attributed to tobacco control. The gains for women have been slightly less, 5.4 years, but tobacco control accounts for 29 percent of that benefit.”
Using data collected by the National Center for Health Statistics from 1965 to 2009, the team recreated smoking life history summaries for groups born each year starting in 1890. These were used along with national mortality statistics and studies that followed large populations to calculate mortality rates by smoking status. This allowed them to estimate the impact of alternative scenarios for what might have occurred had the era of tobacco control never happened.
NEW HAVEN — New Haven is going on a diet. As part of an initiative to create a healthier Elm City, health professionals, city government and Yale University are challenging city residents to collectively shed 375,000 pounds. That translates into just under three pounds for each of the city’s some 130,000 residents.
The Get Healthy CT weight-loss challenge is a joint initiative of the city, Cornell Scott-Hill Health Center, Yale School of Public Health and Yale-New Haven Hospital.
The weight target coincides (sort of) with New Haven’s 375th anniversary last year. A weight-loss calculator on the Get Healthy CT website (GetHealthyCT.org) will track progress. The website offers tips, exercise programs and events to help people attain their individual goals.
New Haven is marked by wide disparities in health, according to public-health officials, who say that large numbers of residents live in underserved neighborhoods where high rates of obesity, tobacco use and other factors contribute to a range of potentially preventable chronic diseases.
“Prevention is critical. Small lifestyle changes in diet and exercise can have a big impact on your health,” said Jeannette Ickovics, professor of public health at Yale and director of the Community Alliance for Research and Engagement (CARE), a partner in the Get Healthy CT initiative.
Ickovics noted that shedding just five percent of body weight — ten pounds for a 200-pound person — can prevent or delay the onset of diabetes.
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