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NEW YORK (Reuters Health) - Up to 80 percent of cancer patients who undergo radiation treatment do not take medications to combat pain, a new study indicates.

Many of the patients cited fears of addiction as well as cost as their reasons for saying no to painkillers. However, the most common reason given was that their healthcare provider had not recommended medication, according to the report.

"To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications," Dr. Charles Simone, from the National Cancer Institute in Bethesda, Maryland, said in a statement.

The current findings come from an Internet-based questionnaire posted on OncoLink (www.oncolink.org) examining analgesic use and pain control in cancer patients getting radiation treatment. Data from 106 patients were included in the analysis.

Forty-six percent of patients reported pain related to the cancer itself, and 58 percent of subjects had pain from their treatment, the report's authors note in the International Journal of Radiation Oncology, Biology, Physics.

The only statistically significant factor linked to non-use of painkillers was educational level. Specifically, individuals with education beyond high school were less likely to use analgesics than those with lower educational levels: 11 percent vs. 36 percent.

Lower rates of use were also noted by whites compared with other races (16 percent vs. 32 percent) and by women than men (17 percent vs. 29 percent).

Patients with pain who chose not to use analgesics often tried alternative therapies.

To improve pain control for cancer patients undergoing radiation, Simone said that his center, the Radiation Oncology Branch of the NCI, has established an electronic system that requires healthcare providers to assess pain levels and pain medication every time they see a patient.

SOURCE: International Journal of Radiation Oncology, Biology, Physics, September 1, 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - Young children who have severe allergic reactions to stings from fire ants can be desensitized in a one-day "rush" protocol, according to a new report.

There's a risk of repeated stings in regions where imported fire ants are endemic, Dr. Michael S. Tankersley told Reuters Health. The one-day protocol, "which can safely reach a protective dose of immunotherapy in a short amount of time, would be a therapeutic option for any-age patient with imported fire ant allergy."

Tankersley, from Lackland Air Force Base, San Antonio, Texas and colleagues describe three children 36 months or younger who completed a one-day rapid immunotherapy protocol with imported fire ant whole-body extract.

The procedure involves 10 injections of the extract given every 30 or 60 minutes, starting with a miniscule amount and gradually building up to a full dose so that the child becomes tolerant.

None of the three children experienced reactions during the treatment other than some mild redness at the injection sites, the team reports in the Annals of Allergy, Asthma & Immunology.

After the rapid desensitization, the children went on to monthly maintenance immunotherapy.

The kids got stung by fire ants several times subsequently and generally did well, although one who didn't keep up with maintenance treatment had breathing difficulties after being stung.

Tankersley stressed the importance of having people with reactions to fire ant stings see an allergist, "as imported fire ant allergy can be fatal."

Immunotherapy provides 95-98 percent protection, he pointed out. Treatment "is recommended for 3-5 years with monthly maintenance injections provided in the office of an allergist."

"We have just completed an initial study using this same protocol in adult patients 18 years and older," Tankersley added.

SOURCE: Annals of Allergy, Asthma & Immunology, September 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - There has been a substantial increase in the number of colorectal cancer screening tests conducted in older Americans, a new study shows.

"Most cases of colorectal cancer are diagnosed in older adults," Dr. Mary C. White, of the Centers for Disease and Control and Prevention, Atlanta, and colleagues note in the Journal of the American Geriatric Society. "Two thirds of new cases of colorectal cancer involve people aged 65 or older and one quarter of diagnoses are made in those aged 80 and older."

They point out that "as the number of older Americans continues to increase, greater attention is being paid to cancer screening in this population."

The researchers reviewed responses from roughly 6,000 participants in the 2000 National Health Interview Survey and a similar number in the 2005 version. All of the subjects were at least 65 years old.

The questionnaire included self-reports of colorectal cancer screening by colonoscopy, sigmoidoscopy, or home fecal occult blood tests.

The proportion of respondents reporting up-to-date colorectal cancer testing increased significantly from 39.5 percent in 2000 to 47.1 percent in 2005.

People who had a family history of the disease and those who had some higher education made greatest use of colorectal cancer testing. The lowest use was by those who reported that they did not visit a particular physician office for usual preventive care, those with uncertain family history of the disease, and those without health insurance.

A lower proportion of women than men were screened for colorectal cancer across all age groups, and the proportion screened declined with older age.

"Since 2001, Medicare has provided reimbursement for use of colonoscopy as a screening tool at 10-year intervals," the investigators point out. "It appears that the change in Medicare coverage for screening colonoscopy was associated with an increase in colorectal cancer testing in older adults."

SOURCE: Journal of the American Geriatric Society, August 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - A weak bladder keeps many women from taking part in recreational sports, according to an Italian study published in the British Journal of Sports Medicine.

In a survey of 679 Italian young and middle-aged women, researchers found that 1 in 7 (15 percent) were bothered by urinary stress incontinence -- that is, small urine leaks when the bladder is under pressure, such as from exercise, coughing, or laughing. On average, these women had suffered with the problem for 6 years.

Being overweight and having had children boosted the likelihood of having urinary stress incontinence, Dr. Stefano Salvatore from University of Insubria, Del Ponte Hospital, Varese, and colleagues found.

Of those affected, nearly half said the condition occurred during routine activities, while nearly a third said they leaked urine only during sports activities.

One in 10 women said the problem led them to give up their favorite sport, while one in five women said they limited the way they engaged in the sport in a bid to reduce leakage episodes.

Sports with repetitive bouncing, such as basketball, tennis and squash, were associated with the highest incidence of incontinence episodes in affected women.

This study, the researchers say, shows that urinary incontinence, even when mild, can have a harmful impact on the quality of women's lives by limiting their participation in healthy-promoting physical activity. Despite this, few women seek help.

Women "should be given information and offered diagnostic and conservative therapeutic options," including pelvic floor exercises, which have proven to be very effective in alleviating urinary incontinence, Salvatore and colleagues conclude. "Unfortunately," they add, pelvic floor exercises were practiced by less than 5 percent of women with urinary incontinence in this study.

SOURCE: British Journal of Sports Medicine 2008.

Copyright © 2008 Reuters Limited.

NEW YORK (Reuters Health) - It's not just the elderly who vulnerable to the ill effects of air pollution, new research suggests.

In a study of 2.7 million deaths across 48 U.S. cities, researchers found that death rates tended to rise on days when ozone pollution increased -- with the older adults being most at risk.

However, while age was the strongest risk factor, there was also evidence that older women were more vulnerable to ozone pollution than older men were, and blacks were more vulnerable than other racial groups.

People with atrial fibrillation -- a heart rhythm disturbance common in older adults -- were also at increased risk of dying on days with poor air quality.

The study, conducted by Mercedes Medina-Ramon and Joel Schwartz of the Harvard School of Public Health, adds to evidence linking daily ozone increases to spikes in death rates.

It also suggests that even moderately elevated levels of ozone may be hazardous for certain vulnerable people.

The difference in pollution-related death rates between the elderly and young, for example, was much greater in cities that typically had relatively low ozone levels than in cities with generally high ozone concentrations.

This suggests that at high levels, ozone has a more uniform effect on death rates, the researchers explain in the journal Epidemiology.

Ground-level ozone forms when sunlight reacts with pollutants from cars, factories and other sources, and is the main component of smog. Ozone levels are typically highest in the summer.

Ozone pollution can cause inflammation in the airways and exacerbate respiratory ills like asthma and emphysema or other chronic diseases like heart disease. Because the elderly are more likely to have pre-existing medical conditions, they are also more vulnerable to the dangers of poor air quality.

In this study, each ozone increase of 10 parts per billion was linked to a 0.65 percent increase in the overall death rate. Among adults older than 65, that figure was 1.1 percent.

The reasons for the disparities between races and sexes are not clear, according to the researchers. They note, however, that one study of young adults found that black volunteers tended to have more breathing problems in response to ozone exposure.

The current findings, according to the researchers, may help lay the groundwork for air quality standards that better protect vulnerable people.

SOURCE: Epidemiology, September 2008.

Copyright © 2008 Reuters Limited.