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Study reveals effects of obesity and metabolic syndrome on breast cancer

Women who eat a low-fat diet can decrease their risk of dying from breast cancer by 21 per cent, new findings suggest

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A new US study has revealed the effects obesity and metabolic syndrome can have on breast cancer.

Both obesity and metabolic syndrome, a cluster of conditions like high blood pressure and high blood sugar, increase the risk of breast cancer, but in differing ways for different subtypes of the cancer.

A University of Oklahoma researcher helped to lead a study that produced those results, which may help physicians better care for patients at higher risk for breast cancer.

The study is from the Women’s Health Initiative (WHI), an effort that began in the early 1990s and continues to yield valuable data about postmenopausal women’s risks for cancer, cardiovascular disease, osteoporosis and other conditions.

The initiative, funded by the National Heart, Blood and Lung Institute, a component of the National Institutes of Health, is the largest women’s health prevention study ever conducted.

Robert Wild, a professor of obstetrics and gynecology in the OU College of Medicine, has been involved with the WHI since its beginning and is a co-author of the latest study, published in Cancer.

The research followed another WHI study showing that women who ate a low-fat diet for about eight years decreased their risk of dying from breast cancer by 21 per cent over the next 20 years.

Those findings led researchers to consider whether the reduced risk was related to a decrease in obesity or an improvement in the conditions associated with metabolic syndrome. As it turns out, the answer is both.

“This study shows that obesity had an effect on breast cancer independent of metabolic syndrome, and that metabolic syndrome had an effect on breast cancer independent of obesity,” Wild said. “And they affected various subtypes in different ways, which influenced whether women were diagnosed with breast cancer and whether they died from it.”

The upshot of the study is simpler: keeping both waist circumference and metabolic conditions under control is important to reduce the risk of being diagnosed with breast cancer and the risk of dying from it.

“This study is essentially saying to get back to the basics,” Wild said. “Prevention is important, and we need to be paying attention to both metabolic syndrome and weight.”

Metabolic syndrome includes increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglycerides, all of which also increase the risk for cardiovascular disease and diabetes.

The study found that:

  1. Metabolic syndrome is significantly associated with 53 per cent more deaths after breast cancer and a 44 per cent higher breast cancer mortality.
  2. Metabolic syndrome is also associated with poor prognosis in two specific types of breast cancer: oestrogen receptor (ER)-positive and progesterone receptor (PR)-negative.
  • ER-positive breast cancer occurs when high levels of oestrogen in the breast cancer cells help the cancer grow and spread. This type of cancer represents 70-80 per cent of all breast cancer diagnoses and typically responds well to hormone therapy, which blocks hormones like oestrogen.
  • PR-negative breast cancer means the cancer has no hormone receptors and therefore does not respond to hormone therapy. It also tends to grow faster than hormone-positive cancers.
  1. Obesity status is significantly associated with more total breast cancers and more deaths after breast cancer, with higher mortality only in women with severe obesity.
  2. Obesity status is also associated with good prognosis in ER-positive and PR-positive cancers. Both can be treated with hormone therapy and tend to grow more slowly than those that are hormone receptor-negative.

Wild said: “The Women’s Health Initiative is the gift that keeps on giving. It is a great opportunity to make use of quality information. In the beginning, I don’t think we knew what a valuable resource it would still be years later.”

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‘Groundbreaking’ endometriosis study identifies patient priorities

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A “groundbreaking” study into endometriosis has identified three areas for future research that can help improve the outcomes for women with the condition.

The study, commissioned by Endometriosis New Zealand, attracted 1,262 participants, including 1,024 people with confirmed endometriosis, making it the largest ever study involving endometriosis patients and supporters in New Zealand.

Study participants identified the management and treatment of endometriosis, the need for a better understanding of its cause and improvements to diagnostic capability as the three main priorities for further research.

While these findings provide a clear pathway for future work, Endometriosis New Zealand chief executive, Tanya Cooke, said endometriosis research had historically been underfunded.

“With an estimated 120,000 New Zealanders living with endometriosis, much more needs to be invested into finding solutions,” Cooke explained.

“The reality is the outcomes for many endometriosis patients are pretty poor, with diagnosis often taking many years and treatment patchy across the country.”

Estimates based on Australian data suggest that endometriosis is likely to be costing New Zealand somewhere in the range of $1.3-1.5bn annually through increased healthcare costs and lost workforce productivity.

Cooke said: “The good news is that our findings align closely with those in Australia and provide three clear priorities for future research – improved treatment options, causation and better diagnostic capability.

“What New Zealand now requires is proper funding for a future research programme that can investigate these priorities more closely and improve the outcomes for individuals living with endometriosis.”

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Virtual care platform secures US$46m to address US maternal health crisis

Pomelo Care will use the funding to scale its care model and improve maternal and infant outcomes

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Marta Bralic Kerns, founder and CEO of Pomelo Care

The US virtual maternity care platform Pomelo Care has secured US$46m in funding to address the US maternal health crisis.

One in 10 babies born in the US today start their life in a neonatal intensive care unit.

Healthcare access continues to worsen, with one in eight births occurring in US counties with limited-to-no access to maternal care. Due to significant gaps in postpartum care, about half of pregnancy-related deaths in the US occur after hospital discharge.

The evidence exists for how to identify people at highest risk for complications and which interventions are most effective, but existing data gaps and provider capacity challenges make it difficult to apply these interventions at scale.

Pomelo has developed a care model that aims to address these challenges by analysing claims and health record data to identify individual risk factors and providing virtual pregnancy, postpartum, and infant care to patients to reduce those risks.

“We’ve long known what works to reduce maternal and infant complications,” said Marta Bralic Kerns, founder and CEO of Pomelo Care.

“The questions have always been: can you identify the patients who are at highest risk, can you deeply engage them in care to drive uptake of the prevention strategies we know work, and can you do it in the highest risk populations with the most limited access to care?”

“This data demonstrates that we absolutely can. And with this additional funding, we’ll have the opportunity to scale our care model to more pregnant people across the country.”

The funding, led by existing investors First Round Capital and Andreessen Horowitz (a16z) Bio + Health, is hoped to help Pomelo accelerate its partnerships with payors across the US and increase access to “evidence-based” care.

Josh Kopelman, partner at First Round Capital and Pomelo board member, said: “It’s rare to come across an opportunity where the incentives between patient, provider and payor are all aligned.

“Marta and the Pomelo team have found an incredible opportunity to dramatically improve outcomes for the highest risk populations, while helping payors reduce their avoidable costs.”

Vineeta Agarwala, general partner at a16z Bio + Health and Pomelo board member, added: “Pomelo is one among a small set of health tech companies that have earned true scale.

“This scale is evident in our partnerships with major Medicaid and commercial plans covering over three million lives, which create the opportunity to collaborate with OB providers, labour and delivery wards, and NICUs nationwide, while serving hundreds of thousands of expecting mothers and newborns with high quality, technology-enabled care.”

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One in three UK fertility patients seek treatment abroad due to high costs

Expensive fertility treatments prompt UK patients to seek help abroad

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One in three fertility patients in the UK seek treatment abroad due to high costs, a new survey has shown.

Fertility Family has gathered insights from 429 UK participants who have experienced difficulties with infertility.

The Infertility Awareness Report found that the high cost of fertility treatment in the UK has driven over one in four people to spend over £10,000 on both treatments and investigative procedures.

The research showed around 35 per cent of people struggling with infertility have considered seeking fertility treatment abroad due to the prospect of lower costs.

Of those seeking fertility treatment in a foreign country, however, only 14 per cent believed that clinics abroad have a higher success rate.

Of those actively trying to conceive almost one in five have used their life savings in the pursuit of having a child, whilst 25 per cent have paid for their fertility treatments using a credit card.

Dr Gill Lockwood, consultant at Fertility Family, said: “While we tend to cast our gaze on women when it comes to infertility, case studies have shown that infertility can impact both women and men in similar ways. However, women have been observed to seek help more than men.

“Although the psychological struggles of infertility can be overwhelming, many patients ultimately reach some type of resolution. Some of the alternatives include becoming parents to a relative’s children, adopting children, or deciding to adopt a child-free lifestyle.

“Needless to say, this resolution is usually psychologically demanding, and patients may feel forever impacted by the experience of infertility.”

A combination of fertility struggles and accessible healthcare have impacted people across the UK significantly, with one in two admitting to feeling “ashamed” due to their difficulties trying to conceive.

A further 31 per cent reported feeling that other people think “less” of them due to their fertility struggles, showcasing the need for better mental health support.

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