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The National Heart, Lung, and Blood Institute (NHLBI) has stopped a clinical trial evaluating a new approach to reduce the risk of recurrent stroke in children with sickle cell anemia and iron overload because of evidence that the new treatment was unlikely to prove better than the existing treatment.

The 26-site trial, Stroke With Transfusions Changing to Hydroxyurea, or SWiTCH, studied 133 participants between the ages of 5 and 18 who had already experienced a stroke. All had been receiving the standard treatment of blood transfusions for at least 18 months and high levels of iron before entering the study. Without further preventive measures, these children were at high risk of another stroke as well as life-threatening conditions due to iron overload.

The study tested whether the drug hydroxyurea, known to prevent complications of sickle cell disease in adults, was as effective as transfusions, the standard therapy, in reducing the risk of recurrent strokes. Hydroxyurea is the only FDA-approved drug for treating sickle cell anemia.

The study also compared two approaches to remove excess iron, a consequence of regular blood transfusions. Participants who continued to receive transfusion therapy were given the standard oral iron-removal drug deferasirox, and participants who were switched to hydroxyurea underwent regular phlebotomy (blood removal) to eliminate excess iron that had accumulated from their earlier transfusions.

Phlebotomy did not reduce liver iron better than deferasirox therapy. Analysis of the available data indicated that continuing the trial was unlikely to show that phlebotomy would provide a greater benefit than deferasirox to control iron accumulation. Without the ability to provide benefits for the management of liver iron, the potential risks of continuing study treatments were no longer warranted.

“Protecting our participants is an important factor in determining whether to stop a trial,” said Susan B. Shurin, MD, acting director of the NHLBI, who is a board-certified hematologist and pediatrician. The NHLBI is part of the National Institutes of Health. ” When an experimental treatment fails to meet its predetermined goals, it is best to return participants to standard treatment as soon as possible.” By the time the trial was halted, approximately one-third of participants had completed the study, during which they were treated and monitored for 30 months. At enrollment, participants were randomly assigned to either the alternative or the standard treatment group. The study’s independent Data and Safety Monitoring Board (DSMB) reviewed interim results from the trial and recommended stopping the study. The NHLBI accepted the recommendation and stopped the study on May 6.

The DSMB noted that no strokes occurred in the 66 participants who received the standard therapy of blood transfusions and deferasirox. In contrast, seven strokes occurred in the group of 67 participants who received hydroxyurea with phlebotomy. Study participants and their families have been contacted, and they will discuss future care options with their health care providers.

NHLBI-supported research has shown that hydroxyurea helps prevent pain crises, a common complication of the disease, and some lung complications in adults. Preliminary studies have suggested that hydroxyurea might also help reduce the risk of stroke recurrence in children with sickle cell disease. Patients currently taking hydroxyurea should continue taking the treatment as prescribed and should talk to their primary care provider if they have any concerns, Shurin advised.

Regular blood transfusions greatly reduce the number of strokes in at-risk children with sickle cell disease. Because repeated transfusions cause side effects such as buildup of excess iron in the body, researchers hope to find more effective and safer ways to reduce stroke risk in young patients. Iron overload can damage organs and lead to cirrhosis (a liver condition), poor growth and development, and heart rhythm disturbances.

“These kinds of studies are so important to finding new treatments and confirming that current standards of care are the best available options,” Shurin explained. ” The field of medicine would not advance without the help of those willing to participate in clinical research. We are grateful to these young patients and their parents for helping advance treatments of sickle cell disease. Their contributions will help us find other approaches to preventing complications of sickle cell disease.”

About 10 percent of children with sickle cell disease suffer a stroke. Having experienced one, they are at high risk of having another unless they receive preventive treatment.

Sickle cell disease affects more than 70,000 Americans. It is seen mostly in persons of African descent, but also in individuals of Middle Eastern, Mediterranean, Central and South American, and Asian Indian heritage. New therapies have helped patients live into middle age and older. Sickle cell disease involves an altered gene that produces abnormal hemoglobin, the protein that carries oxygen in the blood. Red blood cells with sickle hemoglobin become C-shaped, stiff, and sticky when they release the oxygen they carry. The deformed cells impede blood flow, causing severe pain and organ damage.

The study was scheduled to run until 2012. Rho Inc. of Chapel Hill, N.C., served as the SWiTCH statistics and data management center. Researchers will analyze and publish the final data in the coming months. SWiTCH was conducted at the following locations:
University of Alabama at Birmingham
Children’s National Medical Center, Washington, D.C.
Nemours Children’s Clinic, Jacksonville, Fla.
University of Miami, Fla.
Nemours Children’s Clinic, Orlando, Fla.
Children’s Healthcare of Atlanta at Scottish Rite
Children’s Healthcare of Atlanta at Egleston
Children’s Healthcare of Atlanta at Grady
Children’s Memorial Hospital, Chicago
Boston Children’s Hospital
Wayne State University, Detroit
University of Mississippi Medical Center, Jackson
The Children’s Mercy Hospital, Kansas City
St. Joseph’s Children’s Hospital, Paterson, N.J.
Montefiore Medical Center, New York City
State University of New York/Downstate Medical Center, New York City
Schneider Children’s Hospital, New Hyde Park, N.Y.
Columbia University Medical Center, New York City
East Carolina University, Greenville
Cincinnati Children’s Hospital
The Children’s Hospital of Philadelphia
Children’s Hospital of Pittsburg
Medical University of South Carolina, Charleston
St. Jude Children’s Research Hospital, Memphis, Tenn.
University of Texas Southwestern Medical Center at Dallas
Baylor College of Medicine, Houston
East Virginia Medical School, Norfolk
Medical College of Wisconsin, Milwaukee

Novartis US donated the deferasirox (EXJADE). Bristol-Myers Squibb and UPM Pharmaceuticals Inc. provided the hydroxyurea for the trial.

To speak with an NHLBI spokesperson about the SWiTCH trial (NCT00122980), please contact the NHLBI Communications Office at (301) 496-4236.

With the rapid and continuous advances in biotechnology, scientists are better able to see inside the nucleus of a cell to unlock the secrets of its genetic material. However, what happens outside of the nucleus has, in many ways, remained a mystery. Now, researchers with the National Institutes of Health are closer to understanding how activity outside of the nucleus determines a cell’s behavior. They looked at mouse immune cells and examined the types, amount, and activity of microRNAs, genetic components that help regulate the production of proteins. Their study provides a map to the variety of microRNAs contained within mouse immune cells and reveals the complexity of cellular protein regulation. The study appears online in the journal Immunity.

An organism is made up of cells containing genetic material in the form of deoxyribonucleic acid (DNA) residing within the nucleus. An organism’s entire collection of DNA is called its genome and consists of genes, short segments of DNA that code for proteins, and many long segments of DNA that do not contain genes. While each cell contains the entire genome, not all of a cell’s genes are making proteins all of the time. Which genes are turned on and which are turned off, and when, determine the behavior of a cell, such as the type of cell it becomes, where it goes, and what it does.

“A plethora of cellular functions, ranging from development, differentiation, metabolism, and host defense, are impacted by protein levels,” said Rafael Casellas, Ph.D., the study’s principal investigator from the Genomics and Immunity Group of the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). ” We were interested in discovering how microRNAs contribute to the regulation of these functions.”

A cell makes proteins through a process called transcription, in which genes are copied from DNA into messenger ribonucleic acid (RNA), which travels from the nucleus into the body of the cell. Not all RNA transcribed from DNA are messenger RNA, however. There are many other forms of RNA that do not code for proteins. MicroRNAs (miRNAs), for example, are small strands of RNA that modulate the production of proteins from messenger RNA, thereby helping to regulate protein levels in the cell. Previous studies have shown that cells are very sensitive to fluctuations in miRNA levels, which require tight control in order to regulate protein activity effectively.

In the current study, the NIH scientists used a new microsequencing technology to comprehensively identify all of the different miRNAs existing in mouse immune cells. In addition to increasing the number of known miRNAs, the scientists also discovered several cellular mechanisms that regulate miRNA abundance. The study found that some miRNA constructs exist in a dormant state within the nucleus until they receive signals from the epigenome to become active. The epigenome regulates transcription and comprises all of the non-genetic material in the nucleus. Other miRNAs, the researchers determined, are not hampered by these epigenetic mechanisms and are controlled simply through transcription. However, for some of these miRNAs, abundance depends upon the amount of target messenger RNA available in the cell.

According to NIAMS Director Stephen I. Katz, M.D., Ph.D., “The data generated from this study represent a useful tool for immunologists and cell biologists to use for future studies on functional aspects of the immune system and basic miRNA biology.”

About one-quarter of all U.S. hospital patients are readmitted over a two-year period for the same conditions that led to their original hospitalization, a new study finds.

These revolving-door figures came from the federal Agency for Healthcare Research and Quality, which analyzed 2006-07 data on 15 million patients in 12 states. Among its findings:
More than one-third of patients with hardening of the arteries (atherosclerosis) were readmitted at least once to the hospital, along with 30 percent of patients with uncomplicated diabetes, 28 percent with high blood pressure, and 21 percent with asthma.
Among Medicare patients, 42 percent had multiple hospital admissions and 38 percent had multiple emergency department visits.
Among Medicaid patients, 23 percent experienced multiple hospital admissions and 50 percent had multiple emergency department visits.
Rates of hospital readmissions and multiple emergency department visits were 22 percent and 38 percent, respectively, for uninsured patients and 19 percent and 29 percent, respectively, for privately insured patients.

Although some patients do need to be readmitted, better outpatient care could prevent unnecessary repeat hospital admissions, which in turn can push up health care costs, according to the AHRQ.

The data in the study came from Arizona, California, Florida, Hawaii, Massachusetts, Missouri, Nebraska, New Hampshire, New York, South Carolina, Tennessee, and Utah.

One in five high school students in the United States has taken a prescription medication that was not prescribed for them, a new survey shows.

Conducted by the U.S. Centers for Disease Control and Prevention, the survey covers a variety of risky behaviors among American youth.

“We are very concerned that 20 percent of high school students are reporting this behavior,” said survey author Danice K. Eaton, a research scientist at the CDC. “It can be dangerous to take a prescription drug that hasn’t been prescribed to you.”

Studies have shown that taking non-prescribed prescription drugs can lead to overdose, addiction and death, Eaton explained. “Taking a prescription drug that hasn’t been prescribed to you is a health risk behavior,” she said.

In the survey, 16,460 high school students were asked if they had ever taken prescription drugs such as OxyContin, Percocet, Vicodin, Adderall, Ritalin or Xanax, without a doctor’s prescription.

The abuse of prescription drugs was widest among whites at 23 percent, followed by Hispanics at 17 percent, and black students at 12 percent.

In addition, the abuse of prescription drugs was most common among 12th graders (26 percent) and lowest among ninth graders (15 percent), the researchers found. But, prescription drug abuse was the same for boys and girls, at 20 percent.

This is the first time a question about prescription drugs has been asked in the survey, Eaton said. The next survey will be in 2011, with the data being released in 2012. This will be the first opportunity to see trends in the abuse of prescription drugs, she noted.

In the meantime, the “awareness that there is such a high prevalence of prescription drug abuse among high school students is the main thing that we can emphasize from our data,” Eaton said.

Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, said there are too many prescription drugs waiting to be abused.

“When prescription drugs are available in a home to the patient for whom they were prescribed, they are also available to the patient’s teenager,” he said.

Educating teens about the potential harms of prescription drugs, and including discussion of prescription medications in all drug control programs, is warranted, Katz said.

“Parental awareness, which this report helps cultivate, and vigilance will be more important still,” he said. “But perhaps the ultimate solution to this problem is a more dedicated societal commitment to disease prevention and health promotion, so that fewer prescription drugs are in circulation, and available for such misuse.”

The survey also asked about alcohol and drug abuse. In all, 72 percent of the students said they had used alcohol. Furthermore, 37 percent had used marijuana, 6.4 percent had used cocaine, 4.1 percent had used methamphetamine and 6.7 percent had used ecstasy.

These findings were basically the same as those in the last survey, which was done in 2007, the researchers noted.

On the bright side, high school students seemed to be eating better.
The number of students who drank a soda a day dropped, from 34 percent in 2007 to 29 percent in 2009.
More students ate fruit or 100 percent fruit juice (30 percent in 2005 and 34 percent in 2009).
Fewer students engaged in risky weight-loss diets, such as not eating, taking diet pills or vomiting or taking laxatives.

However, students are still engaging in other risky behaviors such as:
78 percent had not eaten fruits or vegetables five or more times daily in the week before the survey.
82 percent said they had not been physically active for at least an hour per day.
19 percent smoked cigarettes.
28 percent rode in a car driven by a person who had been drinking alcohol.
39 percent of sexually active students had had sex without using a condom.

These numbers are also similar to the 2007 numbers, the researchers noted.

SOURCES: Danice K. Eaton, Ph.D., research scientist, Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.

Genetic analysis of a woman with breast cancer has yielded important information about an extremely dangerous type of breast cancer that largely affects blacks and younger women, say U.S. researchers.

By comparing three genomes — the genome of a 44-year-old black woman who had “triple negative” breast cancer and the genomes of her breast tumor and a metastatic tumor that developed in her brain — the scientists identified 20 genetic changes in a subset of breast tumor cells that probably played a role in the spread of the cancer that led to her death within a few months.

The findings suggest that sequencing entire genomes of cancer patients, along with the genomes of their primary and metastatic tumors, could improve understanding of how tumors spread and possibly lead to the development of new drugs that target important cancer-causing genetic errors, according to the researchers, from the Washington University School of Medicine in St. Louis.

“We are getting an intimate look at the lethal spread of a breast cancer, which is now possible because we can sequence entire genomes quickly at reasonable cost,” Elaine Mardis, co-director of the university’s Genome Center and the study’s senior author, said in a university news release.

“This work lays the foundation for understanding the genetic basis of tumor progression and metastasis and for identifying new drug targets that can improve the outlook for women with this disease,” she added.

The study is published in the issue of Nature.

Researchers are reporting that they’ve linked a gene to a rare condition that makes people develop thin “peach fuzz” hair, potentially paving the way toward greater insight into male-pattern baldness.

The finding won’t immediately lead to a better treatment or cure, said Angela M. Christiano, co-author of the study, published April 15 in the journal Nature. And though it’s “just a tiny little piece of the puzzle,” it could provide perspective about a component of male-pattern baldness known as shrinkage, said Christiano, director of the Center for Human Genetics at Columbia University.

Contrary to popular belief, male-pattern baldness doesn’t cause hair to stop growing. Instead, hair still grows but it’s short and fine, like peach fuzz, Christiano said.

“If you look at a very bald scalp, they are still making tiny little peach-fuzz hairs,” she said. “A follicle is still there. The hardware is still there to grow a hair of some kind.”

People with a rare condition called hereditary hypotrichosis simplex have the same problem, although it begins at birth.

In the new study, Christiano and her colleagues examined the genetic makeup of members of two Pakistani families and one Italian family whose members have inherited the condition. The researchers discovered a gene in which a mutation appears to cause the problem.

The gene, called APCDD1, is located in a region of chromosome 18 that has been shown in previous studies to be linked to other forms of hair loss. The researchers also found that APCDD1 inhibits a signaling pathway that has long been shown to control hair growth in mice, but has not been extensively linked to human hair growth.

In addition to providing more insight into hereditary hypotrichosis simplex, the gene research “gives us an inroad into understanding male-pattern baldness” because the conditions are similar, Christiano said. It may be a matter of reprogramming the hair software because the hardware is still there, she said.

Part of the challenge of studying baldness is that mice don’t suffer from the equivalent of male-pattern baldness, making animal research less effective in understanding how hair growth works, she said.

Dr. Doris Day, a dermatologist in New York City, said that about half of people older than 50 have hair loss. “It can be debilitating, especially to women, who have fewer options for treatment,” Day said.

Drugs such as Rogaine and Propecia treat baldness, but they do so by preventing future hair loss rather than growing new hair, Christiano said.

Also, Day said, the medications have side effects. “Most of the drugs block hormones or enzymes,” she said. “However, they are not specific to the scalp so side effects can include decreased libido as well as potential damage to the liver.”

“The medications need to be taken indefinitely in order to remain effective,” she said, “and for some people, the medications do not adequately control the hair loss.”

A gene-based treatment, by contrast, might allow hair to grow normally. And understanding the genetic basis of baldness could help researchers find better treatments for other conditions, such as alopecia, which causes hair loss, Christiano said, adding that she has alopecia.

SOURCES: Angela M. Christiano, Ph.D., director, Center for Human Genetics, Columbia University Medical Center, New York City; Doris Day, M.D., dermatologist, New York City;

Women who smoke marijuana during pregnancy may impair their baby’s growth and development in the womb, a new study suggests.

Poor fetal growth and reduced head circumference at birth are linked to an increased risk of problems with thinking, memory and behavior in childhood. Cigarette smoking during pregnancy is known to impair fetal growth, but studies on the potential effects of marijuana have been inconclusive.

For the new study, researchers in the Netherlands followed more than 7,000 pregnant women, 3 percent of whom acknowledged smoking marijuana at least during early pregnancy. They found that babies born to marijuana users tended to weigh less and have smaller heads than other infants.

What’s more, the study found, the longer a woman had used marijuana during pregnancy, the stronger the impact on birth size — suggesting that the drug itself was to blame.

And while most marijuana users in the study also smoked cigarettes, the drug appeared to have effects over and above those of tobacco. In fact, marijuana showed stronger effects on birth size than tobacco, the investigators report in the Journal of the American Academy of Child and Adolescent Psychiatry.

The findings suggest that marijuana use, even restricted to early pregnancy, may have irreversible effects on fetal growth, write the researchers, led by Hannan El Marroun of Erasmus University Medical Center in Rotterdam.

To prevent this, they add, women who smoke marijuana should quit before becoming pregnant.

The study included almost 7,500 pregnant women who were surveyed on their use of alcohol, tobacco and drugs, and had ultrasounds to chart fetal growth during the first, second and third trimesters.

Overall, 214 women said they had used marijuana before and during early pregnancy; 81 percent quit after learning they were pregnant, but 41 women continued to smoke marijuana throughout pregnancy.

The researchers found that, on average, marijuana users gave birth to smaller babies, particularly those who had used throughout pregnancy.

Women who had smoked only during early pregnancy had babies who were

156 grams — about 5.5 ounces — lighter than infants born to women who had not used the drug. Women who had continued to smoke past early pregnancy had babies who were 277 grams, or nearly 10 ounces, smaller.

Based on ultrasound, marijuana use only in early pregnancy impaired fetal growth by about 11 grams per week, while use throughout pregnancy slowed fetal growth by roughly 14 grams per week. That compared with a deficit of 4 grams per week with tobacco use, the researchers found.

Similar patterns were seen when the researchers looked at fetal head circumference.

According to El Marroun’s team, mothers’ marijuana use could stunt fetal growth for several reasons. Like tobacco smoking, it may deprive the fetus of oxygen. It is also possible that the byproducts of marijuana directly affect the developing nervous and hormonal systems of the fetus.

Finally, the researchers note, pregnant women who use marijuana may have other factors in their lives – such as a less-than-healthy diet or chronic stress — that could contribute to poor fetal growth.

SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry

If you’re ready to ditch your toddler’s diapers for good, the best time to start potty training may be between the second and third birthdays.

A new study suggests 27 to 32 months is the ideal window for moving your child out of diapers. Children who were toilet trained after 32 months were more likely to have urge incontinence — daytime wetting and bed-wetting — between ages 4 and 12.

And potty training children sooner than 27 months generally doesn’t work either, according to background information in the study. Prior research has shown potty training too soon just prolongs the process.

“There are two schools of thought on potty training. One is to try to train the kids very, very early, and another says you should wait until kids are older and demonstrating signs of being ready. But there has never been a study scientifically showing when is the best time,” said lead study author Dr. Joseph Barone, chief of urology at Bristol-Myers Squibb Children’s Hospital in New Brunswick, N.J. “This study gives parents an idea of when it’s a good time to train,” he said.

Although there are always parents on the playground who brag they trained their child in a day, the study — published in the December 2009 issue of the Journal of Pediatric Urology — found timing was more important than technique.

Researchers asked the parents of 157 children ages 4 to 12 who were seen by a doctor for urge incontinence about when they started potty training and which method they used. Their answers were compared to those from the parents of 58 children matched for age, gender, race and other factors who did not have urge incontinence.

The mean age for toilet training of children with urge incontinence was 31.7 months, compared to 28.7 months for children who did not have problems with daytime wetting.

As for technique, parents were given three choices: a child-oriented approach, described as waiting for the child to show signs of readiness before initiating training and then letting the child direct the toilet training process; a parent-oriented approach, described as starting training when the parent was ready and then bringing the child to the toilet at regular, defined intervals, or a combination of the two.

Researchers found no difference in the method of toilet training and the likelihood of having problems with wetting at ages 4 to 12.

Age shouldn’t be the deciding factor in beginning potty training, said Peter Stavinoha, author of the book “Stress-Free Potty Training” and a clinical neuropsychologist at Children’s Medical Center of Dallas.

The key is making sure your child is physically and developmentally ready, Stavinoha said. Although many children will show potty training readiness at about 2 1/2, it can vary, Stavinoha said.

“Many parents approach potty training as something over which they have total control,” Stavinoha said. “Parents are a big contributor to their child’s development, but they don’t really control it. Parents are there to facilitate, to guide, to reinforce and to praise, but parents shouldn’t put pressure on themselves that if they do a series of steps, the children will achieve a certain outcome.”

If you feel like you’ve been changing diapers forever, you’re not alone. Over the last few decades, the mean age of potting training has crept up in the United States and other countries, including Brazil, Switzerland and China, the article said. In 1980, the mean age U.S. children were toilet-trained was 26 months. In 2003, it was 36.8 months.

One possible explanation for later potty training is the widespread availability and convenience of disposable diapers, the study authors propose.

Tips to Trouble-Free Toilet Training

When you think it’s time, Barone and Stavinoha offer these tips for getting kids trained:
Look for signs of readiness. These include showing interest in the potty or toilet; staying dry during naps or for several hours during the day; being able to follow simple directions; being able to pull down their own pants; using words, posture or facial expressions that indicate they have to go.
Make a small potty available in the bathroom. Try doing practice runs when you think your toddler might need to go by having him sit or stand in front of the potty for a few minutes several times a day. Most likely, your toddler won’t actually go, Stavinoha said. But it can help them recognize the urge to go and associate the potty with it.
If your child resists, don’t sweat it. Setting up a battle of wills will only make the process unnecessarily difficult on mom and dad. Back off for a few weeks, then try again.
While potty training, avoid asking: “Do you have to go to the potty?” “You’re almost guaranteed your child will tell you ‘no’,” Stavinoha said.

If a child is 4 or 5 and still not staying dry during the day, or if you suspect the reason may have a physical cause, discuss it with the pediatrician, Stavinoha said.

SOURCES: Joseph Barone, M.D., chief, urology, Bristol-Myers Squibb Children’s Hospital, Robert Wood Johnson University Hospital, New Brunswick, N.J., and associate professor of surgery at UMDNJ-Robert Wood Johnson Medical School; Peter Stavinoha, Ph.D., clinical neuropsychologist, Children’s Medical Center of Dallas;

Quitting smoking after a diagnosis of early stage lung cancer doubles the odds that a patient will live another five years, a new study finds.

“The results are quite dramatic. I don’t think anybody would have expected such a dramatic difference. It’s incredible,” said Dr. Norman Edelman, chief medical officer for the American Lung Association. “The important caveat is that this is early lung cancer.”

Early stage lung malignancies can have cure rates of 50 percent to 60 percent, Edelman noted. The tragedy is that very few lung cancers (perhaps 20 percent, the authors stated) are diagnosed at this early stage.

The new findings are published in the Jan. 21 online edition of BMJ.

According to an accompanying journal editorial, fewer than one-third of all patients with lung cancer are still alive just one year after diagnosis.

Of course, the best way to prevent lung cancer is to never smoke, or to quit if you do smoke. People who quit smoking have a dramatically lower incidence of being diagnosed with lung cancer over the life span, experts note.

But it’s been less clear how quitting smoking might affect patient prognosis after a diagnosis has already been handed down, the study authors said.

To find out, the British researchers pored over data from 10 prior observational studies looking at the impact of quitting smoking post-diagnosis.

“We used meta-analysis to summarize their findings,” said study lead author, Amanda Parsons, a Ph.D. candidate at the U.K. Centre for Tobacco Control Studies at the University of Birmingham College of Medicine and Dentistry. “Quitting smoking was associated with around double the chance of surviving at any time point compared to people who continued to smoke.”

Only 29 to 33 percent of early stage lung cancer patients who kept smoking survived for five years, while 63 to 70 percent of patients who quit survived that long, Parsons stated.

The survival seemed to come from a lower likelihood of tumor recurrence, not from heart/lung improvements, the researchers said.

All the patients were early stage and had been treated with either surgery, chemotherapy or radiation so, Parsons added, “the results can only be applied to this group of lung cancer patients. This work does not tell us anything about the benefits of quitting smoking if you have advanced disease.”

And because all of the studies included in this analysis were observational in nature, it’s not certain yet whether quitting smoking actually caused the decline in deaths.

Still, the findings beg the question of whether smoking cessation counseling should be routinely offered to people diagnosed with lung cancer.

According to Parsons, “smoking cessation support is not routinely offered to patients with lung cancer although some hospitals may offer this support.” That’s in Britain, Edelman noted, and the odds of there being any consistency in this area is even less likely in the U.S., which has no overarching health care system.

“Certainly the American Lung Association pushes smoking cessation for everybody. We say over and over again — it’s never too late to quit. There’s good evidence that you can get benefits if you’re 70 years old,” he said.

SOURCES: Amanda Parsons, Ph.D. candidate and research fellow, U.K. Centre for Tobacco Control Studies, University of Birmingham College of Medicine and Dentistry, Birmingham, U.K.; Norman Edelman, M.D., chief medical officer, American Lung Association