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21 FEB 2014 /  White paper draft

Compiled by Ralph Turchiano

 

•        Detailed research references and further affiliations on each article are posted at http://www.healthreserachreport.me .

 

In this Issue:

Exercise may slow progression of retinal degeneration

Annual screening does not cut breast cancer deaths, suggests Canadian study

Could pizza herb prevent winter vomiting disease?

Prenatal vitamin A deficiency tied to postnatal asthma

Grape seed promise in fight against bowel cancer

Can citrus ward off your risk of stroke?

Natural compound attacks HER2 positive breast cancer cells

Probiotic treatment for vaginal thrush on the way

Garlic counteracts virulent bacteria

Thyroid cancer nearly triples; research blames “epidemic” on over diagnosis of harmless tumors

Exercise may slow progression of retinal degeneration

Animal study points to possible behavioral therapy for people with macular degeneration

Washington, DC — Moderate aerobic exercise helps to preserve the structure and function of nerve cells in the retina after damage, according to an animal study appearing February 12 in The Journal of Neuroscience. The findings suggest exercise may be able to slow the progression of retinal degenerative diseases.

Age-related macular degeneration, one of the leading causes of blindness in the elderly, is caused by the death of light-sensing nerve cells in the retina called photoreceptors. Although several studies in animals and humans point to the protective effects of exercise in neurodegenerative diseases or injury, less is known about how exercise affects vision.

Machelle Pardue, PhD, together with her colleagues Eric Lawson and Jeffrey H. Boatright, PhD, at the Atlanta VA Center for Visual and Neurocognitive Rehabilitation and Emory University, ran mice on a treadmill for two weeks before and after exposing the animals to bright light that causes retinal degeneration. The researchers found that treadmill training preserved photoreceptors and retinal cell function in the mice.

“This is the first report of simple exercise having a direct effect on retinal health and vision,” Pardue said. “This research may one day lead to tailored exercise regimens or combination therapies in treatments of blinding diseases.”

In the current study, the scientists trained mice to run on a treadmill for one hour per day, five days per week, for two weeks. After the animals were exposed to toxic bright light — a commonly used model of retinal degeneration — they exercised for two more weeks. The exercised animals lost only half the number of photoreceptor cells as animals that spent the equivalent amount of time on a stationary treadmill.

Additionally, the retinal cells of exercised mice were more responsive to light and had higher levels of a growth- and health-promoting protein called brain-derived neurotrophic factor (BDNF), which previous studies have linked to the beneficial effects of exercise. When the scientists blocked the receptors for BDNF in the exercised mice, they discovered that retinal function in the exercised mice was as poor as in the inactive mice, effectively eliminating the protective effects of the aerobic exercise.

“These findings further our current understanding of the neuroprotective effects of aerobic exercise and the role of BDNF,” explained Michelle Ploughman, PhD, who studies the effects of exercise on the healthy and diseased brain at Memorial University of Newfoundland, and was not involved with this study. “People who are at risk of macular degeneration or have early signs of the disease may be able to slow down the progression of visual impairment,” she added.

Annual screening does not cut breast cancer deaths, suggests Canadian study

Value of breast screening should be reassessed, say researchers

Annual screening in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care, concludes a 25-year study from Canada published on bmj.com today.

Furthermore, the study shows that 22% of screen detected breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received screening in the trial. Over-diagnosis refers to the detection of harmless cancers that will not cause symptoms or death during a patient’s lifetime.

Regular mammography screening is done to reduce mortality from breast cancer. Women with small (non-palpable) breast cancer detected by screening have better long term survival than women with palpable breast cancer. But it is not clear whether this survival difference is a consequence of organised screening or of lead time bias (when testing increases perceived survival time without affecting the course of the disease) and over-diagnosis.

So researchers based in Toronto, Canada decided to compare breast cancer incidence and mortality up to 25 years in over 89,000 women aged 40-59 who did or did not undergo mammography screening.

Women in the mammography arm of the trial had a total of five mammography screens (one a year over a five year period), while those in the control arm were not screened.

Women aged 40-49 in the mammography arm – and all women aged 50-59 in both arms – also received annual physical breast examinations. Women aged 40-49 in the control arm received a single examination followed by usual care in the community.

During the 25 year study period, 3,250 women in the mammography arm and 3,133 in the control arm were diagnosed with breast cancer and 500 and 505, respectively, died of breast cancer. “Thus, the cumulative mortality from breast cancer was similar between women in the mammography arm and in the control arm,” say the authors.

At the end of the five year screening period, an excess of 142 breast cancers occurred in the mammography arm compared with the control arm, and at 15 years the excess remained at 106 cancers. This, say the authors, implies that 22% of the screen detected invasive cancers in the mammography arm were over-diagnosed – that is, one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial.

They stress that these results may not be generalisable to all countries, but say, in technically advanced countries, “our results support the views of some commentators that the rationale for screening by mammography should be urgently reassessed by policy makers.”

While they believe that education, early diagnosis, and excellent clinical care should continue, they conclude that annual mammography “does not result in a reduction in breast cancer specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community.”

In an accompanying editorial, Dr Mette Kalager and colleagues believe that long term follow-up does not support screening women under 60.

They agree with the study authors that “the rationale for screening by mammography be urgently reassessed by policy makers,” but point out that this is not an easy task “because governments, research funders, scientists, and medical practitioners may have vested interests in continuing activities that are well established.”

Could pizza herb prevent winter vomiting disease?

Scientists have found that carvacrol – the substance in oregano oil that gives the pizza herb its distinctive warm, aromatic smell and flavour – is effective against norovirus, causing the breakdown of the virus’ tough outer coat. The research is published today (12 February) in the Society for Applied Microbiology’s Journal of Applied Microbiology.

Norovirus, also known as the winter vomiting disease, is the leading cause of vomiting and diarrhoea around the world. It is particularly problematic in nursing homes, hospitals, cruise ships, and schools, and is a very common cause of foodborne-disease outbreaks. Although the disease is unpleasant, most people recover fully within a few days. But for people with an existing serious medical problem, this highly infectious virus can be dangerous.

Dr Kelly Bright, who led the research at the University of Arizona said “Carvacrol could potentially be used as a food sanitizer and possibly as a surface sanitizer, particularly in conjunction with other antimicrobials. We have some work to do to assess its potential but carvacrol has a unique way of attacking the virus, which makes it an interesting prospect.”

Unfortunately the human form of norovirus is nearly impossible to work on in the laboratory so the research has been carried out using the mouse form of the virus, which is considered the most similar in its resistance to antimicrobials and disinfectants.

In the experiments, carvacrol appeared to act directly on the virus capsid – a tough layer of proteins that surrounds the virus – causing it to break down. This would give another antimicrobial the opportunity to enter the internal part of the virus and kill it. So if carvacrol is used as a sanitizer in the future, it’s likely to be in conjunction with another antimicrobial. And because it is slower acting than many disinfectants, such as bleach, it would be best used as part of a routine cleaning regimen to provide long-lasting antimicrobial residue on surfaces.

The good news is that because carvacrol acts on the external proteins of the virus, it is unlikely that norovirus would ever develop resistance. It would also be safe, non-corrosive and it won’t produce any noxious fumes or harmful by-products. This makes it particularly attractive for use in settings where people are likely to be vulnerable to traditional bleach or alcohol based cleaners, such as schools, hospitals, long-term care facilities, child day-care centres, and drug and alcohol rehabilitation facilities.

The bad news: no amount of pizza could prevent norovirus, and quite apart from other negative health effects of a mainly pizza diet, concentrated carvacrol, although non-toxic, would be quite unpalatable, causing a burning sensation and then numbness of the tongue!

Prenatal vitamin A deficiency tied to postnatal asthma

Smooth muscle abnormalities in developing airways may be overlooked factor in asthma

NEW YORK, NY (February 12, 2014) — A team of Columbia University Medical Center (CUMC) investigators led by Wellington V. Cardoso, MD, PhD, has found the first direct evidence of a link between prenatal vitamin A deficiency and postnatal airway hyperresponsiveness, a hallmark of asthma. The study, conducted in mice, shows that short-term deficit of this essential vitamin while the lung is forming can cause profound changes in the smooth muscle that surrounds the airways, causing the adult lungs to respond to environmental or pharmacological stimuli with excessive narrowing of airways. The findings were published online in the Journal of Clinical Investigation.

“Researchers have long wondered what makes some people more susceptible than others to developing asthma symptoms when exposed to the same stimulus,” said Dr. Cardoso, senior author, director of the new Columbia Center for Human Development, and a faculty member in the Division of Pulmonary Allergy Clinical Care Medicine. “Our study suggests that the presence of structural and functional abnormalities in the lungs due to vitamin A deficiency during development is an important and underappreciated factor in this susceptibility.”

“More generally,” Dr. Cardoso said, “our findings highlight a point often overlooked in adult medicine, which is that adverse fetal exposures that cause subtle changes in developing organs can have lifelong consequences.”

Previous studies had shown that retinoic acid (RA)—the active metabolite of vitamin A—is essential for normal lung development. Until now, however, little was known about the impact of prenatal RA deficiency on postnatal airway function.

In an earlier study, Felicia Chen, MD, a member of Dr. Cardoso’s team and first author of the current paper, identified a number of genes regulated by RA signaling in fetal lung development. Additional analysis showed the abnormal presence of genes involved in the formation of smooth muscle when RA signaling was disrupted. This finding prompted the researchers to take a closer look at the effects of vitamin A deficiency on the development of the smooth muscle that surrounds airways as they continued to form and branch.

The researchers used a mouse model in which they could control when and in what amount vitamin A would reach the developing fetus through maternal diet. “We timed the vitamin A deficiency to the middle of gestation, coinciding with the period of formation of the airway tree in the fetus,” Dr. Cardoso said. Fetuses that were deprived of vitamin A were found to have excess smooth muscle in the airways, compared with controls.

In a subsequent experiment, the mice were again deprived of vitamin A during the same developmental stage, but returned to a normal diet after that stage and until adulthood. “When the animals reached adulthood, they appeared normal—that is, they had no problems typically associated with vitamin A deficiency,” said Dr. Cardoso. “However, pulmonary function tests showed that their lungs were clearly not normal.” When the mice were challenged with methacholine, a chemical that causes the airway to contract, their response was significantly more severe than that of controls.

Additional experiments determined that, during development, RA utilization largely occurs where the bronchial tubes branch to form new generations of airways. As each new tube is formed, it is surrounded by smooth muscle. According to the researchers, RA signaling temporarily inhibits the development of smooth muscle in airways in areas that are still branching, preventing precocious and excessive formation of these cells. “If an animal is deprived of vitamin A, RA signaling is disrupted and smooth muscle overdevelops,” said Dr. Cardoso.

Finally, the study showed that the structural and functional changes in the airways occurred in the absence of inflammation. “This does not imply that inflammation is not an important component of pulmonary conditions characterized by hyperresponsiveness, such as asthma,” said Dr. Cardoso. “But it reminds us of the multifactor origin of asthma and indicates an additional, structural component that cannot be overlooked.

The findings underscore the importance of sufficient vitamin A in the diet, which remains a significant challenge in developing countries. The study also has potential clinical implications in the developed world. “Most pregnant women in the U.S. are probably getting enough vitamin A in their diet, but it’s possible that their babies are not making proper use of it,” said Dr. Cardoso. “The body has a very complex system for processing vitamin A, and this system is prone to interference from outside factors, such as cigarette smoke and alcohol. We need to understand more precisely how early exposures of the fetus to adverse environmental factors can interfere with crucial developmental mechanisms, such as the one we found linking vitamin A to airway structure and function.”

Grape seed promise in fight against bowel cancer

University of Adelaide research has shown for the first time that grape seed can aid the effectiveness of chemotherapy in killing colon cancer cells as well as reducing the chemotherapy’s side effects.

Published in the prestigious journal PLOS ONE, the researchers say that combining grape seed extracts with chemotherapy has potential as a new approach for bowel cancer treatment – to both reduce intestinal damage commonly caused by cancer chemotherapy and to enhance its effect.

Lead author Dr Amy Cheah says there is a growing body of evidence about the antioxidant health benefits of grape seed tannins or polyphenols as anti-inflammatory agents and, more recently, for their anti-cancer properties.

“This is the first study showing that grape seed can enhance the potency of one of the major chemotherapy drugs in its action against colon cancer cells,” says Dr Cheah, researcher in the School of Agriculture, Food and Wine.

“Our research also showed that in laboratory studies grape seed taken orally significantly reduced inflammation and tissue damage caused by chemotherapy in the small intestine, and had no harmful effects on non-cancerous cells. Unlike chemotherapy, grape seed appears to selectively act on cancer cells and leave healthy cells almost unaffected.”

The researchers used commercially available grape seed extract, a by-product of winemaking. Tannins extracted from the grape seed were freeze-dried and powdered. The extract was tested in laboratory studies using colon cancer cells grown in culture.

The research showed grape seed extract:

• showed no side effects on the healthy intestine at concentrations of up to 1000mg/kg;
• significantly decreased intestinal damage compared to the chemotherapy control;
• decreased chemotherapy-induced inflammation by up to 55%
• increased growth-inhibitory effects of chemotherapy on colon cancer cells in culture by 26%

“Our experimental studies have shown that grape seed extract reduced chemotherapy-induced inflammation and damage and helped protect healthy cells in the gastrointestinal tract,” says Dr Cheah. “While this effect is very promising, we were initially concerned that grape seed could reduce the effectiveness of the chemotherapy.”

“In contrast, we found that grape seed extract not only aided the ability of chemotherapy to kill cancer cells, but was also more potent than the chemotherapy we tested at one concentration.”

Co-author and project leader Professor Gordon Howarth says: “Grape seed is showing great potential as an anti-inflammatory treatment for a range of bowel diseases and now as a possible anti-cancer treatment. These first anti-cancer results are from cell culture and the next step will be to investigate more widely.”

Fellow co-author and joint lead researcher Dr Sue Bastian, Senior Lecturer in Oenology, says: “These findings could be a boost to the wine grape industry as it value adds to what is essentially a by-product of the winemaking process.”

 

Can citrus ward off your risk of stroke?

PHILADELPHIA – Eating foods that contain vitamin C may reduce your risk of the most common type of hemorrhagic stroke, according to a study released today that will be presented at the American Academy of Neurology’s 66th Annual Meeting in Philadelphia, April 26 to May 3, 2014.

Vitamin C is found in fruits and vegetables such as oranges, papaya, peppers, broccoli and strawberries. Hemorrhagic stroke is less common than ischemic stroke, but is more often deadly.

The study involved 65 people who had experienced an intracerebral hemorrhagic stroke, or a blood vessel rupture inside the brain. They were compared to 65 healthy people. Participants were tested for the levels of vitamin C in their blood. Forty-one percent of cases had normal levels of vitamin C, 45 percent showed depleted levels of vitamin C and 14 percent were considered deficient of the vitamin.

On average, the people who had a stroke had depleted levels of vitamin C, while those who had not had a stroke had normal levels of the vitamin.

“Our results show that vitamin C deficiency should be considered a risk factor for this severe type of stroke, as were high blood pressure, drinking alcohol and being overweight in our study,” said study author Stéphane Vannier, MD, with Pontchaillou University Hospital in Rennes, France. “More research is needed to explore specifically how vitamin C may help to reduce stroke risk. For example, the vitamin may regulate blood pressure.”

Vannier adds that vitamin C appears to have other benefits like creating collagen, a protein found in bones, skin and tissues.

Vitamin C deficiency has also been linked to heart disease.

 

Natural compound attacks HER2 positive breast cancer cells

 

DURHAM, N.C. – A common compound known to fight lymphoma and skin conditions actually has a second method of action that makes it particularly deadly against certain aggressive breast tumors, researchers at Duke Medicine report.

The compound is called psoralen, a natural component found in foods such as figs and celery, and researchers have long understood that it that works by disrupting DNA replication and causing cell death when activated by an energy source such as UV light.

Duke researchers have now identified another way the compound works to kill tumor cells, raising the potential for psoralen to be developed as an effective therapy for cancers that are particularly vulnerable to this second mode of action.

Reporting in the Feb. 14, 2014 issue of the journal PLOS ONE, the researchers detail how psoralen blocks the signaling pathway of the HER2 receptor, which is overproduced in 25 percent of breast cancers, plus ovarian, gastric and other solid tumors. When HER2 is overproduced, it fuels uncontrolled cell growth, leading to an aggressive form of cancer. Psoralen shut down this process in experiments using HER2 overexpressing breast cancer cell lines.

“This was very unexpected,” said senior author Neil L. Spector, M.D., the Sandra Coates Associate Professor of Medicine at Duke. “The therapy has been known to kill cancer cells by causing DNA damage, but it is also having a direct anti-tumor effect on HER2 overexpressing breast cancer cells by blocking HER2 signaling.”

Psoralen also attacks another form of HER2 that is present in the nucleus of tumor cells. This form of the protein is resistant to cancer therapies such as lapatinib and trastuzumab that are otherwise effective in targeting HER2-positive cancers.

“Cancer drugs can recognize HER2 receptors when they are outside of the cell, but they don’t recognize the truncated version inside the cell nucleus,” Spector said. “We have shown that psoralen is effective in targeting this other form of HER2 that is resistant to current HER2-targeted therapies.”

Spector said the benefits of psoralen remain dependent on its activation by an energy source, which has been an impediment to its use in solid tumors. Currently, psoralen is primarily used as a topical treatment in conjunction with UV light exposure in a process called PUVA. The treatment is used for skin conditions such as psoriasis and as a therapy for lymphoma by exposing treated blood to UV radiation during a dialysis-type procedure.

“The challenge all along has been to figure out a way of generating UV light deeper in the body,” Spector said. That challenge is close to being resolved. In a previous publication, Duke investigators from the Pratt School of Engineering, working in collaboration with Spector and scientists from Immunolight, the company that has funded the research, reported the development of micron-sized particles that absorb energy from X-rays to emit UV light in and around cells, much like the cathode ray tube technology used in televisions.

The tiny particles are injected into tumors along with the psoralen, then targeted by low-dose X-ray that cause the micron particles to create the UV light necessary to trigger psorlen’s anti-tumor properties. Spector said the technology is being tested in animals, and may be approved for human trials as early as this year.

“A good part of four years has been trying to figure out how to overcome the biophysics challenge of generating enough energy inside the body to activate the particles and the drug,” Spector said. “We’ve come a long way.”

Probiotic treatment for vaginal thrush on the way

Scientists are testing vaginal pessaries containing ‘good’ probiotic bacteria for the treatment of vaginal thrush. Research published today (19 February) in the Society for Applied Microbiology’s Journal of Applied Microbiology shows that this approach is likely to be a viable alternative to using precious antimicrobial drugs.

The team, led by Dr M. Cristina Verdenelli at Università di Camerino, Italy, tested five strains of lactobacilli for their antimicrobial potential against the most common type of vaginal infections, Candida. Their in vitro experiments showed that the combination of two strains, Lactobacillus rhamnosus IMC 501® and Lactobacillus paracasei IMC 502®, also known as SYNBIO®, patented by Synbiotec Srl, had all the necessary characteristics.

Dr Verdenelli said “We’ve all heard of using natural yoghurt to manage vaginal thrush as an alternative to antimicrobial medicines, but we wanted to test whether the type of probiotic bacteria found in yoghurt could actually kill or restrict the growth of candida. The results in the lab have been very good and we have moved on to test our formulation in patients.”

Dr Verdenelli’s team were looking for two main characteristics of the bacteria: their ability to produce a substances that would likely kill the candida and their ability to grow on human cells alongside the yeast infection. Of the five strains they tested, the SYNBIO® formulation had the best overall characteristics, adhering well to human cells, growing alongside candida, and producing hydrogen peroxide to kill the yeast cells

Results from the human study, carried out at the Department of Obstetrics/Gynecology and Centre for Perinatal and Reproductive Medicine, Santa Maria della Misericorida, University Hospital of Perugia, in collaboration with Professor Gian Carlo Di Renzo, are pending.

With the increasing problem of antimicrobial resistance, it is vital to consider alternative methods of preventing and control infection and this study is a good example of scientists doing just that.

18 February 2014

Garlic counteracts virulent bacteria

Garlic contains a substance that is particularly effective in encounters with even the hardiest bacterial strains. A young researcher at the University of Copenhagen will soon be defending his PhD thesis on the positive properties of the malodorous plant.

Aggressive multi-resistant infections constitute an increasing health problem all over the world. Bacteria are developing resistance at an alarming pace, so new pharmaceuticals that can combat this threat are in great demand.

“We know that there is a potent chemical compound in the garlic plant that neutralises resistant bacteria by paralysing their communication system. My PhD thesis demonstrates that ajoene – the substance present in garlic – specifically prevents the bacteria from secreting the toxin rhamnolipid which destroys white blood cells in the body. White blood cells are indispensable because they play a crucial role in the immune defence system, not only warding off infection, but also killing bacteria,” explains Tim Holm Jakobsen, PhD Student at the Faculty of Health and Medical Sciences, who will be defending his thesis on 21 February.

A tough sheath of biofilm

When bacteria clump together in what is known as biofilm – where they surround themselves with a tough film of organic materials – they become resistant to antibiotics. Researchers have been devoting much of their attention to Pseudomonas aeruginosa bacteria, which cause infections in patients with chronic leg ulcers, for example, and in the lungs of patients suffering from cystic fibrosis.

“Ajoene supports and improves treatment with conventional antibiotics. We have clearly demonstrated this on biofilm cultivated in the laboratory and in trials involving mice. When we add antibiotics to biofilm they have very little effect, and ajoene alone barely makes any difference. It is only when the two are combined that something significant happens,” explains Tim Holm Jakobsen.

Combination treatment with ajoene and antibiotics kills more than 90 per cent of the normally virulent biofilm.

From a technical perspective, the ajoene blocks the communication system – known as Quorum Sensing – in the bacteria, which is used for purposes including creating infection.

Chemists outstrip nature

A large number of natural substances have proved extremely effective as medicines; taxol from the yew tree is used to treat breast cancer, for example, while artemisinin from sweet wormwood is effective against malaria. However, to improve on the original substances from nature – and to assure sustainable pharmaceutical production – researchers are working to augment natural materials through chemical synthesis.

“Garlic contains so little ajoene that you would need to eat around 50 a day to achieve the desired effect. This means we have to pick up the ball from Mother Nature and run with it,” says Tim Holm Jacobsen, who hopes that the pharmaceutical industry will be quick to turn its attention to producing of the natural substance to which the research group currently holds the patent.

“There’s a lot of money in pharmaceuticals for treating chronic illnesses such as diabetes, but if we are to win the race against bacteria, we need to bring new antibiotics into play. Nature is a great starting point for developing medicines – two-thirds of all new pharmaceuticals are based on natural substances,” concludes Tim Holm Jakobsen.

 

 

 

 

Thyroid cancer nearly triples; research blames “epidemic” on over diagnosis of harmless tumors

By LINDSEY TANNER

AP Medical Writer

CHICAGO (AP) — A dramatic rise in thyroid cancer has resulted from overdiagnosis and treatment of tumors too small to ever cause harm, according to a study that found cases nearly tripled since 1975.

The study is the latest to question whether all cancers need aggressive treatment. Other research has suggested that certain cancers of the prostate, breast and lung as well as thyroid grow so slowly that they will never become deadly, and that overzealous screening leads to overtreatment.

The thyroid is a hormone-releasing gland in the neck that helps regulate the body’s metabolism. Thyroid cancer treatment often includes surgery to remove the butterfly-shaped gland, followed by lifelong daily hormone pills.

Thyroid removal is done for 85 percent of all people diagnosed despite guidelines that say less aggressive surgery is reasonable for lower-risk thyroid tumors, the study authors said.

“Our old strategy of looking as hard as possible to find cancer has some real side effects,” said Dr. Gilbert Welch, co-author of the thyroid study and a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.

Welch said patients “can no longer assume” that labeling a disease as cancer means treatment is necessary. “It’s a challenging rethinking,” he added.

Welch and Dartmouth colleague Dr. Louise Davies analyzed government data from 1975 to 2009 and found thyroid cancers jumped from 5 cases per 100,000 people to 14 per 100,000. Most of that increase was in papillary thyroid cancers, the most common and least deadly kind; those cases jumped from about three cases per 100,000 to more than 12 per 100,000.

The results suggest there is “an ongoing epidemic of thyroid cancer” nationwide, they said.

The study was published online Thursday in JAMA Otolaryngology.

Despite the increase, thyroid cancer is relatively uncommon; more than 60,000 cases were diagnosed nationwide last year, according to the American Cancer Society. Risk factors for thyroid cancer include diets low in iodine – rare in the United States – and radiation exposure. Women are more commonly diagnosed than men.

The new research echoes previous studies but “certainly raises some provocative questions,” said Dr. Brian Burkey, a Cleveland Clinic head and neck cancer specialist.

Experts know that better detection methods including CT scans and ultrasound, have led to more thyroid cancers being diagnosed, but they don’t know which ones will become aggressive, Burkey said.

“Thyroid cancer even if treated has a fairly high recurrence rate even if it doesn’t kill,” he said.

Burkey is among researchers planning a major study seeking to provide answers. Patients diagnosed with thyroid cancers will be randomly assigned treatment or just observation.

In the meantime, the study authors offer some advice: Physicians could “openly share with patients the uncertainty surrounding small thyroid cancers – explaining that many will never grow and cause harm to a patient,” but that it’s not possible to know for certain which ones are harmless.

That would allow patients to make better informed decisions, and some might opt for close monitoring instead of treatment, the authors said.

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These reports are done with the appreciation of all the Doctors, Scientist, and other Medical Researchers who sacrificed their time and effort. In order to give people the ability to empower themselves. Without the base aspirations for fame, or fortune. Just honorable people, doing honorable things.