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Showing posts with label Months. Show all posts
Showing posts with label Months. Show all posts

Friday, July 5, 2013

Ariz. Twins Suffer Strokes Months Apart

Kathryn Tucker, a senior care coordinator for an Arizona insurance company, had just gone to bed when she felt a sharp pain the back of her head on the right side before her vision went out and she went numb.

Her brother was at her Chandler, Ariz., apartment and got her to the hospital where doctors at first dismissed her symptoms as a migraine with aura. But Tucker, only 26, was having a stroke.

"I was absolutely terrified," said Tucker, who was sent home from the emergency room that day in July 2012 without medical intervention.

"I slept for three days straight," she said. "Then, when I woke up, my vision was horrible. Everything was distorted and one-dimensional. I could barely get around."

Her health deteriorated so she ended up going to an urgent care facility. From there, she was referred to a neurologist who diagnosed a stroke.

Nine months later to the day, her twin sister, Kimberly Tucker, suffered a stroke in exactly the same way, except on the left side. Kimberly Tucker had left school in Tucson to take care of her sister after her stroke. Then in April, their roles reversed.

The Tucker girls are fraternal twins and do not share the same DNA. There is a family history of stroke, but doctors are unsure of a genetic link until further testing is done.

Both suffered a stroke on opposite sides of the occipital lobe, which sends visual input from the brain to the retinas.

"Honestly, it's rare for us to actually evaluate two sisters who've had strokes within months of each other," said Dr. Joni Clark, a vascular neurologist at Barrow Neurological Institute in Phoenix. "If they had a family history, it would not be a surprise. It's quite uncommon."

Stroke is a leading cause of death in the United States, killing nearly 130,000 Americans each year, according to the Centers for Disease Control and Prevention, which observes National Stroke Month in May.

About one-third of strokes are believed to occur in people younger than 65.

For those younger than 45, the stroke risk has jumped 14 to 20 percent, according to Clark.

"We see this mainly among young people who have risk factors that you should see in elderly patients.

"Here at Barrow, we see a huge population of stroke patients -- and, in my own experience, which is anecdotal, I see a fair number of young people with stroke," said Clark. "The majority are spontaneous."

Obesity, which leads to diabetes, high blood pressure and high cholesterol, is a risk.

"You'd also be surprised how many young adults don't exercise," said Clark. "It's sad, because the rise is due to good, old stroke risk factors that shouldn't happen when they are young."

Doctors say that lifestyle habits are linked to an increase in the incidence of strokes among young people. Kathryn Tucker was a smoker and had stopped using birth control just weeks before her stroke. She also was a migraine sufferer.

It was discovered later that Kathryn Tucker had a PFO, or patent foramen ovale, a small hole in the heart that may have contributed to her stroke.

"There were several things that probably all together put Kathryn at risk," said Clark, who treated Kathryn Tucker, but not her sister.

Kathryn Tucker said her prognosis is "really good" now that she has stopped smoking and taking the pill.

The twins said they were also worried about their overuse of caffeinated energy drinks -- three to four a week, although there is no medical evidence linking those drinks to stroke.

"Don't think you are impervious to stroke," said Kimberly Tucker, who is still undergoing therapy. "We think we are invincible until we are not. This taught us a huge lesson that we are not guaranteed great health and we need to take care of our bodies."

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Thursday, June 13, 2013

Sorafenib (Nexavar) Delays Rare Thyroid Cancer By 5 Months

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Main Category: Cancer / Oncology
Also Included In: Endocrinology
Article Date: 03 Jun 2013 - 2:00 PDT Current ratings for:
Sorafenib (Nexavar) Delays Rare Thyroid Cancer By 5 Months
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Sorafenib (Nexavar) stops metastatic thyroid cancer tumor growth for nearly twice as long as a placebo, researchers from Abramson Cancer Center and the Perelman School of Medicine at the University of Pennsylvania announced as they reported on a randomized phase III trial at the ASCO Annual Meeting in Chicago, Illinois.

If the US FDA (Food and Drug Administration) approves liver and kidney cancer drug Nexavar for use in radioactive iodine-refractory differentiated thyroid cancer, it would be the first effective agent for this disease. Nexavar is a kinase inhibitor that mediates tumor cell division and growth of tumor blood vessels.

Thyroid cancer is the fastest-increasing cancer worldwide. It is the sixth most common cancer in females. Over 213,000 new thyroid cancer diagnoses are made annually. 30,000 people die from the disease each year globally.

In 90% of cases thyroid cancer can be effectively treated and cured with surgery and radioactive iodine treatment. However, for the remaining 10% who do not respond to standard therapies, the tumors spread and appear in the lungs, bones, lymph nodes and other parts of the body.

Doxorubicin is the only other drug for thyroid cancer that has metastasized. It was approved in 1974. However, doctors do not prescribe it because it is highly toxic and ineffective.

Study leader, Marcia S. Brose, MD, PhD, said:

"Until we began using sorafenib, we had no medical options for these patients who suffered due to progression of their disease. Now, we can give patients hope - a breakthrough medication that can stop the progression of the disease for 5 months. This trial is the first step in a promising series of clinical trials to identify new drugs that are shifting the horizon for patients with advanced thyroid cancer."

The multicenter, international trial, known as DECISION, involved 417 metastatic thyroid cancer patients. 207 of them were randomly selected to receive oral drug sorafenib (400 mg twice daily), while 210 took a matching placebo. The DECISION trial started in October 2009.

The researchers reported that: 12% of the sorafenib patients experienced tumor shrinkage0.5% of those on placebo experienced tumor shrinkage42% of patients in the sorafenib group had stable disease after 6 months33% of patients in the placebo group had stable disease after 6 monthsPFS (progression-free survival) in the sorafenib arm was 10.8 monthsPFS among the placebo patients was 5.8 monthsIn this cross-over trial, 70% of the placebo patients switched over to sorafenibThe researchers say that overall survival data is not yet available.

Side effects reported among the sorafenib patients included rash, fatigue, weight loss, elevated blood pressure, diarrhea, and skin reaction. All adverse events are similar to those reported in patients receiving sorafenib for liver and kidney cancers.

Nexavar is approved by the FDA for the treatment of unresectable hepatocellular carcinoma (approved for liver cancer in November 2007) and advanced renal cell carcinoma. Nexavar is approved in more than 100 countries for these indications and is currently being evaluated for a range of cancers.

Dr. Brose presented the team's findings on Sunday, June 2nd in Room E353a, McCormick Place in Chicago. The findings of the trial were also presented in a plenary session in N Hall B1 of McCormick Place.

Bayer HealthCare Pharmaceutical and Onyx Pharmaceuticals funded the trial. (Editor's note: Dr. Brose has received consulting fees and honoraria from these companies)

Kemal Malik, MD, Member of the Bayer HealthCare Executive Committee and Head of Global Development, said "This trial is representative of our continued commitment to fully understanding sorafenib's potential applicability, especially in hard-to-treat cancers where there are limited treatment options."

Pablo J. Cagnoni, M.D., Executive Vice President, Global Research & Development and Technical Operations, Onyx Pharmaceuticals, said "In the past 30 years, there have been no new treatment options approved for patients with radioactive iodine-refractory differentiated thyroid cancer. We are pleased with the results of the DECISION study, which demonstrate sorafenib's activity in patients who have no other treatment options."

According to Bayer HealthCare Pharmaceutical, the Phase 3 DECISION data will form the basis for sorafenib's regulatory submissions for the treatment of RAI-refractory differentiated thyroid cancer. An sNDA (supplemental New Drug Application) in the USA is planned for the middle of this year, with further submissions to follow worldwide.

DECISION stands for "stuDy of sorafEnib in loCally advanced or metastatIc patientS with radioactive Iodine refractory thyrOid caNcer".

Written by Christian Nordqvist


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